Letter: How pharmacists can bring down the NHS drugs bill

Sir: The Audit Commission is rightly concerned by the burgeoning NHS drugs bill ('Better use of drugs 'could save pounds 425m' ', 8 March). Among other things, its report, A Prescription for Improvement, emphasises the role of the community pharmacist in tackling the spiralling costs associated with prescribing. But the Audit Commission does not go far enough in this respect. There are six straightforward ways of using community pharmacists to bring the drugs bill under control.

First, where prescriptions call for 60 or 90 days' treatment, a 28- day limit with a repeat facility should be placed on the quantity to be dispensed at any one time. This would significantly reduce the vast amount of unwanted medicines returned to pharmacies or destroyed by patients and allow for much better and closer monitoring of patients' progress. Second, the Government and pharmacists together should develop ways of encouraging the greater use of generic rather than branded medicines. Third, pharmacists should have a much greater role in assisting GPs with prescribing advice. It is pharmacists who know most about the efficacy of the broad range of drugs available.

Fourth, expensive branded generic medicines that have no added therapeutic value compared with other, less expensive generics should be blacklisted. Fifth, GPs should be required to specify on prescriptions the dose and length of course for each medicine. At the moment, there is vast over-prescribing, which is made even worse when prescriptions are repeated. Finally, the Government should act to stop money being wasted through dispensing by doctors. Dispensing by doctors costs the taxpayer more than dispensing by pharmacists, and dispensing doctors consistently issue more prescriptions per patient than their non-dispensing colleagues.

If these steps were taken by the Government, year-on-year savings to the NHS would be enormous.

Yours faithfully,

DAVID N. SHARPE

Chairman

Pharmaceutical Services

Negotiating Committee

Aylesbury, Buckinghamshire

10 March