§ Mrs. Ann WintertonTo ask the Secretary of State for Health what representations she has received from the Association of the British Pharmaceutical Industry in connection with the changes which have been announced to the limited list prescribing system.
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§ Dr. MawhinneyMy right hon. Friend the Secretary of State for Health met the Association of the British Pharmaceutical Industry on 19 November to discuss the implications of the autumn statement and the proposed changes to the selected list scheme.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health if she will make a statement giving details of the changes which she has announced to the limited list system of drugs which may routinely be prescribed; what are the names of those individuals who are to serve upon the advisory committee which is to consider the changes in question; what new categories of products are to be considered for inclusion in the system; what are the reasons for including those categories; and if she will indicate the timetable by which she expects progress to be made on this subject.
§ Dr. MawhinneyI refer my hon. Friend to the replies I gave my hon. Friends the Members for Taunton (Mr. Nicholson) and for Wimbledon (Dr. Goodson-Wickes) on 24 November at column589 and on 26 November at columns 808–9 respectively.
The categories listed were chosen because they covered a range of products at varying price levels and therefore offered scope for savings while enabling all real clinical needs to continue to be met.
The Advisory Committee on NHS Drugs will in future be asked to take into account in its recommendations in all therapeutic categories the purpose for which the drugs are normally used as well as the indications for which they have been licensed.
I expect the advisory committee to start reviewing the new categories early in 1993. I hope that changes in the list of non-prescribable drugs will be made before the end of that year.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health what plans she has to meet representatives of the pharmaceutical industry, the medical profession and patient representatives, in connection with her announced changes to the limited list prescribing system.
§ Dr. MawhinneyMy right hon. Friend the Secretary of State has already met the Association of British Pharmaceutical industry. Requests from other organisations to hold meetings about the selected list scheme wilt be considered in the normal way. I expect that in any case this issue will be on the agenda at many of the regular meetings which Ministers or the Department hold with professional and other organisations.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health what assessment she has made of the impact upon the British pharmaceutical industry, in terms of profitability, employment and product development, of the changes which have been announced to the limited list prescribing system.
§ Dr. MawhinneyI refer my hon. Friend to the reply I gave the hon. Member for Linlithgow (Mr. Dalyell) on 26 November at column810. The relative profitability of the United Kingdom pharmaceutical industry and decisions on product development depend on factors in both the United Kingdom and other key pharmaceutical markets. It is not possible to assess whether there will be any effect on employment in the United Kingdom pharmaceutical industry until decisions on individual products have been taken.
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§ Mrs. Ann WintertonTo ask the Secretary of State for Health if she will make a statement on the effectiveness of the limited list prescribing system(a) in reducing the cost of drugs to the NHS and (b) in promoting improved patient care.
§ Dr. MawhinneyIn 1985–86 the selected list scheme saved £75 million on the drugs bill. It is not possible to make meaningful estimates for subsequent years but we have every reason to believe that significant savings continue to be made. Savings from the recently announced extension of the scheme will depend on the recommendations of the independent Advisory Committee on NHS Drugs. Drugs needed to meet all clinical needs will remain available on NHS prescription. Limiting the rate of growth of the drugs bill will ensure that the overall resources available to the NHS can be put to best use in order to provide the highest possible standards of patient care.
§ Mrs. Ann WintertonTo ask the Secretary of State for Health if she will make it her policy to publish in the form of a consultation document the details of any changes which are to be made to the limited list prescribing system prior to bringing forward the necessary order to this House.
§ Dr. MawhinneyWe intend to follow the established procedures for amending the list of drugs which GPs cannot prescribe under the national health service. Recommendations on particular drugs are made by the Advisory Committee on NHS Drugs, which comprises doctors, dentists and pharmacists appointed after consultation with relevant professional organisations. The manufacturers concerned are able to submit representations to the committee before it makes its recommendations to my right hon. Friend the Secretary of State.
§ Mr. BlunkettTo ask the Secretary of State for Health (1) how many national health service prescriptions were written for appetite suppressant medicines in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines for appetite suppression currently available will cease to be prescribable on the NHS as a result of new limited list regulations;
(2) how many national health service prescriptions were written for anti-diarrhoeal medicines in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines currently available for the treatment of diarrhoea will cease to be prescribable on the NHS as a result of new limited list regulations;
(3) how many national health service prescriptions were written for medicines acting on the skin in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines acting on the skin currently available will cease to be prescribable on the NHS as a result of new limited list regulations;
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Prescriptions dispensed by chemists and applicance contractors in England (Prescriptions in thousands) Group 1990 total2 Pensioners 1991 total3 Pensioners Pensioners as a percentage of total Appetite suppressants 358.0 1— 379.3 50.0 13.2 Anti-diarrhoeal 1,498.5 1— 1,377.6 480.2 34.9 Acting on the skin 25,280.8 1— 26,607.3 7,232.6 27.2 (4) how many national health service prescriptions were written for medicines acting on the ear and nose in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines currently available for the treatment of ear and nose condtions will cease to be prescribable on the NHS as a result of new limited list regulations;
(5) how many national health service prescriptions were written for medicines for the treatment of vaginal and vulva/ conditions in 1990 and 1991; how many of these prescriptions were for women aged over 60 years; and which medicines currently available for the treatment of vaginal and vulva] conditions will cease to be prescribable on the NHS as a result of new limited list regulations;
(6) how many national health service prescriptions were written for contraceptives in 1990 and 1991; and which contraceptives currently available will cease to be prescribable on the NHS as a result of new limited list regulations;
(7) how many national health service prescriptions were written for allergic disorders in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines currently available for the treatment of allergic disorders will cease to be prescribable on the NHS as a result of new limited list regulations;
(8) how many national health service prescriptions were written for topical anti-rheumatics in 1990 and 1991; how many of these prescriptions were for pensioners; and which topical medicines currently available for the treatment of rheumatism will cease to be prescribable on the NHS as a result of new limited list regulations;
(9) how many national health service prescriptions were written for hypnotic and anxiolytic medicines in 1990 and 1991; how many of these prescriptions were for pensioners; and which hypnotic and anxiolytic medicines currently available will cease to be prescribable on the NHS as a result of new limited list regulations;
(10) how many national health service prescriptions were written for medicine used in the treatment of anaemia in 1990 and 1991; how many of these prescriptions were for pensioners; and which medicines currently available for the treatment of anaemia will cease to be prescribable on the NHS as a result of the new limited list regulations.
§ Dr. MawhinneyDetails of the prescriptions dispensed by chemists and appliance contractors in England in 1990 and 1991 for each of the categories of drug that will be added to the selected list scheme are shown in the table. Information on prescriptions issued to pensioners is not available for 1990. No decisions have been made on which drugs within each groups will cease to be prescribable on the national health service. Such decisions will be based on advice from the independent Advisory Committee on NHS Drugs.
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Group 1990 total2 Pensioners 1991 total3 Pensioners Pensioners as a percentage of total Ear and nose 5,590.8 1— 5,773.0 1,442.4 25.0 Vaginal and vulval 2,553.7 1— 2,414.2 355.8 14.7 Contraceptives 7,036.8 1— 7,118.1 — — Allergic disorders 4,901.1 1— 5,171.0 952.2 18.4 Anti-rheumatics 3,979.6 1— 4,394.9 2,501.8 56.9 Hypnotic and anxiolytic 17,634.1 1— 16,820.9 9,586.0 57.0 Anaemia 4,364.1 1— 4,229.0 1,875.4 44.3 1 Not available. 2 1990 data are based on fees. 3 1991 data (new Prescription Cost Analysis) are based on items.