THOUSANDS of patients will be picking up different medicines from the pharmacy as the NHS continues efforts to save millions on its drugs bill. Patients were urged last night to get behind the cash drive as it emerged that Norfolk has already made the biggest savings in the country through cheaper drugs.

THOUSANDS of patients will be picking up different medicines from the pharmacy as the NHS continues efforts to save millions on its drugs bill.

Patients were urged last night to get behind the cash drive as it emerged that Norfolk has already made the biggest savings in the country through cheaper drugs.

NHS Norfolk, the primary care trust (PCT) that covers most of the county, saved �7.9m from its �150m prescribing budget last year on the four most-used types of drugs - the biggest saving of any PCT in the country. The money was used to reduce the debt which the local NHS inherited from its predecessors. NHS Yarmouth and Waveney saved �1.3m.

The figures come from research by Keele University just published by the National Audit Office, the government's financial watchdog. Nationally the savings added up to �394m.

The change involves prescribing alternatives to big-brand drugs, so patients may literally see packaging differences.

NHS Norfolk is promising to make more savings by widening its efforts to new types of drugs.

Most of the savings last year were made on statins, which are given to treat high cholesterol. The second biggest area was in proton pump inhibitors (PPIs) which reduce stomach acid and are used to treat dyspepsia.

The next area where patients will see changes is blood pressure drugs, called ACEs and ARBs. The effects should be the same, though people may notice different packaging, drug names and colours of pills.

Debi Bhattacharya, lecturer at the University of East Anglia's School of Pharmacy, who did a survey on local GPs' attitudes to cheaper drugs last year, said: “The main message is that GPs need the support of patients.

“All the switching is evidence-based, but it is difficult for GPs if patients are not behind it.

“Most patients understand a cheaper one is as good and will save the NHS money, but some may think if it is cheaper it is not as good.

“The evidence is there is no difference in the drug, so what proportion of that is real and what is patient perception I don't know.

“If patients won't take it then any saving is worthless, and in that case GPs will switch back.”

Ian Small, NHS Norfolk's deputy head of prescribing, said practices had been told to prescribe cheaper drugs when they were equally or more effective, starting with statins and PPIs.

He said: “NHS Norfolk's prescribing team is currently looking at other drugs which could be substituted to make similar savings.

“It means NHS Norfolk will continue to offer the best value for money for patients and make significant savings, while maintaining excellent service to local people.”

NHS Norfolk spent �148,000 on a computer programme called Scriptswitch, which allows GPs to see what the PCT's recommended alternative is when they are making the prescription.

Cheaper drugs can be generic substitutions, which happen when the patent on a drug has expired, so other manufacturers can make cheaper versions of exactly the same drugs. Therapeutic substitutions, which offer bigger potential for savings, are when a slightly different drug with the same effect is prescribed in place of the more expensive drug.

One of NHS Norfolk's predecessors, North Norfolk PCT, was the biggest spender per patient in England on statins and proton pump inhibitors. In 2005-6 it was spending 37p for each daily dose of statins, compared with an average of 21p across England and just 10p in the area using the cheapest drugs.

From 2010, pharmacists will be able to switch drugs on prescriptions for a generic alternative unless the GP has specifically said he wants a particular brand. The number of unfamiliar packets in the bathroom cabinet looks certain to increase.