Some supplements, travel vaccinations, the painkiller fentanyl and gluten-free foods are among the items that may no longer be available on the NHS due to a major savings initiative.
With the publication of the NHS Delivery Plan on Friday 31 March, NHS England is leading a review of ‘low value’ prescription items and developing new guidance for CCGs, with a view to making potential savings of up to £400 million per year.
The review focuses on prescriptions that may be considered to have "relatively low clinical value or priority" or are readily available over the counter – sometimes at lower cost than the NHS pays for these items.
A first consultation focuses on 10 items, including Fentanyl (predicted saving: £10.13 million), travel vaccines (£9.47 million) and gluten-free foods (£21.88 million).
A second consultation will then review a wider range of items, including pain relief, hayfever, indigestion and suncream. Combined, the two groups of items could produce savings of around £400 million a year.
NHS England chief executive Simon Stevens said in an interview with the Daily Mail: “There’s £114 million being spent on medicine for upset tummies, haemorrhoids, travel sickness, indigestion, [and] that’s before you get to the £22 million-plus on gluten-free that you can also now get at Morrisons, Lidl or Tescos.
“Part of what we are trying to do is make sure that we make enough headroom to spend money on innovative new drugs by not wasting it on these kind of items.”
John Smith, PAGB chief executive, commented that many people could be more likely to visit the pharmacy for OTC remedies if they understood the cost of medicines to the NHS, and argued that appropriate prescribing in certain circumstances and based on sound clinical judgement does have a place.
“We understand the financial pressures the NHS is facing and the need therefore to ensure that the medicines bill is used as efficiently as possible. This is an important debate, but one which needs to be had in a much wider context.
“We believe that the priority should be on identifying and implementing opportunities to empower more people to appropriately self care for self treatable conditions. This would help to reduce the number of unnecessary GP consultations and A&E visits each year for ailments that people could treat at home, or with advice from a pharmacist, using an over-the-counter (OTC) medicine.
“PAGB recently conducted research with 5,000 UK adults, which found that 80 per cent of people would be more likely to seek advice from pharmacists and use OTC remedies for coughs, colds and other self-treatable conditions, if they understood the cost of these medicines to the NHS.”
“However, some medicines that are available OTC to manage self-treatable conditions are also prescribed for the treatment of long-term or more serious illnesses, or, in the case of nicotine replacement therapy, to prevent illness, disability and NHS costs in the future. Therefore, healthcare professionals should be able to continue to use their clinical judgement on appropriate prescribing in these circumstances. In addition, any change in prescribing policy may have a disproportionate effect on vulnerable groups.
“PAGB believes, therefore, that while the review of prescriptions for medicines available to purchase OTC is appropriate; it is important that NHS England does not simply opt for a one-size fits all solution.”