Pressure for generics now at 'silly' level
The GPC has called on the Government and primary care organisations to stop putting 'mindless pressure' on GPs to prescribe generically before the situation gets 'silly'.
Latest figures this month show GPs have already met the Department of Health's March 2002 deadline to increase the proportion of generic scripts to 72 per cent from 63 per cent in 1998 in a bid to cut drug costs.
Ten-year prescribing data reveal 76 per cent of scripts were for generic drugs in the year to March 2002 compared with 43.2 per cent in 1992. The percentage of items dispensed generically also rose from 35.6 per cent to 53.0 per cent over the same period.
But GPs have been put under further pressure by the PCT star-ratings system, which includes generic prescribing in its list of performance indicators. Maximum points are set for 80 per cent or more scripts prescribed generically with between 76 per cent and 79 per cent the expected average for a PCT.
GPC prescribing chair Dr Peter Fellows said it would be 'mistaken and mindless' for the department and PCTs to push for further rises, adding 70 per cent was 'about the optimum' level for generic prescribing among GPs.
He warned rates could fall as GPs were forced to prescribe newer branded drugs such as glitazones in diabetes for which there is no generic alternative to meet national service framework demands.
The BNF and Medicines Control Agency also state many long-acting and slow-
release formulations must be prescribed by brand name.
Dr Fellows, a GP in Lydney, Gloucestershire, said: 'As is so often the case we get Government targets set by managers who don't know what they're talking about. It's gone about as far as it can go and it's getting a bit silly.'
He said GPs already faced pressure from PCOs to use 'cheap and dubiously standardised' drugs from abroad to meet tight prescribing budgets: 'What concerns me is mindless pressure from PCT prescribing advisers to keep upping and upping generic prescribing it is not realistic.'
Generics were 'by no means best all the time' as side-effects could vary and elderly patients could be confused by switching to different drugs, he said.