The NHS cut down on prescriptions deemed to have low clinical value

[Avenged7Fold]

http://www.bbc.co.uk/news/health-39413915

A number of them are available over-the-counter at a lower price than the cost to the NHS of prescribing them.

The products include omega 3 and fish oils, travel vaccines and gluten-free foods as well as a range of pain relief drugs for which there is said to be limited evidence.

Evidence submitted to NHS England - and seen by the BBC - argues that the prescribing of gluten-free products dates back to the 1960s when there was not the choice there is now in supermarkets and shops.

Cutting back on prescriptions for the 10 products could save the NHS over £100m a year.

'Low value' medicines on the list and their annual cost to the NHS:

• £30.93m on Liothyronine to treat underactive thyroid
• £21.88m on gluten-free foods
• £17.58m on Lidocaine plasters for treating nerve-related pain
• £10.51m on Tadalafil, an alternative to Viagra
• £10.13m on Fentanyl, a drug to treat pain in terminally ill patients
• £8.32m on the painkiller Co-proxamol
• £9.47m on travel vaccines
• £7.12m on Doxazosin, a drug for high blood pressure
• £6.43m on rubs and ointments
• £5.65m on omega 3 and fish oils

NHS Clinical Commissioners has also highlighted other products which it also wants reviewed.

This includes suncream, cough and cold remedies and indigestion and heartburn medicines, which could bring the saving to £400m a year.

NHS Clinical Commissioners chief executive Julie Wood said

Costs are climbing and we need to trim the fat. This is a good move imo but done at a time where the attitude toward the NHS is poor.

Doxazosin will likely be replaced by an effective drug and Fentanyl i assume will be replaced by a cheaper alternative.

I am for all taking away the sort of prescriptions that are deemed top have low clinical value or are easily obtainable for cheaper than the cost to the NHS.

Now most of that list i would deem as fine to cut.Gluten free foods are definitely much easier to obtain and for a reasonable price, although i think a food grant for lower income ceoliac sufferers is a more appropriate solution than a prescription.

What do you think GD?

 

[adolf hamster]

if it's all stuff that either doesnt work or you can get elsewhere it makes sense.

if anything its strange that common over the counter medicines are given away anyway.

 

[Avenged7Fold]

if it's all stuff that either doesnt work or you can get elsewhere it makes sense.

if anything its strange that common over the counter medicines are given away anyway.

Yup, especially since the big NHS contracts end up costing them more than you!

 

[adolf hamster]

Yup, especially since the big NHS contracts end up costing them more than you!

tbf though that's also an issue, the whole point of a massive contract buyer is you get bargaining power, unless your the nhs it seems.

 

[Clarkson]

Suncream, cough/cold remedies, indegestion and heartburn medicines? Cretins actually milk the NHS for this stuff? Bet they're the same people who don't want to pay 20p for a pack of paracetemol.

 

[antijoke]

Long overdue shakeup that has been needed for a while to be honest!

Luckily my GP is a pretty good one, and when I've been they've always told me if it was cheaper for me to just pick up medicine from Boots for example rather than pay for a prescription.

 

[Avenged7Fold]

You would think that with easy to produce 'cheap' medicine like some of those listed, it is pretty easy to have companies compete for your contract. I cant help but feel there is some level in foul play on the business side of things when it comes to medicine contracts (obviously not at the same level as America).

They are also cracking down on handing out antibiotic treatments for everything as well from what i have heard.

I was so surprised that sun-cream was available on prescription. Granted some people require it more than others and luckily i could never get burned in this country but i cant help but feel that something like sun-cream (which is expensive!) shouldn't be offered free.

To add to my statement earlier that if people had low income and ceoliac disease and as a result required things like gluten free food, they should instead get a grant: giving one price gouging company a monopoly on NHS contracts hardly encourages gluten free food companies to compete for their regular customers if some can get it free elsewhere...

 

[antijoke]

You would think that with easy to produce 'cheap' medicine like some of those listed, it is pretty easy to have companies compete for your contract. I cant help but feel there is some level in foul play on the business side of things when it comes to medicine contracts (obviously not at the same level as America).

They are also cracking down on handing out antibiotic treatments for everything as well from what i have heard.

Indeed! How the NHS get stitched up so much is crazy.

From what I remember I think the antibiotics being limited is because they think the thinks it stops will eventually (I think 20+ years) be immune to it, saw it on the news a few weeks back.

