Prescribing scheme set for judicial review

The Association of the British Pharmaceutical Industry (ABPI) has won a judicial review over a government scheme that pays GPs to switch patients to generic drugs.

The ABPI believes it is illegal under European law for doctors to be paid to prescribe certain drugs, but is not questioning the switching programme itself. 

"We have sought a judicial review on the question of doctors being paid for switching to generic drugs. We are not against the switching programme itself although we have got concerns that patient welfare should come first rather  than money, although we do understand the NHS needs value for money," says Richard Ley, head of media relations at the ABPI.

The ABPI says it is also concerned that no central guidance is available to ensure switches are not being made without proper regard to the welfare of individual patients. The Department of Health (DoH) says it "will rigorously defend this legal challenge from the ABPI".

It asserts that the NHS could potentially save GBP 84m (USD 170.8m) if it switched to low cost generic statins, which are safe, of good quality and just as effective, and used to treat many millions of patients worldwide.

"The purpose of the legal provisions now contested by the ABPI is to control commercial activities not the work of public health organisations," the DoH stated.

"We are talking here about achieving best value for money for the taxpayer and are backed by authoritative guidance from NICE. Cost-effective prescribing releases resources for more patients to receive treatment," it concluded.

The ABPI is now waiting for a court date for the judicial review, but does not expect one much before the end of the year.

"The guidance recently issued by the DH contains many provisions to safeguard the patient, but fails to go far enough.  For example, guidance should require patients to give informed consent to a switch rather than leave them to object if they wish to do so," asserts the ABPI. A number of GPs are said to be uncomfortable with the new guidance from the DoH.

Dr Laurence Buckman, Acting Chairman of the BMA's GP Committee said: "Family doctors feel there is a conflict of interest in a scheme that offers financial inducements to prescribe patients cheaper, generic medication. The BMA would be pleased if primary care organisations did not have pressure brought on them to save money in this way. Prescribing decisions should be made on the basis of what a doctor thinks is the most clinically effective drug for their patient. In some cases this may not be the generic."

The guidance does not address the legal issue of payments to induce doctors to switch their prescribing from one specific medicine to another, named medicine, claims the ABPI. As this needs to be clarified, they sought, and won permission for, a judicial review.

"However, the ABPI has made it clear to the DH that it is available for further discussions at any time in order to avoid the need for the case to go before the courts," concluded the industry body.