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CAMHS won't see you now

Low scorers say figures are wrong

Dispensing practices are prescribing twice as many branded drugs for hypertension as non-dispensing practices, a new study reveals.

The findings have prompted calls from GPs for a review of how dispensing practices are funded to limit potential 'conflict of interest'.

Of the antihypertensive drugs prescribed by dispensing practices, 25 per cent were branded, compared with 11 per cent for non-dispensing.

Smaller practices were also significantly more likely to prescribe branded products ­ a finding that remained after adjusting for dispensing status.

Study researcher Dr Mary Joan Macleod, senior lecturer in clinical pharmacology in the department of therapeutics at the University of Aberdeen, said: 'It's a recognised problem. GPs are businesses so

it's just one way they have of trying to maximise their return.

'It may well be that there needs to be a more transparent system with adequate funding for rural practice.'

Dr Peter Fellows, chair of the GPC prescribing subcommittee, said: 'Dispensing practices have to make a profit but the whole issue of how it's paid for has to be reviewed. I was disappointed that it wasn't looked at more closely in the new contract.'

Dr Fellows, who dispenses at his practice in Lydney, Gloucestershire, added: 'There is an image that dispensing doctors are making a lot of profit but that's fallacious. We have to treat it as a serious business; we need a whole new system, maybe a fee per item.'

Dr John Ashcroft, who is CHD lead for Erewash PCT in Derbyshire and has an interest in reimbursement policy, warned: 'There is a conflict of interest and it's never been properly addressed.

'It's unfortunate doctors feel they have to put down something different on the prescription because it influences their income. A system that puts doctors in that position is not a good system.'

The research, published in September's British Journal of Clinical Pharmacology, was part of a wider study of antihypertensive prescribing in all practices in Grampian, Scotland, in 1998/9 and 2001/2.

Dr Malcolm Ward, Dispensing Doctors Association chair, disputed the findings, saying Prescription Pricing Authority data provided 'no evidence' that dispensing doctors prescribed more branded drugs.

By Emma Wilkinson

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