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MPs’ report criticises influence of drugs industry on GP prescribing
Zosia Kmietowicz
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Too many GPs are influenced by the pharmaceutical industry, which spends £850m (
1130m; $1670m) every year on marketing its products in primary care, says a report from the Public Accounts Committee, the government’s spending watchdog.
And the NHS spends at least £200m more than it should on medicines because GPs do not heed official guidelines and continue to prescribe branded medicines rather than generics, says the report.
The committee’s comments follow a survey by the National Audit Office which found that one in five GPs said their prescribing choices were swayed more by industry marketing that by official NHS advice.
"It’s hard to doubt that the blandishments of the pharmaceutical industry are having an effect," said Edward Leigh, chairman of the Public Accounts Committee.
The Department of Health should set a minimum level above which gifts and hospitality to GPs from the pharmaceutical industry should be declared to trusts, says the report. It also says that despite increases in generic prescribing in recent years there is a wide variation between primary care trusts in the proportions of generics being prescribed for some conditions. For example, GPs in some trusts prescribe 86% generic versions of statins, but in other trusts the figure is just 28%.
GPs must concentrate more on following official guidelines, increasing the prescribing of generic drugs where clinically appropriate, said Mr Leigh. "The fact that primary care trusts vary hugely in the extent to which their GPs prescribe generic drugs for common conditions shows what can be achieved."
The committee calls on the Department of Health to develop better prescribing indicators to measure the proportion of generics dispensed and the potential savings that could be made by prescribing more effectively. It also says that the "medicines management" indicators in the Quality and Outcome Framework, on which nearly all GPs achieve maximum points, need to be set higher and to include a reward for generic prescribing where appropriate.
The report calls for greater awareness among the public about the cost of drugs to reduce waste, perhaps by displaying the cost of items on the packaging. Most prescriptions—88%—are dispensed free and the standard charge for the rest does not reflect the cost of the items, says the report.
"Unused and wasted drugs cost the NHS at least £100m a year and almost certainly a lot more," saidMr Leigh. "The Department of Health must do more to find out why this is happening."
Trusts should be encouraged to pilot formularies which have been agreed between primary and secondary care to boost cost effective prescribing. And strategic health authorities should work with the National Prescribing Centre to promote agreed formularies across health sectors and trusts, recommends the report.
Department of Health: Prescribing Costs in Primary Care is at www.parliament.uk
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