P

lans to employ a private firm to take the reigns of GP prescribing budgets in order to slash costs have come under fire by the Royal Pharmaceutical Society of Great Britain and the British Medical Association.

According to media reports, private company Assura is promising to generate significant savings on the amount PCTs spend on medicines by incentivising doctors to dish out fewer drugs or prescribe cheaper generic versions.

A spokesman for Assura told PharmaTimes UK News that the company is “in early discussions” with two Primary Care Trusts and has approached several others with regard to taking control of prescribing budgets, but that it is wrong, as has been suggested in the media, that the company is at the point of signing any contracts.

He also denied reports that doctors would be paid to switch to generic drugs. “The conceptual model we are looking at does not involve paying doctors to prescribe cheaper drugs. It involves working with doctors to ensure the best health outcomes for patients through managing their medicines better and reducing waste,” he told PharmaTimes.

According to media reports, under the group’s plans any profits made by driving down the drugs bill would be shared by the firm and GPs in the scheme.

Vivienne McVey, Assura’s medical director, told Pulse that its proposals could make savings of £500,000 for trusts and possibly reduce their expenditure by 10%, which would generate a profit pot of £2 million that would be shared with GPs.

Assura has reportedly claimed that it can help garner savings without affecting the quality of patient care, but the Royal Pharmaceutical Society of Great Britain has described plans to give GPs cash for prescribing less drugs as “irresponsible bribery that potentially places patients at risk”.

“Prescribing is a core role for GPs, and the proposals to reward doctors who change their prescribing habits when it may not be in the best interests of patients is unacceptable,” argues RPSGB Director of Policy and Communications, David Pruce.

Risking lives?
Furthermore, he points out that employing a private firm to take over the prescribing budget could mean that pharmacists – who are experts in medicines - will effectively be removed from any prescribing decisions “for the sake of financial reward” which, Pruce stresses, “is not only morally wrong - it could put the lives of patients at risk”.

The fact that some PCTs are even in talks with private firms to take control of drug expenditure suggests that their faith in the government’s flagship reform practice-based commissioning - under which PCTs are given their own budgets to make local decisions on what services to commission - is wearing thin.

But Pruce says it boils down to “the reality that there are huge discrepancies between the amount of resources PCTs put into managing prescribing budgets”, and he claims that the most successful PCTs have teams of pharmacists working alongside local prescribers to foster high-quality and cost-effective prescribing, which, he says, is an “effective way of keeping costs down and the quality of prescribing up”.

Pruce insists that PCTs should be using their resources to improve their prescribing, and Laurence Buckman, Chairman of the British Medical Association’s GPs Committee, agrees. He says that, while PCTs are under pressure to reduce overspends on their drug budgets, the emphasis should always be on improving quality. “It should never just be about cutting costs and certainly never about financial reward. Prescribing should be driven purely by what is in the best interests of the patient,” he stressed.

“Getting good value for money from prescribing budgets has been a priority for all PCTs for years, but this has been done by working directly with practices and pharmacists, not through using private companies,” he concludes.