PCTs widen scope of drug switch scheme
By Rashmi Wadehra
Proton pump inhibitors overtake statins as source of greatest savings
Proton pump inhibitors have taken over from statins as the drug class that PCTs are keenest for GPs to switch.
New prescribing figures have raised concerns among some experts after indicating the widening scope of PCT schemes to clamp down on drug costs.
From April to June 2007, PCTs made 11.2% savings after opting for cheaper alternative PPIs, overtaking the 8.1% savings achieved for statins. The statistics cover trusts using software produced by prescription information company ScriptSwitch.
The company claimed PCTs appeared to have learned from statin switching and were now applying that 'groundwork' intensively to PPIs.
PCTs have saved costs by pressing GPs to prescribe lower doses of PPIs and replace lansoprazole with omeprazole.
PCTs now appear to be tackling osteoporosis drugs, with savings made by switching from risedronate to alendronate.
Other savings were made for cardiovascular drugs when atorvastatin was dropped in favour of simvastatin, and clopidogrel was changed to dispersible aspirin.
Professor Roger Jones, founding president of the Primary Care Society for Gastroenterology, said there were concerns over the blanket applicability of drug switching to all patients.
He said: 'There is a good deal of anecdotal evidence, some of which might well have a basis in pharmacogenomics, of patients feeling much better on one agent than another very similar one.'
Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex, said switching was inevitable, but that more savings would be generated if practices were reimbursed for the additional workload.
'Drug switching is a cost-effective method for PCTs to liberate resources. If the drugs are of equal efficacy and are of no clinical detriment to patients, then the scope for switching will widen even further.
But what seems to be overlooked is the administrative costs.Switching has increased the number of visits to GPs, nurse time and reception time.'