Points to cut prescribing are 'immoral'

Concerns have been raised about primary care organisation adopting the quality framework as a template for local prescribing initiatives.

Cambridgeshire PCT is offering the equivalent of 34 quality points to practices using generic versions of drugs such as statins.

An average practice can earn up to £4,250 if GPs prescribe certain drugs for hypertension, osteoporosis, diabetes, pain relief and allergy.

A spokeswoman for Cambridgeshire PCT said: 'The PCT is not offering an extra 34 points as part of the quality framework scheme.

'However, we have introduced a local incentive scheme - as has been the case in previous years - which incorporates points in a similar way to the quality framework.'

Likewise, Wandsworth PCT in south-west London offers GPs a ‘platinum points' scheme, a local addition to the framework.

Just as in the quality framework, each point is worth £124.60 for a practice list size of 5,861.

Up to eight points can be earned if 70 per cent of statin scrips are for simvastatin, with a sliding scale in place when between 50 and 70 per cent of statin scrips are for the drug.

Dr Peter Fellows, chairman of the GPC prescribing sub-committee, said such schemes were 'immoral'.

'This is a pure cost-saving trick and I don't approve. PCTs are going over the top and are leaning on GPs to use simvastatin.'

If pressure from consultants to reduce total cholesterol targets in the quality framework from 5mmol/l to 4mmol/l is successful, these goals are unlikely to be achieved on a generic statin, added Dr Fellows.

GPC deputy chairman Dr Laurence Buckman said GP practices could adopt whatever local incentive schemes they think appropriate, but disagreed with PCTs linking these incentive schemes to the framework.

'They're nothing to do with the quality framework.

'PCTs calling them this is misleading and inaccurate.'

A spokesman for the Association of the British Pharmaceutical Industry said: ‘It is responsible for the NHS to use cheaper, older generic medicines where appropriate, provided that individual patient need is borne in mind.'

However, he added: 'Doctors should feel able to use newer and more expensive drugs where clinically necessary.'


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