Doctors ordered not to prescribe new anti-flu drug

DOCTORS SHOULD not prescribe the new anti-flu drug Relenza on the NHS, Frank Dobson, the Secretary of State for Health, announced yesterday.

DOCTORS SHOULD not prescribe the new anti-flu drug Relenza on the NHS, Frank Dobson, the Secretary of State for Health, announced yesterday.

He upheld a recommendation from the National Institute for Clinical Excellence (Nice) that the drug should not be made widely available on the health service. Nice's rapid assessment committee said last week that there was insufficient evidence to justify recommending the drug for the high- risk groups such as the elderly, who are most vulnerable to flu. Demand for the drug, if it was made available, would "distort the wider application of GP resources", it said.

The committee had fast-tracked the investigation into Relenza so that recommendations could be given to doctors before winter. It assessed trial data supplied by the manufacturer. When the product was granted a European licence this year there were predictions that demand for the drug could cost the NHS up to £100m a year.

The drug's manufacturer, Glaxo Wellcome, was infuriated by the Nice decision and is to appeal against it. It has hinted that it will move production from the UK if the appeal fails. The company stands to lose millions of £in lost prescriptions for the drug.

Mr Dobson has asked Nice to issue full guidance based on its initial advice to doctors. GPs could override the advice, as Relenza has a product licence and so cannot be banned, but they are expected to comply with Mr Dobson's ruling. If family doctors prescribe the drug they will have to explain why they have defied the recommendations.

"Nice formulated their advice to me about Relenza on the evidence submitted to them by the company, and under a procedure and to a timetable agreed with the company. Those involved in formulating the advice are independent experts," said Mr Dobson.

"I have therefore asked Nice to issue guidance to the NHS based on their advice to me. I believe that this decision is in the long-term interest of patients, the NHS and research-based pharmaceutical companies."

Glaxo Wellcome has claimed that Relenza, the first anti-viral flu treatment to be developed, can reduce the severity of flu symptoms, such as headaches, fever and congestion, and shorten the duration of the illness by a few days. Trials have shown Relenza must be taken within 48 hours of the onset of symptoms, which are difficult to distinguish from those of a cold, against which it has no effect. It is inhaled as a powder into the lungs and costs £24 per treatment. It is available in eight countries, including Germany, France and the US.

In Britain, in an average year, 4,000, mainly elderly people, die of influenza. An epidemic can take this total to 30,000. An estimated 150 million working days are lost due to flu.

Professor Michael Pringle, chairman of council of the Royal College of GPs, supported the Government's decision: "We believe that GPs should encourage all vulnerable groups to be immunised against flu and we will join in encouraging GPs not to prescribe Relenza this year."

"The Government's support for Nice's decision is vital for the NHS," said Stephen Thornton, chief executive of the NHS Confederation. "Without such a clear cut national decision, patients would have been forced into the lottery of post-code prescribing under which health authorities and the new primary care groups would have had to take local decisions about Relenza availability."