GPs warned over off-label drug use to save money

The GPC has warned GPs against prescribing more off-label or unlicensed medicines to save money, following an update to GMC guidance.

Mr Dickson: ‘It is vital that our guidance on prescribing and managing medicines is up to date and relevant for doctors working today’
Mr Dickson: ‘It is vital that our guidance on prescribing and managing medicines is up to date and relevant for doctors working today’

Draft GMC guidance supports GPs to prescribe off-label or unlicensed drugs if no appropriate licensed drug is available or they are satisfied it is as safe and effective as the licensed alternative.

The advice, now out for consultation, says GPs must also possess adequate insurance or indemnity cover to do so.

The GMC said GPs could now take cost into account when prescribing an off-label alternative to a licensed medicine.

Niall Dickson, chief executive of the GMC, said: ‘Between 1995 and 2009 the number of drugs prescribed by GPs tripled. It is vital that our guidance on prescribing and managing medicines is up to date and relevant for doctors working today.’

Dr Bill Beeby, chairman of the GPC prescribing subcommittee, warned that although using some drugs off-label may be cheaper and as effective as licensed drugs, GMC rules provided no extra protection for GPs against liability claims.

‘GPs shouldn’t be changing prescribing [habits] to be hunting around for cheap off-label alternatives to save money,’ he said.

Dr Beeby said GPs should still be ‘very cautious’ about the using medicines off-label.

GPC negotiator Dr Chaand Nagpaul said: ‘Doctors still remain clinically accountable and responsible for prescribing a drug. This is no relaxation on clinical responsibility, just clarification.’

The guidance comes a week after the release of new QOF indicators that will pay GPs to conduct a review of prescribing and produce their own practice targets for improvement.

The GMC consultation also reiterates that doctors should avoid prescribing for themselves and their families, and that controlled drugs should only be prescribed in an emergency, when lives or health are at serious risk.

The GMC consultation will run from 6 April until 27 May.

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