Lack of funds is not why doctors are slow to prescribe newer medicines
A lack of central funding is not the reason why doctors in the United Kingdom are more reluctant to prescribe recently launched medicines, according to research carried out for a group representing American pharmaceutical companies with subsidiaries in the UK.
The Office of Health Economics (OHE), which is financed by the pharmaceutical
industry, was asked by the American Pharmaceutical Group to look at why
the uptake of new medicines in the UK five years after launch is only
62 per cent of the average in 12 other developed countries.
The OHE looked at what is supposed to happen to additional resources
allocated to the National Health Service in England, which it says is “difficult
for an outside observer to plot in detail”, and then asked prescribing
leads at primary care trusts what they thought happens in practice.
Published research shows that general practitioners in the UK are reluctant
to change their prescribing habits, even when clinical trial evidence
suggests that they should. This restraint is reinforced by GPs’ partners
and peers but counteracted in part by the advice of hospital consultants
and pharmaceutical company representatives, the OHE says.
PCT prescribing leads reported that the greatest influence on prescribing,
and thus whether new medicines are used, is exerted by central Government
and the Department of Health. In early 2003, prescribing leads said that
even with increased NHS funding they still had insufficient resources
to permit investment in local initiatives. All available funds are being
used to meet guidance such as national service frameworks and that issued
by the National Institute for Clinical Excellence. Quality standards
proposed for the new GP contract are expected to exacerbate this trend.
The main reason given for this is that the performance of PCTs is measured
by how well they meet these centrally set targets.
Clive Jackson, chief executive of the National Prescribing Centre, told
The Journal: “While British GPs tend to be conservative in their
prescribing, there are examples of rapid uptake of products where there
is good evidence, backed by official guidance, at the time of launch.” He
agreed that NSFs and NICE guidance have a big influence on prescribing
but added that NSFs had been developed with professional input to show
where value-for-money changes could be made in high priority areas.
“The pharmaceutical industry has an important role in developing
new drugs,” Mr
Jackson said. “But their introduction has to be handled in a controlled
and managed manner.”
The OHE report recommends that PCTs should be required to ring-fence
some funds for new medicines and other health technologies (such as diagnostic
tests and information technology) and to state in their annual reports
how much money they are spending on new technologies. It adds that the
new GP contract could be used to speed the introduction of new technology
rather than stifling it. |
