Hospital Pharmacist
Vol 10 No 1 p12
January 2003

Review of circulars and official publications
by Alex Bower, MRPharmS

The document, "Pharmaceutical industry competitiveness and performance indicators 2002" was published by the Department of Health (DoH) on 18 November 2002. A joint DoH/industry task force was first set up in 2000 to look at ways of ensuring that the United Kingdom remains an attractive location for research and development by the pharmaceutical industry. The indicators are produced as a monitoring tool, and the latest set indicate that:

• The pharmaceutical industry continues to make an important contribution to the UK economy as a whole, and especially to its balance of trade

• The basic scientific research infrastructure in the UK remains strong

• The medicines regulation process is relatively rapid (although the United States has a faster process)

• The UK's record on pharmaceutical innovation remains comparatively strong, but cannot be taken for granted

• The uptake of new medicines remains slow in the UK compared with other countries

The report indicates that the UK spends comparatively little on new medicines compared with other countries considered, with the exception of Japan. The overall picture is one where the prescribing of medicines is subject to a wider range of influences in the UK than in other comparator countries, apart from New Zealand.

The report does not indicate what policy changes, if any, will be implemented as a result of the report. On the basis of remaining competitive, however, it might be conjectured that it could herald a drive for a faster uptake of new products and a relaxation of some current control mechanisms. Hospital pharmacists might wish to debate whether this would be a good or bad thing. The document is available here

The Medicines Control Agency issued "Consultation letter MLX 288; Advertising of medicines to the public: proposed amendments to the medicines (advertising) regulations 1994" on its website on 4 November 2002. It is proposed to remove the UK-specific controls for diseases for which advertisements to the public are prohibited. The first UK regulations on advertising medicines to the public were introduced in 1978.

The proposed change is made in the light of the trend towards a patient-centred health service in which patients can receive information about medicines they purchase over the counter. This empowers patients to manage their own conditions where it is safe to do so.

The proposals relate to a small list of pharmacy or general sale list medicines with indications in the licence for which the product cannot be advertised to the public. Examples are aspirin 75mg for secondary prevention of heart attack or stroke, and products containing calcium and vitamin D for patients with osteoporosis. Products such as theophylline and aminophylline for asthma, nitrates for angina, and ispaghula and fish oils for hyperlipidaemia, would need careful consideration to ensure that patients are referred for medical investigation rather than being encouraged to self-medicate. Comments are invited by 27 January 2003.

"Developing services for carers and families of people with mental illness" was issued by the DoH on 8 November 2002. This document aims to help local mental health services develop support services for carers of people with mental health problems.

The document does not specifically mention hospital pharmacy, but section 5.2 notes that carers highlight the need for information about medication and side effects as a key issue. The report notes that information packs for carers can be helpful. Hospital pharmacist colleagues working in the mental health field may wish to contact relevant people locally to identify how information about medication can best be provided. This might result in a significant piece of work, which would need to be appropriately resourced.

The Medicines Control Agency and the Medical Devices Agency are to be merged from April 2003 to form the Medicines and Healthcare Products Regulatory Agency (MHRA). It is proposed that the new agency operates on a trading basis. A consultation document entitled "Medicines and Healthcare Products Regulatory Agency trading fund" is available here. Comments are invited by 15 January.

"Supplementary prescribing" appeared recently on the DoH website. The aim is to train up to 1,000 pharmacists and several thousand nurse prescribers by the end of 2004. An outline curriculum for training is available on the Royal Pharmaceutical Society's website. It can be expected that this initiative will involve hospital pharmacists either as trainers or as early supplementary prescribers.

The following circulars have been issued recently by the Scottish Office:

HDL(2002)73, entitled "Local health plans: revised guidance", was issued on 8 October. The document sets out the purpose, content and process for producing local health plans (LHPs). The time scale for LHPs is to be three years with a planning "window" from September to February. Hospital pharmacy managers will wish to ensure that they make a contribution to this process.

HDL(2002)74, entitled "Coronary heart disease and stroke", was issued on 3 October. This sets out an implementation plan. LHPs should already have included provision for local managed clinical networks (MCNs) for cardiac services and stroke. Specific coronary heart disease (CHD) and stroke prevention strategies should be developed by the MCNs before December 2004. Hospital pharmacy managers will no doubt wish to consider the implications for pharmaceutical services.

"Promoting the development of managed clinical networks in NHS Scotland" was issued on 18 September 2002. MCNs will have an important influence on the way services are provided in the future. Hospital pharmacy managers will wish to ensure that relevant MCNs are made aware of the potential contribution from pharmacy services. An appendix gives contact details for neurology, with particular reference to stroke, vascular services, cleft lip and palate, CHD, stroke, diabetes, palliative care, epilepsy, and multiple sclerosis.

  * PDF files on PJ Online require Acrobat Reader 4 or later.

Mr Bower is a consultant pharmacist