Pill scare saves NHS pounds 25m

Doctors believe secret motive for contraceptive alert is to gain money for the Government

SENIOR figures in the British Medical Association believe that cost-cutting was behind the Government's sudden and alarming warning, issued to 1.5 million women last week, about the dangers of seven types of oral contraceptive.

The dramatic move on Thursday, which caused a nationwide outcry, will save at least pounds 25m a year from the NHS drugs budget, and possibly much more, the Independent on Sunday has learned.

The seven contraceptive pills featured in the warning, as more likely than others to cause thrombosis in women, are the most expensive - bar one - of all the 26 combined oestrogen and progestogen pills available free to women from the NHS.

They cost more because they are sophisticated third-generation, low-dosage drugs often given to women who experience side-effects with cheaper, less modern birth pills. It is to these cheaper pills that many women will now switch.

The average price of three months' supply of the drugs in the warning is pounds 6.55, compared with an average of pounds 2.45 for the other 19 brands available. If the 1.5 million users - half of all women in Britain taking birth pills - were to switch, the NHS would save pounds 25m a year. Butmany women may be scared off the Pill altogether, making the final saving much higher.

"Given that the risks are still very small, and less than the risks associated with pregnancy, I find the correlation of price on the discredited drugs compared to their alleged increased risk a very interesting one," said Dr Peter Holden, chairman of the BMA GP committee.

In private, other senior BMA figures are much more outspoken. One said : "These are all expensive drugs. They're all twice the price of their nearest competitors. The Government grasped this as an opportunity to cut costs."

The Government is known to want to reduce the cost of family planning. Three years ago it tried to force women on the Pill to switch to cheaper brands when the then Secretary of State for Health, Virginia Bottomley, put forward plans to limit the range available on the NHS. But she had to back down.

The Government's warning on Thursday that taking the seven types of oral contraceptive could double the risk of a blood clot was based on three unpublished studies. But the warning was immediately criticised as scaremongering by the scientist leading the principal study, Walter Spitzer of McGill University, Montreal.

It was widely pointed out that the increase in risk of thrombosis from taking the pills was still only half of that incurred by being pregnant. And, though a number of other countries have seen the findings, only the British government said immediately and unequivocally that the seven drugs were unsafe.

Dr Holden said: "I find it very curious, given the department's normally measured response when giving advice on drugs which are not the subject of an immediate withdrawal."

However, Kenneth Calman, the Government's Chief Medical Officer, insisted yesterday: "This is not a cost issue. Cost has not been mentioned. It is not relevant. The issue is whether women should be told about this risk (of thrombo-embolism), and they have been."

Professor Calman, who did not attend the Department of Health press conference which revealed the warning but was informed in advance, supported "very strongly" the Government's move to go public. "The line is correct, and how it was handled is correct," he said.

However, Labour's health spokeswoman, Harriet Harman, last night said she would demand assurances from Stephen Dorrell, the Secretary of State for Health, that ministers were not secretly motivated by the multi-million- pound potential cost savings.

She said: "I am demanding a categorical reassurance from Stephen Dorrell that the cost of these drugs had absolutely nothing to do with the speed of the Government's advice to GPs to stop prescribing them. He needs to reaffirm that in the light of supicions that have naturally been aroused. If cost becomes a hidden consideration, then that is a very desperate situation."

Pills subject to warning

Femodene pounds 5.70

Femodene ED pounds 5.70

Marvelon pounds 4.57

Mercilon pounds 8.31

Minulet pounds 5.70

Tri-minulet pounds 7.95

Triadene pounds 7.95

Basic NHS Prices at September 1995 3 months' supply

Pills not subject to warning

Binovum pounds 2.24

Brevinol pounds 1.67

Cilest pounds 5.84

Conova pounds 2.34

Eugynon pounds 2.07

Loestrin 20 pounds 2.58

Logynon pounds 2.85

Logynon ED pounds 2.85

Microgynon pounds 1.80

Neocon 1/35 pounds 2.27

Norimin pounds 1.90

Norinyl 1 pounds 1.83

Orthonovin pounds 2.35

Ovram pounds 1.11

Ovranette pounds 1.86

Ovysmen pounds 1.70

Synphase pounds 3.24

Trinordiol pounds 3.28

Trinovum pounds 2.83

Average price of drugs:

3 months

1 year

Annual cost

if taken by 1.5m women

subject to warning

pounds 6.55

pounds 26.20

pounds 39,300,000

not subject to warning

pounds 2.45

pounds 9.80

pounds 14,700,000