BMA welcomes relaxed off-label prescribing rules

GMC plans to relax off-label prescribing rules have been backed by the BMA.

But the BMA criticised 'impractical' demands for clinicians to review all repeat prescriptions.

Updated GMC guidance is set to grant GPs greater leeway when prescribing off-label or unlicensed drugs. Responding to a consultation on the plans, the BMA said the guidance would rightly permit doctors to lower prescription costs.

The response, seen by GP, said: ‘The BMA is of the view that doctors have an ethical duty to use available resources efficiently, and this duty extends to prescribing decisions.’

Previous GMC guidance was more restrictive, requiring that off-label or unlicensed drugs must ‘better serve the patient’s needs’ than a licensed alternative.

Wording in the updated guidance allows clinicians to prescribe these drugs if deemed as safe and effective as the licensed form.

Prescribing off-label is usually undertaken when treating children, for whom many drugs are not licensed. Using cheaper, unlicensed drugs instead of more costly alternatives can cut prescribing costs.

But Dr Bill Beeby, chairman of the GPC prescribing subcommittee, recently warned GPs to be ‘very cautious’ attempting this.

The GMC also wants clinicians to determine whether every repeat prescription is ‘still needed, effective, tolerated and that the patient’s condition is stable enough to warrant the repeat prescription without further examination or assessment’.

The BMA criticised the demands as ‘impractical’. ‘We feel that this is not compatible with current working patterns and resources,’ it said.

The Royal Pharmaceutical Society said it may not be necessary to alert patients to licensing status of drugs routinely used off-label.

‘To decide that a patient does not need to be informed that the medicine is not licensed, on the basis that the use of the product is routine, undermines the principle of "no decision about me without me",’ it said.

The GMC rules would mean prescribing off-label must be supported by ‘authoritative clinical guidance’.

The BMA and the Royal Pharmaceutical Society urged the GMC to define what forms of guidance would be acceptable. Both organisations also called for more guidance on the difference between off-label and unlicensed prescribing.

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