Gepan now on Drug Tarriff

25 November, 2015

The initiative is a positive step for patients. Rather than being tied to time-consuming and inconvenient hospital appointments, a system which can make them feel that they are ill and dependent on others, they are empowered to manage their condition at home and improve their quality of life.

 Gepan® instill is a non-viscous liquid which is introduced to the bladder via a catheter, a straightforward process which can be quickly taught to patients. It temporarily coats the lining of the bladder, known as the GAG layer, sealing over cracks and weaknesses to prevent urine seeping through to the deeper layers and causing inflammation.

 There are several types of these GAG layer replenishment therapies using different substances to coat the inner wall of the bladder, but an independent review of them all (Madersbacher, 2013) found that Gepan® instill was the favoured treatment.

 This was based on clinical evidence, however there are several other reasons for Gepan® instill being the best choice.


  • The non-viscous 40ml solution comes in a pre-filled syringe with an innovative tip which fits directly on to most catheters, and flows easily into the bladder. No needles, sharps disposal boxes, “drawing up” procedure or thick, sticky fluid to force along the tube.


  • There was a high level of treatment satisfaction with doctors (82%) and patients (77%) in a study (Nordling, 2008). Effectiveness, safety and tolerability of instillations were investigated in 286 patients with chronic cystitis. All the main symptoms (pain, urgency and frequency) showed a statistically significant decline over three months.


  • Gepan® instill has also been shown to be more effective than the standard treatment for Overactive Bladder Syndrome, Tolerodine Tartrate (Gauruder-Burmester,  2009). The retrospective study concluded that Gepan® instill “results in a more sustained improvement or cure of the symptoms of overactive bladder”.  After a year of treatment, 72% of a Gepan® instill patients enjoyed reduction of symptoms, as opposed to 43% of those on Tolterodine Tartrate. Then when the patients were followed up a year after the treatment had stopped, 56% of Gepan patients still had symptom improvements while just 15% of Tolterodine patients were able to say the same thing.


 Quality of life is an important issue for people with chronic cystitis, a poorly understood condition which can severely limit the lives of patients. As well as suffering terrible pain, people can become almost housebound because of the frequency and urgency of the need to empty their bladder – sometimes 30 times a day. Since this also occurs through the night, people become fatigued and become less able to cope with their condition and life in general.

 In these circumstances, it can be extremely challenging even to get to hospital for treatment, especially if it is a lengthy journey on public transport. Some hospitals are successfully moving to home instillation as the norm, showing patients how to self-catheterise and instill themselves. However these people have still needed to come to hospital every few months to collect their prescriptions – until now.

 Susannah Fraser, of the patient support group the Cystitis and Overactive Bladder Foundation, welcomed the news that Gepan® instill can now be prescribed by GPs for Interstitial Cystitis, Recurrent Bacterial Cystitis, Radiation Cystitis and Overactive Bladder.

 She said:The Cystitis & Overactive Bladder Foundation are delighted that Gepan has been approved for drug tariff enabling our members to obtain the product from their general practitioner and use it in the comfort of their own home to suit them and take account of their lifestyle and commitments We look forward to working with Purple Orchid in the future.”

 Dr Karen Gardiner, Managing Director of Purple Orchid, the UK distributer of Gepan® instill, added: “Purple Orchid is the women’s self-care company, so getting approval for GP prescriptions was central to our philosophy about helping people to take care of themselves. I truly believe that making one small change can make a big difference and our mission is to support people to make at least one small change at a time to improve their long-term health.

 “We are delighted that people with chronic cystitis can make this change with Gepan® instill, empowering them to be more in control of their own daily lives, and wish them every success with this.”


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