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New generics prescribing target to ramp up pressure on GPs

By Nigel Praities

GPs face fresh restrictions on their prescribing of branded drugs after the Government confirmed it is to introduce a new target to encourage PCTs to raise the bar on generic prescribing.

The new nationwide prescribing indicator will match the highest performing areas in the country - who currently spend over 82% of their drug budgets on generics.

But some GPs warn the move may endanger patient care.

The NHS Institute for Innovation and Improvement said it would be monitoring prescribing for all generics from now on and planned to publish a league table of generic prescribing rates in September to pressure PCTs to improve their performance.

Many PCTs already monitor generic prescribing locally, but Mark Jennings, priority programme director for delivering quality and value at the NHS Institute, said the national tables would be an unpleasant surprise for some PCTs.

‘With the statins indicator, there were some PCTs who had very much taken action on this and others who were more surprised to find out their performance. We don't expect the situation to be any different with this indicator,‘ he said.

The Government is keen to slash the costs of primary care prescribing even further after it was strongly criticised by a parliamentary committee of MPs for allowing GPs to prescribe too many high-cost medicines earlier this year.

But some GPs are unconvinced by the plans, warning any generics target over 80% could harm patient care. Dr Jim Kennedy, RCGP prescribing spokesperson, said prescribing generics for some conditions had ‘clear risks'.

‘There are dangers of going too far with generic prescribing. Once you get around the mid 80s you start to run into problems, especially with hormone preparations, long-acting medications and some of the epilepsy drugs,' he said.

This new Better Care Better Value indicator will amplify pressure on GPs to cut prescribing costs. Pulse exclusively revealed last year the generic statin indicator would rise from 70% to 77% and new NHS indicators for drugs such as PPIs, antiplatelets and ACE inhibitors will be introduced this month.

Dr Bill Beeby, chair of the GPC clinical and prescribing subcommittee, said there was a ‘clearly defined' maximum for generic prescribing around 80%.

‘There could be problems if this becomes a fixed target, but as an aspiration it is OK,' he said.

Generic drugs: GPs facing new national targets Generic drugs: GPs facing new national targets How will the new indicator work?

- It will be based on the amount PCTs spend on generics as a percentage of their total drugs budget
- Data from April until June will be used, with league tables of PCT generic prescribing rates published in September
- The top-performing quartile of PCTs will be used as the ‘reference point', with the latest data in this group showing their generic prescribing rates were all over 82% (2006-07 data from the NHS Prescription Pricing Division)

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