§ Mr. Greenwayasked the Secretary of State for Social Services which products of which companies are on the non-reimbursable list for drugs; and if he will make a statement.
§ Mr. Kenneth ClarkeWe are consulting the medical and pharmaceutical professions and the drugs industry on the content of the limited list. Until this consultation is complete it is not possible to list the medicines which will no longer be available under the National Health Service.
§ Mr. Greenwayasked the Secretary of State for Social Services (1) what expert machinery he is developing to assess new drugs currently under research which are to be reimbursable in the future;
(2) whether his Department has considered the prescribing anomalies which could arise as a result of the removal from the National Health Service of each drug which it is proposed will not be available from April 1985;
(3) whether his Department has undertaken individual evaluation of the likely medical and social impacts of the proposed removal in April 1985 of certain drugs currently prescribed under the National Health Service.
§ Mr. Kenneth ClarkeThese matters will be fully considered during our consultations with the medical and pharmaceutical professions and the drugs industry.
§ Mr. Greenwayasked the Secretary of State for Social Services (1) whether the World Health Organisation essential drug list was used by his Department in the selection of those drugs which will continue to be available under the National Health Service after the proposed introduction of a limited list of generic medicines;
(2) why the terms of product licences and data sheets issued and approved by his Department were not used in determining which drugs would continue to be available under the National Health Service after the proposed introduction of a limited list of drugs rather than the British National Formulary.
§ Mr. Kenneth ClarkeThe list of drugs to remain available on the National Health Service will not be determined until our consultation with the medical and pharmaceutical professions and the drugs industry is complete. No single source of information was used to prepare the provisional list published on 8 November.
§ Mr. Greenwayasked the Secretary of State for Social Services whether he plans to extend the proposed restrictions to doctors' prescribing of medicines beyond the therapy classes currently proposed; and for which other illnesses he believes it reasonable to limit treatment.
§ Mr. Kenneth ClarkeNo. We have announced the full extent of the therapeutic categories covered by our limited list proposals.
§ Mr. Bodyasked the Secretary of State for Social Services whether he will publish any information he has about the price in the United Kingdom of drugs and medicines whose prescription he proposes to restrict, and their price in other countries.
§ Mr. Kenneth ClarkeThe drugs to remain available on the National Health Service in the categories affected by our limited list proposals will not be finalised until full consultation has taken place.
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§ Mr. Michael Morrisasked the Secretary of State for Social Services whether he will exclude from the limited list of drugs any product still protected by patent.
§ Mr. Kenneth ClarkeOur stated intention is to provide an adequate range of cheap and effective generic drugs in the therapeutic categories covered by our limited list proposals. We are now consulting to ensure that no essential drug is omitted from the list.
§ Mr. Traceyasked the Secretary of State for Social Services how many pre-printed letters in an identical format his Department has received from doctors protesting about restrictions on National Health Service prescribing; what response he is making; and if he will make a statement.
§ Mr. Kenneth ClarkeHon. Members have to date sent us 145 copies of a pre-printed letter circulated by Roche Products Ltd. This letter simply requires the doctor to endorse it with his surgery stamp, sign it and send it to his Member of Parliament. I believe the company supplied a stamped envelope addressed to the doctor's own Member of Parliament for the purpose. The letter contains a number of inaccuracies and misleading statements. We shall be replying to all letters, including this prepared campaigning letter, in due course.
§ Mr. Dobsonasked the Secretary of State for Social Services if he will place in the Library a copy of his letter of 8 November to the British Medical Association about limited list prescribing.
§ Mr. Kenneth ClarkeYes. Copies of my letter have now been placed in the Library.
§ Mr. Dobsonasked the Secretary of State for Social Services why he rejects the introduction of generic prescribing or generic substitution in the family practitioner services of the National Health Service.
§ Mr. Kenneth ClarkeWe do not reject generic prescribing. We have always encouraged doctors to prescribe generically whenever possible. A scheme of compulsory generic substitution across all therapeutic groups would be indiscriminate and would have an adverse effect on the research based pharmaceutical industry in this country. In addition the medical profession have raised with us what they see as a serious problem of legal liability if such a scheme were introduced.
§ Mr. Dobsonasked the Secretary of State for Social Services (1) from whom he obtained advice in selecting the drugs to be included in the limited list he announced on 8 November;
(2) if he will give the number of prescriptions dispensed on the National Health Service in 1983 of each of the drugs which will no longer be available for prescription under the National Health Service on the basis used to calculate the estimated savings given in his statement on 8 November;
(3) if he will list the drugs which will no longer be permitted to be prescribed under the National Health Service, giving the cost of the private purchase of each drug by a patient on the basis used to calculate the estimated savings given in his statement on 8 November;
(4) if he will give details of how he arrived at the estimated savings to the National Health Service from the introduction of limited list prescribing mentioned in his statement of 8 November.
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§ Mr. Kenneth ClarkeOur estimate of savings from the introduction of limited list prescribing is based upon the cost to the National Health Service of drugs within the broad therapeutic groups under consideration. We are consulting the medical and pharmaceutical professions and the drugs industry on the content of the limited list and until this consultation is complete it is not possible to list the medicines which will no longer be available under the National Health Service or their individual costs. No single source of information was used to prepare the provisional list published on 8 November.
§ Mr. Dobsonasked the Secretary of State for Social Services why no middle-range pain killers are included in the limited list he announced on 8 November.
§ Mr. Kenneth ClarkeAnalgesics for the relief of moderate to severe pain are not affected by the limited list proposals.
§ Mr. Dobsonasked the Secretary of State for Social Services why his Department's evidence to the Greenfield committee rejected the idea of limited list prescribing in the National Health Service.
§ Mr. Kenneth ClarkeThe paper prepared by officials of our Department and put to the Greenfield committee in 1981 rejected the idea of a limited list of drugs across all therapeutic groups. It was not concerned with the present proposals, which affect only less essential therapeutic categories.
§ Mr. Dobsonasked the Secretary of State for Social Services what is his estimate of the number of items which will be bought across the counter by patients who formerly bought them on prescription.
§ Mr. Kenneth ClarkeWe cannot estimate this. It will be a matter of personal choice.