HC Deb 25 March 2003 vol 402 cc193-4W
Mr. Kevin Hughes

To ask the Secretary of State for Health (1) what the cost to the NHS was for treatments prescribed for dyspepsia; and what percentage of this amount was spent on(a) proton pump inhibitors, (b) H2 receptor antagonists, (c) alginates and (d) antacids in each year since 1997; [102999]

Net ingredient cost (£ million) of products for treatment of dyspepsia dispensed it the community in England
BNF description 1997 1998 1999 2000 2001
1.1.2 Alginates 20.2 21.1 21.5 21.5 21.5
Alginates as a percentage of total dyspepsia drugs 4 5 5 5 5
1.1.1 Antacids 3.1 2.9 2.6 2.5 2.4
Antacids as a percentage of total dyspepsia drugs 1 1 1 1 1
1.3.1 H2-receptor antagonists 169.8 139.2 124.2 83.8 53.5
H2-receptor antagonists as a percentage of total dyspepsia drugs 36 31 26 19 12
1.3.5 Proton Pump Inhibitors 279.1 291.1 323.1 327.8 364.4
Proton Pump Inhibitors as a percentage of total dyspepsia drugs 59 64 69 75 82
Grand total 472.2 454.3 471.5 435.6 441.7


1. The therapeutic classifications are based on British National Formulary sections 1.1.1, 1.1.2, 1.3.1, and 1.3.5.

2. The data are based on prescription items dispensed in the community, ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England.

3. The data do not cover drugs dispensed in hospital or private prescriptions.

4. The net ingredient cost (NIC) refers to the cost of the drug before discounts and does not include any dispensing costs or fees. It does not include any adjustment for income obtained where a prescription charge is paid at the time the prescription is dispensed or where the patient has purchased a pre-payment certificate.


Prescription Cost Analysis (PCA) data from the Prescription Pricing Authority

Mr. Kevin Hughes

To ask the Secretary of State for Health what research his Department is conducting into the management of dyspepsia. [103000]

Ms Blears

The Department funds research to support policy and delivery of effective practice in health and social care. The Department's health technology assessment (HTA) programme commissioned a systematic review of the management of dyspepsia that reported in 2001.

The HTA programme has four current projects related to dyspepsia. These are: randomised trial comparing the efficacy and costs of endoscopy with Helicobacter pylori testing versus non-invasive Helicobacter pylori testing alone in the management of dyspepsia; systematic review and modelling of the cost-effectiveness of screening for Helicobacter pylori to reduce mortality and morbidity from gastric cancer and peptic ulcer disease; the place of minimal access surgery amongst people with gastrooesophageal reflux disease—a UK collaborative study: and comparison of the cost effectiveness of four strategies for the prevention of non-steroidal anti inflammatory drug induced gastrointestinal toxicity—a systematic review with economic modelling.

(2) what cost savings have been made to the NHS drugs bill for proton pump inhibitors since July 2000. [103001]

Mr. Lammy

The National Institute for Clinical Excellence (NICE) published its guidance on the use of proton pump inhibitors (PPIs) in the treatment of dyspepsia in July 2000. The guidance made a number of recommendations intended to achieve the most clinically and cost-effectiveness use of PPIs. NICE estimated that its advice, if fully implemented, could lead to a reduction in the use of PPIs. Such a reduction has not yet occurred. We anticipate that the impetus to better target these treatments will increase when NICE publishes its clinical guideline on the primary management of dyspepsia, due later this year.

Information on the net ingredient cost of all drugs used to treat dyspepsia that were dispensed in the community in England from 1997 is shown in the table.

The main Government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC) which receives its funding from the Department of Trade and Industry via the Office of Science and Technology. The MRC is not currently conducting any research into the management of dyspepsia but spent an estimated £4 million in 2001–03 on a wide range of basic and clinical research into disorders of the digestive system. The MRC always welcomes high quality applications for support of research into any aspect of human health, and these are judged in open competition with other demands on funding.

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