§ Mr. Nicholas WintertonTo ask the Secretary of State for Health what has been the total expenditure by the national health service in each of the last five years for which figures are available on(a) Zantac, (b) Cimetidine and (c) Tagamet.
§ Mr. SackvilleThe data for Zantac and Tagamet are commercially confidential. Information in respect of Cimetidine is shown in the table. 123W
Prescribing information for the chemical entity cimetidine 1991 1992 1993 Prescriptions (thousands) 2,617.4 2,635.4 2,608.9 Net Ingredient Cost (£ thousands) 48,333.9 45,860.7 33,816.0 Figures are based on items and cover all prescriptions dispensed by community pharmacists, appliance contractors, dispensing doctors and also include prescriptions submitted by prescribing doctors for items personally administered.
§ Mr. Nicholas WintertonTo ask the Secretary of State for health (1) in what percentage of cases of stomach ulcers(a) Zantac, (b) Cimetidine, (c) Tagamet or (d) other acid blockers are prescribed;
(2) what information she has concerning the percentage of cases of stomach cancer in which (a) Zantac, (b) Cimetidine, (c) Tagamet or (d) other acid blockers are prescribed.
§ Mr. SackvilleThis information is not available centrally.
§ Mr. Nicholas WintertonTo ask the Secretary of State for Health what information she has concerning the comparative typical costs of a full course of treatment for stomach ulcers involving(a) antibiotics for helicobacter whether or not in conjunction with acid blockers and (b) a course of acid blockers not in association with antibiotics for helicobacter; and if she will make a statement.
§ Mr. SackvilleThe medicines resource centre has published data on comparative costs on the treatment of duodenal ulcers, copies of which have been placed in the Library.
§ Mr. Nicholas WintertonTo ask the Secretary of State for Health what consideration she has given to the implementation of a screening programme involving a short course of antibiotics for helicobacter as a means of substantially reducing the incidence of(a) stomach ulcers and (b) stomach cancer; how the costs of such a programme might compare to a typical course of treatment involving acid blockers over a period of several years and surgery to remove all or part of the stomach; and if she will make a statement.
§ Mr. SackvilleWhether to carry out a test for, and subsequently treat, helicobacter pylori infection is primarily a clinical decision to he made by the doctor concerned.
§ Mr. Nicholas WintertonTo ask the Secretary of State for Health whether Zantac, Cimetidine and Tagamet are branded or generic products; by whom they are manufactured; whether the antibiotics used for the treatment of helicobacter stomach infections are branded or generic products; and what would be the effect upon the national health service drugs budget of a substantial switch from treatment by the former to the latter.
§ Mr. SackvilleZantac is the brand name used by Glaxo for drug preparations of the chemical ranitidine hydrochloride. Tagamet is the brand name used by SmithKline Beecham for cimetidine preparations. Cimetidine is also available in other branded and generic versions. All the antibiotics commonly used in the eradication of helicobacter pylori are available as generic versions, except Clarithromycin, which is available only in the proprietary form. It is not possible to calculate the effects on the national health service drugs bill of a switch from H2-antagonists to antibiotic drugs for the treatment124W of ulcers as not all prescribing of acid suppressants is for the treatment of ulcers.
§ Mr. Nicholas WintertonTo ask the Secretary of State for Health what information her Department holds relating to the incidence of helicobacter or similar infections in patients suffering from heart disease; what research it is funding in this area; and if she will make a statement.
§ Mr. SackvilleThe Department has no information at present. However, we are aware that research into this subject is taking place.
The Department of Health has not funded any research into this subject. The main agency through which the Government support biomedical and clinical research is the Medical Research Council, which receives its grant-in-aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster.
§ Mr. Nicholas WintertonTo ask the Secretary of State of Health what(a) research projects, (b) publications and (c) meetings, conferences or seminars her Department has funded to promote a greater awareness of the benefits deriving from antibiotic treatment of helicobacter stomach infections in cases of stomach ulcers compared to treatment by a protracted course of acid blockers; and if she will make a statement.
§ Mr. SackvilleThe medicines resource centre, which is funded by the Department, has made available to all general practitioners and family health services authorities prescribing advisers detailed information on the success rates achievable with the various regimes, their relative costs versus maintenance therapy and the appropriate selection of patients for this intervention. The medical advisers support centre, which also is departmentally funded, has recently promoted a series of local workshops and educational meetings for FHSA prescribing advisers on this subject and more are planned for 1995–96. The MASC is also co-operating in a practice-based GP endoscopy research project which aims to speed up the rate at which patients are given a specific diagnosis and appropriate treatment, including eradication therapy. The drug and therapeutics bulletin, published by the Consumers Association and distributed to all GPs at the Department's expense, covered this topic in its February 1993 edition. Copies of the relevant D and TB and MeReC publications have been placed in the Library.
Further research into the most efficacious and economic treatment regimes should commence later this year as part of the national health service health technology assessment research and development programme.
§ Mr. Nicholas WintertonTo ask the Secretary of State for Health when her Department first became aware of the developments in the treatment of stomach ulcers associated with the use of antibiotics whether or not in conjunction with acid blockers in preference to the use of such acid blockers alone; when her Department first took steps to ensure that these developments were drawn to the attention of general practitioners; how she accounts for the period between the two dates; how many operations were performed during that period for the removal of all or part of a stomach as a result of stomach ulcers; and what claims for compensation her Department is either facing or accepting.
§ Mr. SackvilleThe use of antibiotics in the treatment of peptic ulcers has been reported and discussed in academic and professional journals for over a decade. Eradication therapy continues to be debated and medical 125W opinion is still divided. These are matters for the profession and the royal colleges, in particular, to lead and inform clinical opinion. Information on the number of gastrectomy and partial gastrectomy operations performed where a gastric ulcer was diagnosed is shown in the table. We are not aware of any claims for compensation against the Department.
Number of gastrectomy and partial gastrectomy operations performed where a gastric ulcer was diagnosed: finished consultant episodes Number 1989–90 749 1990–91 753 1991–92 556 1992–93 504 Source:
Hospital Episodes System, Department of Health.
The above figures are 100 per cent. estimates from a 25 per cent. sample database. A finished consultant episode is defined as a period of health care under one consultant in one health care provider.