NPA response to consultation on restricting prescribing of OTC medicines

29 Mar 2018

The NPA said it was regrettable that doctors are now being prevented from prescribing some ‘low value’ treatments and medicines that are available over the counter at pharmacies.

The comments come as NHS England today published new guidance entitled ‘conditions for which over the counter items should not routinely be prescribed in primary care: A consultation on guidance for CCGs.’

The NPA said that while it is right the NHS should examine access to treatments, in the light of tight budgets, the measures could mean that society’s most disadvantaged no longer have access to certain treatments.

Helga Mangion, NPA policy manager, said: “Some of the treatments on this list might only cost a couple of pounds privately, but for our poorest that’s a couple of pounds they cannot afford.

“It establishes the worrying principle that it is fair for the NHS to remove a treatment that could be given to our most needy for free, just because that treatment is available privately.

“The reality is doctors will not prescribe an item that is available over the counter for a lower cost, unless there is a clinical need, and this guidance merely exacerbates the UK’s growing health inequalities.”

During the consultation, the NPA argued that there would have been far greater efficiencies to be had by helping people with long term conditions make optimal use of medicines, with support from a local pharmacist.

Helga said: “Research has shown that the community pharmacy new medicine service (NMS) increases medicine adherence by 10 per cent, compared with normal practice.

“It is estimated that the NMS offers the NHS short-term savings of £75.4 million and long-term savings of more than half a billion pounds and it should be extended into other therapeutic areas where there is significantly suboptimal medicines use.

“Furthermore, medicines use reviews should be developed into full clinical reviews in community pharmacies, including ongoing monitoring and follow-up of patients.

The NPA also said that it recognised the need to ease GP pressure, cited as a driver for the new guidance, but said a minor ailments scheme, delivered by community pharmacy, would serve patients and GPs better.

Helga said: “Minor ailments schemes allow people to get what are usually prescription-only medicines from pharmacies for self limiting conditions without the need for a prescription.

“Data collected from nearly two million patient consultations in local schemes showed that 84.3% of patients would have gone to their GP if the scheme was not available.

“In 95.8% of consultations no onward referral to other NHS providers was necessary.”

To read the new guidance in full visit https://www.england.nhs.uk/wp-content/uploads/2018/03/otc-guidance-for-ccgs.pdf