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Tagged In:  NHS, Prescription drugs

Cutting 'ineffective' or 'inappropriate' medicines and other products from GPs' prescription lists could save up to £400 million per year.




NHS England has announced that it's reviewing its guidance on low-value prescription items which it considers to be 'ineffective, inappropriate for prescription on the NHS or unsafe'. To be carried out in consultation with consultants, doctors and clinical commissioning groups (CCGs), the review was triggered by recommendations from NHS Clinical Commissioners. It's believed that there are potential savings of up to £400 million, freeing up money to be spent in other areas which deliver better value.

Initially, 10 products have been included in the review, ranging from the synthetic hormone Liothyronine (used to treat underactive thyroid conditions) and Tadalafil (an alternative to Viagra) to travel vaccines and omega 3 supplements. Collectively, prescribing of these currently costs NHS England around £128 million each year. Further work will consider banning prescribing of other medicines which are of relatively low clinical value and are readily available over the counter from pharmacists, often at far lower cost, including cough and cold remedies, antihistamines and suncream.

An NHS England spokesperson commented, "The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes."

While many doctors, nurses and other health professionals may welcome the review, not everyone has reacted positively. The British Dietetic Association (BDA) has expressed concern about the inclusion of gluten-free foods on the initial list of 10 products being targeted. It believes there could be a significant impact on patients with coeliac disease, particularly those on low incomes or with limited mobility, who may find it too costly or difficult to access the products they need.

"A complete removal of gluten-free products from prescription is not the answer," said Lisa Vokes, Chair of the BDA Gastroenterology Specialist Group. " There are alternative models that could be implemented, such as pharmacy led schemes or voucher schemes with regular reviews with a dietitian. Placing dietitians at the heart of the process can improve effectiveness and efficiency while maintaining an appropriate standard of provision for patients.

The charity Melanoma UK is worried about the future widening of the guidance to include products such suncreams, which they say are vital for patients suffering from debilitating skin conditions. CEO Gill Nuttall said, "We fully appreciate that the NHS should not be abused in any way at all, and we know there are issues across the whole of the NHS, not just in prescription medicines, but we would urge NHS England to think very carefully before placing suncreams in their list."

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