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At the heart of general practice since 1960

Legal threat to PCT drug switching 'bribes'

By Nigel Praities

The UK pharmaceutical industry is to take its legal challenge over GP prescribing incentives straight to the European Court, in a move which a Pulse investigation reveals could strike out two-thirds of PCT drug switching schemes.

A survey of 92 PCTs reveals the precarious position many trusts could be left in, with 67% offering GPs incentives to switch patients' medication, and 12% paying GPs inducements to circumvent the QOF.

Dr Peter Fellows, a member of the GPC prescribing subcommittee and of the advisory council of the Association of the British Pharmaceutical Industry, said schemes that paid GPs to ignore QOF targets were ‘corrupt' and compared them with recent political scandals.

‘I think this is as bad as [Peter] Hain. If he has lost his job because of not declaring £100,000 in his leadership campaign, why on earth should patients not know that their doctor is being bribed to prescribe a drug that is less good?' he said.

The ABPI was granted a judicial review into the legality of prescribing incentive schemes in the British courts last year, but the case is now to be transferred straight to the European Court.

Drug switch schemes form a central plank of the Government's drive to cut the primary care prescribing bill, but the ABPI insists incentivising doctors to prescribe named drugs is illegal under EU advertising law.

An ABPI spokesperson said: ‘As the advertising regulations implement EU law, the case raises issues of interpretation of European law and could [also] affect practice in other EU member states.'

Professor Martin Cowie, head of the health services research group at the National Heart and Lung Institute, said the case was ‘hugely important' to the UK, but unlikely to have much impact in the rest of Europe, where drug switching schemes were almost unheard of.

‘The whole concept of switching a whole class, from one to another, is something I have only seen in the NHS. The UK is very conservative and cost-conscious,' he said.

Professor Cowie said most of Europe was sceptical of the benefits of switching. ‘Most of them would look at you and say "that seems like a huge amount of effort for not much return",' he said.

The Pulse investigation reveals that a number of PCTs reimburse practice costs to support switching schemes. Others allow exception reporting or reimburse lost QOF points to ensure that GPs keep patients on cheaper medications.

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