APPENDIX 9
Letter from the Head, NHS GPs Division,
British Medical Association (GD 12)
Thank you for seeking our views on the above
issue.
In the interests of effective prescribing, as
long as the general practitioner considers that the generic product
is best for the patient, the BMA's General Practitioners Committee
supports generic prescribing. A GP must be able to ensure that
a specific proprietary preparation will be supplied for a particular
patient if necessary. Our comments follow:
— The GPC is concerned about the rising
prescribing costs in general practice due to the unexpected price
increase in category D drugs. Category D lists those drugs for
which there is a problem of availability at the lowest price.
Endorsement of the manufacturer/supplier and pack size is needed.
In the absence of such an endorsement, payment will default to
the lowest price as listed. Broken bulk may be claimed if necessary.
— By definition, all drugs in the category
D of the drug tariff are in short supply. The category D item
list has greatly increased. Previously, there were only a few
drugs in this category, however, there are now approximately 190.
— There must be adequate reassurance
on the bio-availability, quality control and product liability
of the substituted product should a GP prescribe generically.
— Prescribing costs are expected to
increase substantially over the next year. The medical profession
needs assurance as to the availability of funding to meet these
costs, and that patient services will not be affected in any way.
— Transferring category A drugs to
the D list causes delays with the Prescription Pricing Authority's
pricing and information service. This causes particular difficulties
for Primary Care Groups which require this information in order
to set their budgets. In addition, virtually all drug budgets
will be overspent because of the supply and cost of generic drugs
which will cause severe problems for PCGs.
— As a result of the continuing increase
of items included in category D of the drug tariff part VIII,
the Prescription Pricing Authority (PPA) is experiencing significant
delays with its prescription processing operation. Essentially,
the PPA now has to deal with more prescriptions manually which
is slowing down the system, thereby delaying payments to GPs.
— Generic drugs are often common remedies.
Therefore shortages cause great difficulty for the medical profession.
We are aware of shortage problems of quite commonly used drugs
such as aspirin, ibuprofen, warfarin etc.
— We understand that if there is a
shortage of a generic drug listed in the drug tariff the pharmacist
supplies the more expensive branded form. The pharmacist is able
to request an increase over drug tariff costs, but the doctor's
budget can only be credited with the drug tariff cost. The more
expensive cost of the branded drug can be charged against the
GP's drug budget.
1 November 1999
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