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Letters to the Editor
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Medicines use reviews
Money paid for level 2 MURs is not wasted
From Mr N. S. Bashford, MRPharmS
Over the past few weeks several articles have referred to the cost effectiveness
of medicines use reviews.
The
White Paper now proposes auditing their quality, with rewards for health
outcomes achieved, and the threat of withdrawal of service from pharmacies
that consistently fail to meet the agreed standards (PJ, 12 April
2008, p429).
Over the first three years of the new contract we were reminded that an MUR
was not a full clinical review (level 3 MUR), but was to be treated as a medicine “MOT”,
a service to ensure that the medicines that we were dispensing were being taken
as intended, used correctly and to identify any prescribing issues.
In some cases the outcome was “none” and the annual MUR for the
same patient was “none”; this should be irrelevant. There does
not have to be an outcome. Neither does there have to be a saving or a reduction
in morbidity as a result of a (level 2) MUR.
There has been a huge saving by the NHS over the past three years, since pharmacy
has been unable to meet the allocated quota. We have only just achieved our
240 MURs this past year after three years of increasing steadily, which is
still considerably more than an average pharmacy.
Primary care trusts are having to pay more each year because the number of
MURs are steadily rising. PCTs even have, within their annual budget forecast,
a proposed “saving” from pharmacy MURs not carried out.
It is understandable that they would want to restrict quantity and pay for
quality. Money paid for level 2 MURs is not wasted. It was originally our money
paid back differently to encourage professional pharmaceutical clinical services.
It should not be up for renegotiation or withdrawal if the above are not achieved.
Syd Bashford
Scarborough |
The
Pharmaceutical Journal