Exclusive: Prescribing deal to ease pressure on GPs and save £100m

Plans to overhaul drug reimbursement could ease prescribing pressure on GPs by slashing over £100m a year from PCT costs, a GP newspaper investigation can reveal.

PCT spending on ‘specials', unlicensed medicines manufactured for individual patients with specific needs, has tripled in two years.

Slashing the cost of specials could double the £49m saving the DoH hopes will come from allowing pharmacists in England to switch branded drugs prescribed by GPs for generic alternatives.

Costs increased from £3.8m a month in England in December 2007 to £11.2m a month in December 2009, equivalent to £162m a year across the UK.

The sharp rise has occurred because the fee manufacturers charge per special has risen 60% in this period, and because pharmacies are increasingly reluctant to mix drugs themselves due to safety fears.

In an attempt to control costs, the DoH is now working with the Pharmaceutical Services Negotiating Committee (PSNC) to amend national reimbursement arrangements.

A PSNC spokesman said that the committee expected that the new arrangements would begin ‘within the next few months'.

If the deal brings the cost of each special down to 2007 levels, it would save the NHS £107m a year.

PCTs are also attempting to control spending by reducing prescribing of specials. Data obtained by GP show trusts estimate that savings of at least 50% could be achieved, worth £81m UK-wide.

PCTs are asking pharmacists to query specials prescribing with GPs and arranging to visit GPs to discuss individual practices' prescribing patterns.

GPC negotiator Dr Chaand Nagpaul said GPs would welcome any measure to reduce the unit cost of drugs and free funds for other services.

Dr Nagpaul said controlling spending on special drugs would be preferable to PCTs placing undue pressure on GPs to cut prescribing.

‘There should not be inappropriate pressure on GPs to deny patients the product they need,' he said.

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