The move - which might cut pounds 60m from the pounds 3bn NHS drug budget - brought a cautious welcome yesterday from the British Medical Association. The drug industry, however, reacted with fury, accusing Dr Brian Mawhinney, the Minister of Health, of a breach of faith.
Dr Mawhinney told the Commons Health Select Committee yesterday there was now more confidence in the quality of non-brand name generic drugs. Many more GPs were now prescribing them voluntarily, many hospitals now used them and doctors' attitudes appeared to be changing. Previously family doctors' leaders have backed generic substitution in principle on a 'tick in' basis - having a box on the prescription form which doctors would tick if they were willing for a generic substitute to be dispensed.
Doubts as to how many doctors would do that, combined with drug industry opposition, prevented that being adopted.
Now, however, the BMA is considering backing a system where generics would be automatically substituted unless the doctor ticked a box insisting that the brand name drug be supplied - a system known as 'tick out'. That, Dr Mawhinney said, would be 'an even bigger step' forward.
Talks are to start with doctors' and pharmacists' leaders 'to see if we can come forward with a proposal that is acceptable to everyone', he told MPs.
About 65 per cent of drugs have a generic substitute - the others are still under patent - and GPs already write prescriptions for generics about 45 per cent of the time, according to Department of Health figures. That would still leave room for significant savings.
The BMA said it would want safeguards, including guidance from the Medicines Control Agency on the quality of generics.
The Association of British Pharmaceutical Industry, however, said it viewed Dr Mawhinney's disclosure 'with utter dismay'. A spokesman said that 'coming on top of everything else' - a 2.5 per cent price cut this year, followed by an effective price freeze, plus extensions to the limited list and tougher target drug budgets for GPs - 'it is bound to have an almost disastrous effect on investment in both research and production in this country'.
The industry claimed it would, 'on behalf of patients', fight the concept that 'patients should not receive the product that their doctor prescribes'.
When the new price deal had been signed with the Government last autumn, the spokesman claimed, there had been an 'implicit agreement' there would be no big new cost cutting initiatives . . . without prior consultation. That agreement had now been breached.Reuse content