 

[booyaka]

THE NHS spent £87.6million last year on paracetamol tablets which can be bought 20 times cheaper in the supermarket. Doctors wrote 22.9million prescriptions for the painkiller at an average cost of £3.83. But a packet of 16 tablets from Asda costs19p.

Also a friend of mine and his wife get gluten free bread/rolls on prescription!!! They both work - earn around £50k between them but get bread and rolls on prescription as one of them has a gluten allergy.......I mean seriously how many others are milking that - it's a joke and needs to be cracked down on.

And don't forget that prescription in Scotland are free!!

 

[dowie]

Suncream, cough/cold remedies, indegestion and heartburn medicines? Cretins actually milk the NHS for this stuff? Bet they're the same people who don't want to pay 20p for a pack of paracetemol.

Indeed - my friend is a GP and quite regularly has 'women of colour' demand hand cream - not just any old moisturiser but a specific expensive brand, all because some GP once agreed to prescribe it and they get free prescriptions. It isn't like it is for a medical issue, just that dry skin shows up easily when you've got dark skin. They're happy to take up an appointment for this and if refused they'll kick off at her, kick off at a reception then waste another appointment chancing it with another GP.

As for people who have issues with gluten - just don't eat gluten, it isn't hard, most supermarkets even have special sections with substitutes for foods that usually contain gluten if you really really don't want to stop eating those... prescribing people food is a total farce.

Good to see they're starting to crack down on the... maybe they could look at getting rid of homeopathy too.

 

[dowie]

Also a friend of mine and his wife get gluten free bread/rolls on prescription!!! They both work - earn around £50k between them but get bread and rolls on prescription as one of them has a gluten allergy.......I mean seriously how many others are milking that - it's a joke and needs to be cracked down on.

How does that work out if they pay for prescriptions? I can understand unemployed people having an incentive to milk the system but why pay £8.40 for a prescription for bread if he/she could just buy it in the supermarket? It isn't *that* expensive. Unless a single prescription covers several months supply or something?

 

[Avenged7Fold]

As for people who have issues with gluten - just don't eat gluten, it isn't hard, most supermarkets even have special sections with substitutes for foods that usually contain gluten if you really really don't want to stop eating those... prescribing people food is a total farce.

If university students can choose to go gluten free because its a fashionable nutrition trend, then i think its fairly difficult to argue that a gluten free diet is both difficult and expensive. Not wanting to cook is not an excuse either (as used in the gluten free thread a while ago). I do recognise there is rare circumstances where people should get a food grant for medical purposes but getting a 'funny tummy' after carb munching your way through pasta and bread is hardly a good enough reason.

How does that work out if they pay for prescriptions? I can understand unemployed people having an incentive to milk the system but why pay £8.40 for a prescription for bread if he/she could just buy it in the supermarket? It isn't *that* expensive. Unless a single prescription covers several months supply or something?

I believe a person is allocated a number of units depending on age. That person can have x amounts of whatever they pick per week or something.

Edit: https://www.glutafin.co.uk/your-pre...ree-food-am-i-entitled-to-on-my-prescription/

 

[Steeps]

While the savings look great in the headline figures, there are a lot more cutbacks to prescriptions not in that list which manage conditions away from the GP/Specialist. We're seeing a trend where self managing products are no longer prescribed (usually at a cost of ~£200 per year per patient) and instead they have to visit the GP 3x more and another couple of specialist visits, along with a reduction in the quality of the treatment of the condition. More needs to be done to look at the overall treatment of a patient including staffing cost/time and not just the price on the prescription of a product.

Paracetamol is already on the NHS prescribing black list, so GP's are not following their own guidelines!

Better training/use of staff resources should be a priority, one of our staff went on maternity recently and she was sent for hospital scans every 3 weeks because the midwife didn't know how to measure properly, nothing was wrong at all! 3 of her friends also had that midwife and the same experience yet nothing is done about wasting staff resources like that.

The issue with the gluten free food prescriptions is because the guidelines have not been updated since it became a more commonly known problem. GF food was hard to come by and much more expensive (5-6x the cost of regular). Food production companies have seen the demand and now produce food that is available widely in supermarkets but because it is available on prescription, people will continue to get it for free if they can.

