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GPC slams PCTs over drug switching payments

PCT schemes to reward generic statin prescribing have been criticised by the GPC for encouraging GPs to ignore QOF cholesterol targets.

Derbyshire PCT has the highest generic statin prescribing rates of any PCT in the country and has introduced a local agreement to reimburse GPs who miss their QOF cholesterol goals. GPs only receive payments if patients are on simvastatin.

Nottinghamshire PCT has a scheme where GPs are able to exception report patients on simvastatin if QOF cholesterol levels are not achieved.

John Ashcroft, a GP and secretary of Derbyshire LMC, supports the scheme in Derbyshire and said the problem was with national cholesterol targets. ‘The QOF isn't that evidence based,' he said. ‘Chasing targets for individuals, without reference to their individual risk, or the cost effectiveness, results in over treatment, waste of resources, and ultimately kills more people than it saves.'

But Dr Bill Beeby, chair of the GPC prescribing subcommittee, said he has ‘great misgivings' about the schemes. ‘Cholesterol targets are there for a reason and since all of the cholesterol targets are for secondary prevention in QOF, the evidence for them is strong. A target is a target, no matter how much it costs,' he said.

The Department of Health said all PCTs were able to develop local incentive schemes in addition to QOF, with local agreement. ‘It is for the PCT to explain and defend any such scheme,' said the spokesperson.

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