More than half of all NHS primary care organisations (PCOs) have introduced new curbs on GP prescribing of high-cost medicines within the last year, including bans on products recommended by the National Institute for Health and Clinical Excellence (NICE), Pulse has reported.
An investigation by the journal received responses from 134 PCOs under the Freedom of Information Act which reveal that, faced with the need to make massive efficiency savings, 73 NHS organisations have increased the size of their primary care prescribing “redlists” – of products which may only be prescribed by a hospital consultant, not a GP – and some lists now include more than 100 products.
Products on some banned lists include NICE-approved statins and treatments for diabetes and osteoporosis, and also products deemed to be “of low clinical priority,” which include some nonsteroidal anti-inflammatory drugs (NSAIDs), contraceptive pills and treatments for Parkinson’s disease, weight loss and erectile dysfunction, according to Pulse.
As well as increasing the lists of products which NHS organisations will not normally fund for prescribing in primary care, some PCOs are taking other actions to cut their drugs bills, the journal reports. For example, the Hywel Dda local health board in Wales is instructing GPs to tell their patients to buy their medicines over-the-counter, while NHS Milton Keynes says it is planning to impose a fine against each consultant-to-GP letter requesting the prescription of a non-formulary drug, and NHS Warrington says it will abolish “routine prescribing for longer than three months for patients who live abroad.”
Pulse’s editor Richard Hoey described the GP prescribing bans as damaging to the care of patients and also quite possibly a false economy, pointing out that many of the drugs approved by NICE and other national bodies are not only cost-effective but also likely to recoup some of their price in the long term by reducing rates of illness.
Commenting on the investigation’s findings, the Association of the British Pharmaceutical Industry (ABPI) said they raise “new concerns about an on-going problem – how to improve patient access to new innovative medicines in the NHS.”
“The NHS Constitution clearly sets out that patients have a legal right to receive a medicine approved by NICE if they are eligible to receive it, and a mandatory direction on primary care trusts requires – within three months of a medicine being approved by NICE – that funding must be made available,” said Paul Catchpole, value and access director at the ABPI.
“These two measures still apply, even in the rapidly-evolving NHS environment,” he added.