 

[ethan]

http://www.bbc.co.uk/news/health-39413915



Costs are climbing and we need to trim the fat. This is a good move imo but done at a time where the attitude toward the NHS is poor.

Doxazosin will likely be replaced by an effective drug and Fentanyl i assume will be replaced by a cheaper alternative.

I am for all taking away the sort of prescriptions that are deemed top have low clinical value or are easily obtainable for cheaper than the cost to the NHS.

Now most of that list i would deem as fine to cut.Gluten free foods are definitely much easier to obtain and for a reasonable price, although i think a food grant for lower income ceoliac sufferers is a more appropriate solution than a prescription.

What do you think GD?

Uh? Co-proxamol is on that list despite it bring discontinued?

 

[hardkore]

My girlfriend takes Liothyronine for her under active thyroid, free on prescription i might add.

Don't know why she gets it for free but can you even get medicine for that over the counter without prescription? The possible effects of not having it are actually pretty dangerous!

Paracetemol yes... stop that obviously along with Gluten stuff and many others but come on!!! Some of those medicines are for pretty serious things!

 

[stoofa]

I take levothyroxine which is a similar product to the one they are listing as a "potential" drug to stop giving. It certainly wouldn't be very good for my health if I was to stop taking it.
One issue is that because I take this drug I get a "medical exception certificate" which means that all of my medication is free and here is the madness. No matter what happens to me, no matter what I am prescribed, I don't pay for any of it.
It would make more sense to have a list of drugs which are to be given free and make the likes of me pay for everything else.
I also take some very expensive anti-rejection drugs (for my kidney transplant). I've never even check to see if these are a free drug to me as the medical exception certificate I have means I simply don't pay for anything I get.

I'm sure savings need to be made, but they shouldn't start toying with removing important medication, they should instead look to get revenue from areas they should be tapping.
I lost sunscreen a couple of years ago. I used to get this on prescription and thus for free. As the recipient of a transplant and the anti-rejection drugs I become a lot more susceptible to cancer and skin cancer is a definite possibility for me. Sunscreen is not cheap and I'm supposed to wear it all year round on any exposed skin. I've been buying it ever since my local authority stopped providing it.
However it would cost the NHS an awful lot more to treat me for cancer should I contract it rather than supplying my with the screen.

 

[Rroff]

I was so surprised that sun-cream was available on prescription. Granted some people require it more than others and luckily i could never get burned in this country but i cant help but feel that something like sun-cream (which is expensive!) shouldn't be offered free.

I don't actually know how it is prescribed on the NHS but personally I burn incredibly easily - but I wouldn't even dream of putting the cost of it on the NHS - I buy a a bottle of Ambre Solaire SPF 50 spray once a year - usually can manage to find it well under a fiver at the right time.

If someone needed say a bottle every week just to live a semblance of a normal life then that would be one thing, anything else and I don't think the NHS should be footing the cost.

However I do think that a basic, but effective, sun cream should be available free or significantly discounted on the NHS for young children as some parents struggling to make ends meet to afford the next iPhone will see it as an unnecessary cost :|

 

[Avenged7Fold]

The business behind Liothyronine in this country is pretty criminal. One company has the license to manufacture and sell it, so prices are insane compared to other countries over in the mainland where T3 can be had for very little by comparison.

I am sure there are alternative treatments available for these people that require it. Surely if Liothyronine is on the list, there is an alternative or a plan for these people.

 

[Avenged7Fold]

However I do think that a basic, but effective, sun cream should be available free or significantly discounted on the NHS for young children as some parents struggling to make ends meet to afford the next iPhone will see it as an unnecessary cost :|

If the sun affected ones quality of life enough, then i imagine normal sun cream wouldn't cut it and they would be prescribed anyway.

I would agree with the free basic one to an extent but simply dont trust parents to not just always go for the basic one as if it is the approved standard and then slather it on rather than get an appropriate strength one for their kid and bite the cost.

My main issue with prescriptions that are relatively available in shops for cheap is that it gives the contracts to big companies who exploit us for the money. Voucher cards for these items if the need is high enough would be better, as a customer can choose between a variety of competing brands eg. people with Ceoliac get £x a week to spend on gluten free foods approved by certain major retailers. The contracts the NHS makes with its suppliers are simply eye watering because of their exclusivity.

 

[VincentHanna]

Who the hell is getting suncream prescribed from a doctor?