Private firm wins contracts to drive down GPs' drugs spend
By Lilian Anekwe
Exclusive: A private firm is to take control of GP prescribing budgets and set practices tough targets to drive down their drug bills, Pulse can reveal.
The most dramatic incursion yet of the private sector into the NHS has been prompted by a loss of faith among PCTs in the ability of practice-based commissioning to deliver savings.
Private firm Assura is negotiating deals with two PCTs to guarantee savings in drug expenditure and is poised to launch the schemes in two undisclosed locations.
The company has negotiated agreements with groups of up to 30 GP practices, made up of former PBC clusters it claims have become disillusioned with red tape and slow progress.
Under the schemes Assura has pledged to split its profits with participating GPs and offered to underwrite the risk for PCTs and GPs.
One scheme promises to deliver a minimum 2% saving on the PCTs' annual prescribing budget - with any additional savings split 50-50 between Assura and the GP collaborative.
Dr Vivienne McVey, medical director of Assura Group, told Pulse it was confident it could make savings of around £500,000 for PCTs, and possibly cut trusts' spending by as much as 10%, which would allow GPs and the company to share profits of up to £2m.
The firm has already targeted a string of drugs at the centre of the National Prescribing Centre's own cost-cutting drive, including statins and preventive inhalers for asthma, and claims savings can be made without any detrimental impact on patient care.
‘The GPs working with us do not feel PBC would enable them to do the things they wanted to do. PBC is slow and GPs have to jump through a lot of hoops to do it,' she said, adding that the scheme had been mooted with at least half a dozen PCTs.
Dr James Kingsland, president of the National Association of Primary Care and a GP in the Wirral, said the scheme was ‘astonishing'.
‘I'm flabbergasted. I don't know how a company like Assura is going to add any value. It smacks of the ultimate failure of PBC. I'm astounded it would be even thought about.'
Dr Michael Dixon, chair of the NHS Alliance, said handing responsibility for managing prescribing budgets to private providers was a model that warranted piloting.
‘PBC does not work in large parts of the country. It would be an admission of failure if a practice devolved all responsibility, but if it is not imposed it's not a bad idea to pilot it.'
But Dr Peter Fellow, chair of the GPC prescribing subcommittee, branded the schemes as 'despicable'.
'Of course GPs will come under pressure because this is about profit for the GPs involved and for the company,' he added. 'I have doubts about these GP collaboratives - the motivation is always going to be financial gain for the practice.'How Assura claims its scheme would work
• Assura controls prescribing budget for a GP collaborative representing 27 practices
• Assura promises PCT to deliver a minimum 2% reduction of current prescribing budget of £24.5m
• Schemes likely to focus on statins, preventive inhalers for asthma, ACE inhibitors, PPIs, and antibiotics
• Savings of £490,000 for PCT but up to £2m saving to be shared between Assura and GP collaborative if saving reaches 10%