Politics - Cheap is best

Pharmaceutical industry to take Government to court over 'unsafe' drug switching schemes
(PULSE)

The pharmaceutical industry is to mount a legal challenge in an attempt to prevent the proliferation of NHS schemes to switch patients to cheaper medication, Pulse has learned.

Lawyers for the Association of the British Pharmaceutical Industry (ABPI) have been granted a judicial review of drug switching, and will argue patients are being put at risk and GPs illegally paid to participate.

The Department of Health has responded to legal moves from the industry by issuing urgent guidance to primary care trusts on how to operate schemes safely, insisting patients must be individually assessed and warning against inappropriate payments to GPs for switching patients to cheaper drugs en masse.

But the ABPI told Pulse the guidance did not go far enough and that patients must give explicit consent before being moved to cheaper alternatives.

In a statement the ABPI said: 'For some time we have had serious concerns about a number of initiatives at primary care organisation level, especially those that provide incentives for switching large numbers of patients to alternative treatments with the sole aim of reducing costs and with inadequate patient safeguards.'

News of its legal action comes as Pulse has discovered that PCTs across the country are extending mass switching beyond statins to ACE inhibitors, proton pump inhibitors and anti-platelets.

Dr Peter Fellows, chair of the GPC prescribing sub-committee, told Pulse: 'Doing all this for very small short-term financial gains is really ridiculous. I will fight to the death to defend doctors' right to prescribe what they think is most clinically effective.'

The ABPI said payments to doctors as a direct financial inducement to prescribe certain medicines in substitution for other named medicines were illegal under European law.

The Department of Health confirmed it was aware of the legal action but that the drug regulator did not accept the accusations.

Jo Haynes, editor of Pulse, said: 'GPs recognise the need to be prudent with NHS cash, but they do object when drug switching schemes are implemented too quickly and without sufficient support.'

That said, the idea that GPs are somehow being bribed to take part in these schemes is offensive and far from the truth, which is that most doctors are failing to get the financial resources they need to carry out switch schemes as thoroughly as they would like.'

For further information, contact:

Richard Hoey, deputy editor of Pulse and go to the Features and Politics Indexes on this web-site for a list of articles on "Counterfeit" drugs

Editorial comment
This appalling government is so bankrupt that it has come to believe that the cheapest drugs are the best no matter what the effect is on patients. Successive Health Secretaries have failed to understand that the tool which GPs use to heal patients are pharmaceuticals. In much the same way as surgical instruments and theatres are the tools of surgeons. They would not skrimp on instruments or theatres but, illogically they carp, complain, cajole, threaten and even bribe GPs to use the cheapest drugs.

With cheapness, as the ABPI says, comes danger. The danger relates to the manufacture of the drugs, especially "generics" which may originate from some unknown backwoods shed in a little known part of the Globe and may be made from poor quality materials. The packaging may be glossy and deceiving.

On the other hand, the packet may be a complete counterfeit. The more of the drug used, the more likely to be counterfeit and profitably counterfeit. Such drugs are the statins and the "life-style" drugs. The counterfeiting of drugs is a multi-billion pound international industry and such drugs are often undetectable.

Both deficient quality drugs and counterfeits can harm or kill - or, simply, not work.

The Secretary of State should be more conscious of the health-line rather than the bottom line. Patients do count.

David Roberts - Ed.

(5/7/07)