GPs urged to stop handing out over the counter drugs
HEALTH chiefs are calling for ‘do not prescribe’ lists to stop doctors handing out medicines that are available to the public over the counter.
NHS officials want patients with minor conditions to pay for their own treatments and GPs to stop prescribing drugs that have a limited effectiveness.
The call has come in submissions to the Scottish parliament’s health committee, which is investigating the supply and demand for medicines around the country.
But critics warn that ‘rationing’ drugs could have an impact on the poorest patients.
NHS Scotland spends almost £1.4billion per year on drugs and the Holyrood committee is examining how the medicines budget is managed and the clinical and cost-effectiveness of current prescribing.
In a written submission, NHS Ayrshire and Arran warns it is ‘wasteful’ when doctors and nurses prescribe a medicine that is not effective.
The NHS in England has a ‘do not prescribe’ list of medicines which are deemed to be of low clinical value.
The list includes some drugs for high blood pressure and pain relief, vitamins and some acne treatments.
It also has a range of minor conditions such as mouth ulcers, indigestion and warts for which it does not recommend doctors issue prescriptions, because over-the-counter remedies can be purchased.
Items on the ‘do not prescribe’ list in England include a quickrelease version of the opioid painkiller fentanyl that is deemed less safe than newer versions of the drug, and creams used to treat musculoskeletal
‘Limited clinical value’
pain that are available over the counter in pharmacies.
Ayrshire and Arran health board’s submission states it could save £300,000 a year through tougher measures.
It said: ‘It is wasteful when prescribers prescribe a non-effective medicine. NHS England has a do not prescribe list of medicines.
‘These are medicines that have limited clinical effectiveness or do not require a prescription because they are available for patients to buy. It is estimated that NHS Ayrshire and Arran could save approximately £300,000 if NHS Scotland introduced a similar list.’
Other health boards have made similar calls.
A submission by NHS Fife’s Area Drug and Therapeutics Committee states: ‘In line with realistic medicine, low clinical value medicines should be identified and reviewed with a suitable alternative prescribed if required.’ Another submission from NHS Grampian’s Area Drug and Therapeutics Committee calls for a ‘move to halt NHS prescription of items with limited clinical value or limited evidence of effectiveness’.
But Dr Tony O’Sullivan, of campaign group Keep Our NHS Public, said: ‘Rationing drugs will have an unintended impact on health inequalities.
‘It is the least well-off who need a prescription most as they are least likely to be able to afford to purchase over-thecounter medication.
‘In addition, by bypassing the family clinician who can no longer provide these drugs, patients may miss out on essential medical advice.’