Thousands of rural family doctors have cut back on, or stopped prescribing, Pfizer medicines since the launch last month of an exclusive distribution arrangement with Alliance Boots, according to a lobby group.

The Dispensing Doctors’ Association (DDA), which represents the interests of about 5,000 family doctors in remote areas who dispense drugs directly to patients rather than through a chemist, says that many doctors resent the new system for adding an extra layer of bureaucracy and cost to their work.

The DDA says that doctors will always put patient safety first, but where identical drugs are available from rival manufacturers, many are opting to prescribe non-Pfizer products.

“There is no doubt that the prescribing of Pfizer products has reduced,” David Baker, the chief executive of the DDA, said. “Obviously, you have to use the right drug for the right patient, and that comes first. But, within that, there is a clear move away from Pfizer products, which is understandable because their terms of trade are not as good.”

Richard West, the chairman of the DDA, said: “It’s an extra workload for no benefit. You have to order through a separate system, which means extra invoices and time spent processing them.”

The new distribution system, which Pfizer says is designed to prevent counterfeit drugs entering the supply chain, has made Alliance Boots the sole distributor of all Pfizer products in the UK – about 15 per cent of the market. By cutting out traditional wholesalers, Pfizer has a direct relationship with every chemist and dispensing doctor in the country.

The scheme is controversial. Critics assert that it has created a monopoly over the supply of Pfizer drugs. They accuse the company of wanting to take greater control of pricing and argue that it could cost the NHS money and lead to delays in getting key medicines to patients.

Last week the debate intensified after AstraZeneca announced similar plans by selecting two companies – AAH and Alliance Boots – to become its exclusive distributors.

The changes in the market have triggered a political backlash and an investigation of pharmaceutical wholesaling by the Office of Fair Trading.

Dr West, who has a practice near Bury St Edmunds in Suffolk, said that the new arrangements had added to existing pressure on doctors to prescribe nonbranded, or “generic”, medicines – which tend to be cheaper – to save money for the NHS.

“It’s tipping the balance,” Dr West said. “This is an added factor which has focused people’s minds.” He noted that Lipitor, a cholesterol-lowering agent made by Pfizer, is about four times as costly as simvastatin, a generic alternative.

A Pfizer spokeswoman said: “Pfizer’s new distribution arrangement has been designed to be as simple and straightforward as possible, and we have tried to ensure that any administrative changes have been kept to an absolute minimum . . . Clinical decisions should be based on the needs of the patient and the clinical effectiveness of the medicine.”

— Pharmacia & Upjohn, a US division of Pfizer, pleaded guilty in Boston to offering a kickback and was fined $19.68 million (£9.9 million). It has also been banned permanently from participating in federal healthcare programmes.

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