NHS England has unveiled detailed proposals of how prescriptions for “ineffective, over-priced and low value treatments” will be cut in order to shave millions off of the NHS’ drugs bill.

A public consultation has now been launched on new national guidelines blocking 18 treatments which together cost taxpayers £141 million a year, including homeopathy, which NHS chief executive Simon Stevens describes as “at best a placebo and a misuse of scarce NHS funds”.

The consultation also covers a further 3,200 prescription items many of which are available over the counter at a significantly lower price than the cost to the NHS, and proposes to limit prescribing of products for minor self-limiting conditions, such as laxatives and eye drops, which currently cost taxpayers £50-100 million a year.

NHS England said it also supports restricting the availability of gluten-free foods on prescription, which costs £26 million a year and is currently subject to a Department of Health consultation.

“The NHS is probably the world’s most efficient health service, but like every country there is still waste and inefficiency that we’re determined to root out,” said Stevens. “The public rightly expects that the NHS will use every pound wisely, and today we’re taking practical action to free up funding to better spend on modern drugs and treatments.”

“An honest, plain English conversation is required about what we should fund and what we should not. We need to end unnecessary expense to give us a bigger therapeutic bang for the NHS buck so we cut the fat and build the therapeutic muscle,” added Sir Bruce Keogh, NHS England medical director.

Commenting on the plans, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, noted that
prescription costs “are a significant expense for the health service, and so if we can take safe, sensible measures to reduce these costs then we should.”

However, she also warned agains “imposing blanket policies on GPs, that don’t take into account demographic differences across the country, or that don’t allow for flexibility for a patient’s individual circumstances, risks alienating the most vulnerable in society.”

Also, while recognising the move to clear out ineffective drugs as “good housekeeping”, The Patients Association said it is concerned that the proposals were developed without any input from patients.

“We must not end up in a situation where individual doctors have to decide whether to give someone a prescription or send them away to buy a medicine themselves, noted chief executive Rachel Power, and added: “While there’s merit in looking at all of these issues sensibly, the fact that it’s happening now is yet another indication that the NHS does not have the financial settlement it needs from government to provide a comprehensive health service.”

‘Serious concerns’
The Royal Pharmaceutical Society welcomed the move to cut funding for homeopathy but said it has “serious concerns” over proposals to restrict prescribing clinically effective medicines to treat common conditions such as head lice or athlete’s foot.

It argues that the move would “fundamentally alter the principle that care is free at the point of delivery and as such should be legislated for by Parliament and not implemented by Clinical Commissioning Groups,” pointing to Principle 2 of the NHS Constitution which states that “Access to NHS services is based on clinical need, not an individual’s ability to pay. NHS services are free of charge, except in limited circumstances sanctioned by Parliament.”

“Expecting everyone to pay for medicines for common conditions will further increase health inequalities and worsen the health of patients who cannot afford them. A blanket ban on prescribing of items available to buy will not improve individual quality of life or health outcomes in England,” warned RPS England Board Chair Sandra Gidley.