Medicines Use Reviews (MURs) are a “wasteful subsidy to pharmacists” that cost the National Health Service £67 million in 2011 alone, a report by the TaxPayers’ Alliance has concluded.
Pharmacist-conducted MURs came into being in 2005 under a drive to address medicines wastage and treatment adherence and thus secure better value for the National Health Service.
But the TaxPayers’ Alliance has questioned both the cost and the effectiveness of the scheme.
In the first instance, it argues that MURs are actually very expensive, costing £28 for a five to 15 minute session. This, it says, equates to payment of between £112 and £336 an hour.
To put this in context, family doctors get paid an average £64.59 a year for a patient on their books, but pharmacists get paid almost half of this for carrying out just one MUR.
This represents a large chunk of cash for pharmacists, especially for national chains, the Alliance notes. Boots carried out nearly £21 million worth of MURs last year and Lloyds £9.1 million, while the national total for the service accounted for £67.3 million of NHS money over the 12-month period.
The group also points to recent evidence from the University of Nottingham, carried out for the National Institute for Health Research, suggesting that MURs are failing in terms of efficacy.
A review of the service by researchers concluded that “MURs did little to increase patients’ knowledge and rarely affected medicine use”, and that “pragmatic constraints of workload and pharmacy organisation undermined pharmacists’ capacity to implement the MUR service effectively”.
Mixed feedback
Feedback from the frontline gathered for the study was also mixed. While many believed MURs to be a valuable service, others took a more negative outlook, with one pharmacist questioning the use of incentives: “However many MURs you do should be however many patients need them. Not ‘you’ve got to do 400 because that’s the target and we want the maximum money out of the government’.”
Citing the research, the Alliance notes that one GP even suggested that “a lot of the advice that pharmacists give is not good. They don’t know the patients and they haven’t got access to the records”, while another said the scheme is “a complete waste of money” with pharmacists just picking off the easy cases.
Speaking to PharmaTimes UK News, Emma Boon, Campaign Director at the TaxPayers’ Alliance, said a cheaper option would be for GPs to carry out MURs as part of their consultations, which many already do. Alternatively, the government could cut the money being offered to pharmacists for the service, she suggests.
“Pharmacists are taking millions of pounds of taxpayers’ money for a service that many doctors just believe isn’t effective,” she said.
The Royal Pharmaceutical Society of Great Britain, however, disagrees. “Frankly this report does not warrant discussion, the anecdotes quoted are not reflective of the wider findings of the study referenced,” said its spokesperson Neal Patel.
“The results of the study showed that most pharmacists perceive that MURs were an opportunity for them to use their professional skills and were of benefit to patients,” he added, and called on “pharmacists, the public and policy makers to ignore this report and focus on the benefits the profession has for patients and their health”.
