NHS chief executive, Simon Stevens, has announced plans to blacklist the prescribing of certain prescription-only and OTC medicines in the NHS Delivery Plan, published last Friday (March 31).

NHS England is to lead a review of ‘low value’ prescription items and develop new prescribing guidance for CCGs, with a view to making potential savings of up to £400 million a year.

A first consultation will focus on ten items, including liothyronine for under-active thyroid (predicted saving £30.9 million), gluten-free foods (£21.9 million), fentanyl (£10.1 million) and travel vaccines (£9.5 million).

A second consultation will then review a wider range of items, including OTC products for pain relief, cough/cold, hayfever, indigestion and suncream. Combined, the two groups could produce savings of around £400 million a year, according to NHS Clinical Commissioners.

Sector responds

John Smith, PAGB chief executive, said that while the review of prescriptions for medicines available to purchase OTC is appropriate, “it is important that NHS England does not simply opt for a one-size fits all solution”.

Many people could be more likely to visit pharmacies for OTC remedies if they understood the cost of medicines to the NHS, he said, but appropriate prescribing in certain circumstances and based on sound clinical judgement does have a place.

The RPS expressed its surprise that homeopathy was not on the list for review.

RPS England chair Sandra Gidley said: “The NHS has traditionally provided treatment free at the point of use for both short term and life-long conditions. [This] announcement could be interpreted as an attack on this important principle. Balanced against this is the need for the NHS to be as cost effective as possible in a term of constrained resources. We understand the need for prioritisation.

“We are in agreement with NHS England that products with low or no clinical evidence of effectiveness should be reviewed with urgency. We are surprised that homeopathy which has no scientific evidence of effectiveness is not on the list for review. We would also agree that procurement of medicines and other products should be reviewed to try and reduce the costs of medicines to the NHS

“We are concerned of how a blanket ban of products to treat life-long conditions such as coeliac disease and chronic pain could have unintended consequences on those who rely on these treatments to both improve the quality of life.

“We would support a person-centred review by pharmacists of those taking these medicines, looking first at medicines waste, which we know contributes to around £300 million of cost to the NHS.”

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