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HEALTH

National Institute for Clinical Excellence

Mr. Burstow: To ask the Secretary of State for Health if all NICE appraisal determinations on health technologies are submitted to him for final approval prior to their dissemination to the NHS. [146388]

Mr. Denham [holding answer 22 January 2001]: The National Institute for Clinical Excellence (NICE) issues its appraisal guidance directly to the National Health Service and is solely responsible for the content of the appraisal determination on which it is based. In accordance with its directions, the dissemination of the final guidance is subject to the approval of my right hon. Friend the Secretary of State. The Department, in common with other consultees, has the opportunity to comment on the content of the draft guidance before the final guidance is drawn up by NICE.

Prescription Drug Prices

Mr. Cohen: To ask the Secretary of State for Health what the level of change in the price of drugs prescribed generically by the NHS was during 2000; if he will list the 10 drugs which have shown the highest rate of increase and what that rate has been in each case. [146453]

Mr. Denham: The prices paid by the National Health Service for the main medicines prescribed and available generically fell by around 30 per cent. overall in 2000, with most of the falls occurring in anticipation of and in response to the introduction of our maximum price scheme for generics in July 2000. This represents an estimated saving to the National Health Service in 2000 of some £170-£180 million compared to prices in January 2000.

The table lists the 10 presentations of the main medicines prescribed and available generically which recorded the highest price increases in 2000. The cost of the increases is taken into account in the estimated savings figure for 2000 and had a marginal effect on it.

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Percentage

Name of presentation Increase in price
Digoxin--Tab 62.5mcg (28-pack)73
Loperamide HCl--Cap 2mg (30-pack)46
Aspirin--Tab E/300mg (100-pack)40
Co-Codamol Eff--Tab 8mg/500mg (100-pack)39
Digoxin--Tab 125mcg (28-pack)29
Digoxin--Tab 250mcg (28-pack)29
Paracetamol--Tab 500mg (100-pack)22
Lorazepam--Tab 2.5mg (100-pack)19
Clomipramine HCl--Cap 10mg (28-pack)15
Dothiepin HCI Cap 25 mg (28-pack)13

Notes:

The main medicines prescribed and available generically, on which the price index is based and from which the data on increases is taken, are defined as the generic preparations subject to the Government price control measures introduced in July 2000 and any other preparations in the top 200 generic medicines in terms of net ingredient cost in the first six months of 2000, the latest period for which comprehensive information is available. Together they represent around 90 per cent. of total net ingredient cost of medicines prescribed and available generically. The price index is based on the average unit Drug Tariff price of each preparation weighted according to quantities (includes estimates for months for which actual data are not yet available) dispensed in 2000-01.


Internet Adoption

Mr. Llwyd: To ask the Secretary of State for Health if he will list the statutory provisions which apply to (a) the adoption of children through the internet and (b) adoption agencies' use of the internet. [146602]

Mr. Hutton: Only councils and approved voluntary adoption agencies may advertise (on the internet and elsewhere) children for the purposes of adoption. Anyone else who does this is committing an offence under section 58(1) of the Adoption Act 1976.

Section 58(1) of the Adoption Act 1976 provides that it is unlawful for any advertisement to be published indicating:




Making arrangements for the adoption of a child is defined in section 72(3) of the Adoption Act 1976 as amended by section 13 of Adoption (Intercountry Aspects) Act 1999.

Section 58(2) provides that any person who causes to be published or knowingly publishes an advertisement in contravention of section 58(1) is guilty of an offence and liable on summary conviction to a fine not exceeding level 5 on the standard scale. The law applies equally to the internet as it does to any other medium.

I wrote to the United Kingdom Internet Service Providers Association on 19 January, informing them that if they become aware of any material on one of their Internet Service Providers advertising children for adoption that is not run by a local authority or approved adoption agency, they must remove it. If they failed to do so then they will be committing an offence and may face prosecution.

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Beta Interferon

Mr. Chope: To ask the Secretary of State for Health what action the Government are taking in response to the views of the beta interferon appeal panel on selecting patients for treatment with beta interferon. [147036]

Mr. Denham: The panel was set up to examine specific procedural points relating to the determination of the Appraisal Committee on beta interferon. The National Institute for Clinical Excellence (NICE) asked the Appraisal Committee to reconsider the matters in the light of the appeal panel's decision.

NICE has now extended the timescale for its appraisal of both beta interferon and glatiramer acetate to enable further research to be undertaken on their cost effectiveness. NICE will review the outcome of the new modelling in the summer and unless there are further appeals would expect to issue its guidance by this November.

Haemophilia

Dr. Naysmith: To ask the Secretary of State for Health what plans he has to provide genetically engineered recombinant treatment products in place of blood products for people with haemophilia in the United Kingdom. [147042]

Mr. Denham: We have already instructed National Health Service trusts to provide recombinant clotting factors to new haemophilia patients and those under age 16. We have recently met representatives from the Haemophilia Society, the United Kingdom Haemophilia Doctors Association and the Royal College of Nursing Haemophilia Nurses Association to discuss the case for extending this provision to all haemophilia patients in England, and are giving careful consideration to the points they made.

Dr. Naysmith: To ask the Secretary of State for Health if he will hold a public inquiry into the infection of people with haemophilia, HIV and hepatitis through contaminated blood products; and if he will make a statement. [147041]

Mr. Denham: The technology to make blood products free from HIV and hepatitis C in sufficient quantities to treat all haemophilia patients in the United Kingdom was not available until the mid 1980s. Once it was, the National Health Service introduced it. All this information is in the public domain and we do not believe that anyone's interest would be best served by a public inquiry.

Mr. Pollard: To ask the Secretary of State for Health if he will make it his policy to enable adults with haemophilia to be offered treatment with genetically engineered recombinant and to establish a no-fault compensation scheme for people with haemophilia who have been infected with hepatitis. [147265]

Mr. Denham: We have already instructed National Health Service trusts to provide recombinant clotting factors to new haemophilia patients and those under age 16. We have recently met representatives from the Haemophilia Society, the United Kingdom Haemophilia Doctors Association and the Haemophilia Nurses

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Association to discuss the case for extending this provision to all haemophilia patients in England, and are giving careful consideration to the points they made.

We have reviewed the previous Government's decision not to offer financial assistance to haemophilia patients infected with hepatitis C through blood products. We concluded that an exception could not be made to the general rule that compensation or financial help is only given when the NHS, or individuals working in it, have been at fault.

Fluoride

Mr. Baker: To ask the Secretary of State for Health what assessment he has made of the relative benefits to dental health of (a) calcium fluoride and (b) sodium fluoride. [147258]

Mr. Denham: The use of sodium salts to deliver fluoride to benefit dental health is more appropriate than the use of calcium salts.

Mr. Baker: To ask the Secretary of State for Health what assessment his Department has made of the report into the safety and efficacy of fluoride in drinking water carried out by the National Health Service Centre for Reviews and Dissemination at the University of York; and what plans he has to establish a public inquiry into the issue. [147259]

Mr. Denham: We accept the findings of the York report that more high-quality research is required and have asked the Medical Research Council to consider how the research base may be strengthened. We do not consider that a public inquiry would be appropriate.


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