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PCTs move to further limit GPs' prescribing

By Nigel Praities

PCTs across the country are asking GPs to work to strict drug formularies as the push continues to control prescribing costs.

Moves to limit the range of drugs GPs can use are revealed just weeks after a parliamentary report called for piloting of primary/secondary care formularies to tighten the screw on drug budgets.

East Sussex and Weald, South Devon and Cornwall PCTs have all introduced joint primary/secondary care formularies in their areas.

They restrict GPs to the most cost-effective options as first-line treatments with other options recommended as second-line. Some offer cash incentives to encourage GPs to participate.

Cambridgeshire PCT has gone even further by introducing a primary care formulary specifically for GPs last year. The scheme includes more than 160 drug groups and aims to cover 70 to 80% of patients. The PCT assesses concordance with the scheme and informs practices when there are areas of high non-formulary prescribing.

Sue Ashwell, director of medicines management at Cambridgeshire PCT, said the scheme was built on consensus over prescribing between primary and secondary care and empowered GPs to shape prescribing in hospitals.

‘We turn round to our hospitals and say "We have looked at all the evidence and this is what we want to do".

‘They won't get people coming out of hospital on more expensive or newer things that GPs are not used to,' she said.

Dr Bill Beeby, a GP in Middlesbrough, Teesside, and chair of the GPC's clinical and prescribing subcommittee, said he supported joint primary/secondary care formularies and that his own trust was looking at introducing one.

‘There is no doubt that the joint formulary approach would have many benefits for patients in providing a consistent approach to the therapeutic management of conditions both in primary and secondary care,' he said.

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