MPs call for more generic prescribing
pharmafile | January 17, 2008 | News story | Sales and Marketing |Â Â Â
Pharmaceutical marketing and the NHS drugs bill are once again in the spotlight with MPs criticising the industry's influence and the cost of medicines GPs prescribe.
A report by the Commons Committee of Public Accounts into the cost of primary care prescribing called for GPs to make savings by more closely following official guidelines and to prescribe generic or cheaper branded drugs where suitable.
The primary care drugs bill has more than doubled in the last ten years and the Department of Health has put increasing pressure on doctors and PCTs to contain prescribing costs.
Further fuel was added to the debate last year when the health secretary decided to re-negotiate the PPRS pricing system and discussions into this are still ongoing.
The Committee also criticised pharma's marketing practices, quoting from last year's National Audit Office survey that showed one in five GPs were more influenced by the industry than official advisers in their prescribing decisions.
The MPs recommended a level be set for all gifts and hospitality provided to prescribers by the industry, above which their PCT should be notified and the information published on an annual basis.
Chairman of the Committee of Public Accounts Edward Leigh said: "It's hard to doubt that the blandishments of the pharmaceutical industry are having an effect. But GPs must concentrate more on following official guidelines, increasing the prescribing of generic drugs where clinically appropriate.
"The fact that Primary Care Trusts vary hugely in the extent to which their GPs prescribe generic drugs for common conditions shows what can be achieved."
The call for greater generic prescribing was backed by the BMA, which said GPs should be encouraged in this where possible, provided medicine quality is monitored.
But it added that generic prescribing in the UK was already 'close to the maximum achievable' and it dismissed MPs' concerns that pharmaceutical marketing unduly influenced GPs.
Dr Bill Beeby, chairman of the BMA GP Committee's Clinical and Prescribing sub-committee, said: "Citing how much pharmaceutical companies spend is not evidence of GPs being swayed by their advertising.
"In a free and open market GPs sift the masses of data they receive from journals, Primary Care Trust prescribing advisers, experts, postgraduate education and pharmaceutical companies. The National Audit Office survey showed that four out of five GPs rely on official NHS sources for their prescribing information."
The primary care drug bill increased from £4 billion in 1996 to £8.2 billion in 2006, driven by the availability of new treatments, the discovery of new opportunities to treat disease with existing medications and moves towards earlier treatment of some diseases.
National Audit Office estimates say £200 million a year – 2.4% of the £8.2 billion primary care drugs bill for 2008 – could be saved without affecting clinical outcomes.
"Efficient management by the Department of Health and NHS bodies can however make the drugs bill more affordable without affecting patient care," the Public Accounts Committee said.
Industry body the ABPI denied that new drugs were over-prescribed and said the £850 million spend quoted for pharma's marketing activities had to be seen in the context of the overall NHS drugs bill and the industry's £3.3 billion investment in R&D in the UK.
Director general Dr Richard Barker said: "The facts simply do not back the assertion that doctors are unduly influenced by the pharmaceutical industry's marketing activities.
"Not only is the UK the poor relation of comparable countries worldwide in terms of prescribing new, innovative medicines but we also have the highest prescribing rates for generics.
"Would any other industry be expected to spend an average of £500 million on developing a new product and then be criticised for telling people about it?"
Recommendations
The Committees outlined a series of measures the Department of Health could take to stem the rising drugs bill.
These included developing more Better Care, Better Value prescribing indicators to measure the proportion of generics dispensed as well as encouraging PCTs to pilot joint primary/secondary care formularies.
MPs also want more to be done to make patients aware of the cost of their treatment and the importance of not wasting medicines, suggesting patients receive information about the cost of the specific items dispensed.
They also took issue with the variation in generic drug packaging and the confusion this can cause patients. The Committee's report suggested the Department of Health and the pharmaceutical industry work together on greater consistency of appearance, labelling and/or packaging of the more common drugs supplied to the NHS.
