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Gold, incentives and meh

GPs are warned off new eczema drugs

GPs have been told not to prescribe new second-line topical treatments for atopic eczema because of concerns over their high cost and long-term safety.

The National Prescribing Centre, which issues prescribing advice on behalf of the Department of Health, has recommended patients should not be treated in primary care with pimecrolimus (Elidel) and that treatment with tacrolimus (Protopic) should be initiated and supervised by a specialist.

It said in its current MeReC Bulletin there was a lack of

trial data to prove the drugs' long-term safety and that they cost at least 10 times more than topical corticosteroids.

But the recommendations have been branded 'shortsighted' by Dr John Adams, a member of the Primary

Care Dermatology Society.

Dr Adams, a GP in Cheadle, Cheshire, said: 'I've prescribed both tacrolimus and pimecrolimus in practice where steroids have proved ineffective. They are the treatment of choice for the face ­ where you can't use potent topical steroids.

'Tacrolimus is one of the few drugs I've used that a patient has said "Thank you, doctor, for changing my life".'

He said denying patients the drugs in primary care could put more pressure on hospital dermatology services: 'The only issue is costs and this reflects the Cinderella status of dermatology.'

The National Institute for Clinical Excellence is currently reviewing both treatments and is due to report in September 2004.

It will report on topical

corticosteroids in July 2004.

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