§ Mr. Michael Morrisasked the Secretary of State for Social Services what monitoring of the direct savings arising out of his amended limited list will be undertaken.
§ Mr. Kenneth ClarkeGeneral practitioner prescribing is already monitored and will continue to be so.
§ Mr. Michael Morrisasked the Secretary of State for Social Services whether he proposes to discuss the implications of his amended limited list on the dental profession with the dental formulary sub-committee of the joint formulary committee.
§ Mr. Kenneth ClarkeThe detailed views of the dental profession were taken into account in producing the final version of the list. Our Chief Dental Officer wrote to the chairmen of the dental formulary sub-committee of the joint formulary committee on 21 February 1985 giving details of the amended limited list and expressing willingness to discuss with the committee how best its professional expert advice could be used in the future administration of the list.
§ Mr. Michael Morrisasked the Secretary of State for Social Services why, in relation to his amended limited list, doctors will be required to write out a prescription for some generic substances when only patent protected brands are available.
§ Mr. Kenneth ClarkeFew of the drugs on the extended list are under patent, though many are currently available only as branded products. Such drugs will be described by their generic or approved names wherever possible as this will lead to savings when, in due course, unbranded equivalents became available. Where brand names are included in the list it is because there is at present no non-proprietary name for the drug in question.
§ Mrs. Renée Shortasked the Secretary of State for Social Services what studies he intends to conduct in order to monitor the extent of television promotions of drugs and the demand for drugs not available on prescription within the National Health Service in connection with his proposed limited list after this has been implemented on 1 April.
§ Mr. Kenneth ClarkeWe have no plans to monitor the extent of television advertising of drugs which are no longer available on National Health Service prescription. It is entirely a matter for manufacturers how much they spend on this or any other way of advertising such drugs. No special steps will be taken to monitor non-NHS sales of drugs, for which detailed information is not in any case available.
§ Dr. Glynasked the Secretary of State for Social Services what representations he has received from the medical profession subsequent to his statement in the House on 21 February on limited list prescribing about (a) 404W the adequacy of the revised limited list and (b) possible exemptions from the limited list; and if he will make a statement.
§ Mr. Kenneth ClarkeWe have received no such representations from the medical profession.
§ Mr. Dobsonasked the Secretary of State for Social Services if he will answer questions about the total number of prescriptions issued for drugs which are no longer to be available on National Health Service prescriptions.
§ Mr. Kenneth ClarkeWe do not disclose prescribing figures for individual named drugs because the information is of commercial value.
§ Mr. Dobsonasked the Secretary of State for Social Services what was the aggregate number of prescriptions dispensed, subdivided by category of product, for the products to be excluded from National Health Service prescription under his limited list proposals in the last year for which figures are available; and what percentage, in total and by category, these prescriptions constituted of all National Health Service prescriptions dispensed in each category.
§ Mr. Kenneth ClarkeIn England in 1983, the last year for which information is available, the numbers of prescriptions for those medicines to be excluded from NHS prescription from 1 April 1985 by category, and those numbers as a percentage of the total number of prescriptions in each category, were as follows:
Column 1 Number of prescriptions for excluded medicines Column 2 Column 1 as a percentage of all prescriptions Analgesics for mild to moderate pain 12,052,000 61 Antacids 5,182,000 60 Benzodiazepines 18,925,000 81 Bitters and tonics 904,000 96 Vitamin preparations 4,506,000 84 Cough and cold remedies 15,599,000 88 Laxatives 1,204,000 23 Total 58,370,000 72 All figures are estimates based on a 1 in 200 sample of prescriptions dispensed by retail chemists and appliance contractors. The figures are rounded to the nearest 1,000.
§ Mr. Dobsonasked the Secretary of State for Social Services what proportion of the estimated savings of £75 million from the imposition of his limited prescribing list will result from the withdrawal from National Health Service prescriptions of substances which can be obtained without any prescription but which, prior to the introduction of the limited list, could be issued on prescription at a doctor's discretion.
§ Mr. Kenneth ClarkeThis information could be obtained only at disproportionate cost.
§ Mr. Onslowasked the Secretary of State for Social Services how Distalgesic is to be prescribed by general practitioners following the introduction of the National Health Service limited drugs list.
§ Mr. Kenneth ClarkeDistalgesic is a brand name for a tablet containing a mixture of two drugs which is out-of patent. It will not be prescribable as a branded product on the National Health Service after 1 April, but the particular 405W combination of drugs that it and other brands contain will continue to be prescribable as "dextropropoxyphene and paracetamol tablets". When a pharmacists receives such a prescription he will dispense which ever branded product he has in stock. This may be Distalgesic or it may be one of the alternative brands, currently Cosalgesic and Dextrogesic. We anticipate that manufacturers will soon produce unbranded dextropropoxyphene and paracetamol tablets. When this happens it will no longer be necessary for pharmacists to dispense a branded product.
§ Mr. Pikeasked the Secretary of State for Social Services which products on his amended limited list of prescribable drugs are currently manufactured in the United Kingdom.
§ Mr. Michael Morrisasked the Secretary of State for Social Services (1) what calculations have been made by his Department of the increase of imports arising from the introduction of his amended limited list;
(2) whether all the products on his amended limited list are currently manufactured in the United Kingdom.
§ Mr. Kenneth ClarkeOur inquiries of wholesalers and generic manufacturers suggest that for the most part demand for the products in question can be met from United Kingdom sources. It is not possible to make precise forecasts since much will depend on market forces, especially in the period immediately after 1 April. Any finished products which are imported will, of course, have to meet our normal standards of safety, quality and efficacy.
§ Sir Dudley Smithasked the Secretary of State for Social Services how many products on the proposed list of drugs and other substances not to be available at National Health Service expense, as published on 21 February, have been included in error; and what steps he proposes to take to inform the medical profession of the position.
§ Mr. Kenneth ClarkeThe proposed list of drugs and other substances not to be available at National Health Service expense as published on 21 February included a small number of products in error. All those who had received copies of the list were immediately sent details of the need to delete six items. The definitive list, included as a schedule to regulations laid on 1 March contains further minor corrections. Copies will be sent to all doctors later this month.
§ Mr. Gryllsasked the Secretary of State for Social Services what was the aggregate number of National Health Service prescriptions written for Barker's Liquid of Life, Dr. Williams' Pink Pills, Mrs. Cullen's Powders and Rock Salmon Cough Medicine in each of the last three years for which figures are available; and if he will make a statement.
§ Mr. Kenneth ClarkeWe are not aware of any prescriptions for these products under the National Health Service in the last three years. However, they are all prescribable products falling within the therapeutic categories covered by the limited list. They have been included in the list of drugs and other substances not to be available at NHS expense, as published on 21 February, so that savings are not eroded by prescriptions for these or similar products as replacements for others to be removed from NHS supply.