§ Mrs. Renée Shortasked the Secretary of State for Social Services what consultation he had with the Committee on Safety of Medicines before deciding to impose restrictions on certain medicines hitherto prescribed on the National Health Service.
§ Mr. Kenneth ClarkeNone. Our limited list will set out the range of drugs available on the National Health Service in the therapeutic categories concerned to meet all clinical needs. Consideration of this matter seems to me to be quite distinct from the work of the committee which, under the Medicines Act 1968 and Community legislation, advises on whether medicines of all kinds should, taking into account safety, efficacy and quality, be authorised for marketing in the United Kingdom.
44W
§ Mr. Lathamasked the Secretary of State for Social Services what arrangements he intends to make in respect of patients in general practitioner local hospitals who receive drugs under the hospital formulary which will not be available on prescription under the National Health Service on their discharge, under the minimum list proposals.
§ Mr. Kenneth ClarkeLimited list arrangements will apply throughout the National Health Service. Our proposals aim to provide effective low cost medicines to meet all clinical needs in the small number of therapeutic categories affected. If there are differences of significance between these proposals and the 400 or so local hospital formularies in existence we would expect these to be reflected in the comments we receive during the course of consultation.
§ Mr. Lathamasked the Secretary of State for Social Services whether he will outline the current methods of 45W supervision and scrutiny of the costs of drug prescribing by general practitioners under the National Health Service; and why he considers them to be inadequate.
§ Mr. Kenneth ClarkeThe present system of prescription monitoring is undertaken by our Department in conjunction with the Prescription Pricing Authority. Prescribers whose costs are above average are visited by our regional medical officers, who also discuss prescribing topics in the course of their regular contacts with general practitioners. While such contacts have proved useful in individual cases the already excessive drugs bill continues to rise and we have concluded that other measures are necessary to constrain it.
§ Mr. Lathamasked the Secretary of State for Social Services whether he will set out in tabular form, for each regional health authority, the cost of drugs prescribed by general practioners for the latest available 12-month period and the number of prescriptions written, indicating whether there are any significant regional variations.
§ Mr. Kenneth ClarkeThe numbers and net ingredient costs of prescriptions dispensed by chemists and appliance contractors in each of the regional health authorities in the 12-month period ending 31 August 1984 are as follows:
Regional health authority Number of prescriptions Total net ingredient cost (£s) Northern 23,175,424 88,038,414 Yorkshire 25,360,162 89,406,379 Trent 30,864,985 108,395,297 East Anglian 9,576,898 37,008,129 North West Thames 22,857,937 83,153,710 North East Thames 25,222,285 86,596,194 South East Thames 24,436,046 87,711,432 South West Thames 18,708,129 69,684,187 Wessex 17,698,564 67,198,886 Oxford 13,014,177 50,180,234 South Western 20,383,769 74,527,658 West Midlands 36,679,522 127,942,745 Mersey 19,497,195 65,562,944 North Western 33,581,582 114,889,909 Many factors including demographic differences and morbidity patterns contribute to regional variations but we are not able to quantify the effect of any one particular factor.
§ Mr. Lathamasked the Secretary of State for Social Services whether he will list the drugs available for prescription under the hospital formulary which will not also be available under limited list prescribing.
§ Mr. Kenneth ClarkeHospital formularies are drawn up on an individual hospital or health authority basis. There are some 400 in existence and the drugs they cover at the moment will not necessarily be the same as the final list of drugs to remain available on the National Health Service in each of the groups covered by our limited list proposals. We will not finally decide which drugs will no longer be prescribable at public expense through the National Health Service until after our consultation with the medical and pharmaceutical professions and the drugs industry is complete.
§ Mr. Gryllsasked the Secretary of State for Social Services what proposals he intends to make to compensate companies for losses in sales occasioned by their products being excluded from National Health Service availability under his limited list proposals.
46W
§ Mr. Kenneth ClarkeI do not believe that a customer would ordinarily compensate a vendor if the customer decided to buy alternative products.
§ Mr. Lathamasked the Secretary of State for Social Services if he will make a statement as to the effectiveness hitherto of the guidance issued to doctors in his Department's cost charts on the costs of prescribable medicines in containing expenditure regarding those groups of medicines to be included in his proposals for limited list prescribing.
§ Mr. Kenneth ClarkeDoctors find our cost comparison charts useful in pointing to the wide variations in costs between similar drugs. So many factors influence prescribing that it is not possible to isolate the impact of the charts in particular therapeutic categories, though there can be no doubt that they have one.