Edward Leigh, who chairs the committee, says this: â€œOne fifth of all general practitioners surveyed by the National Audit Office say their behavior in prescribing drugs is more influenced by pharmaceutical company marketing than by official National Health Service advice. And the NHS spends each year at least $400 million more than it should as a result of GPs prescribing too great a proportion of higher cost, branded medicines, rather than generic versions which are cheaper, but no less effective in clinical outcomes.â€
He continues: â€œItâ€™s hard to doubt that the blandishments of the pharmaceutical industry are having an effect. But GPs must concentrate more on following official guidelines â€“ increasing the prescribing of generic drugs where clinically appropriate. The fact that primary care trusts vary hugely in the extent to which their GPs prescribe generic drugs for common conditions shows what can be achieved.â€
Of the entire NHS budget, one quarter of all primary care expenditure is for meds, with both the volume and cost having increased exponentially over previous years. In 1996, 485 million scrips were dispensed in England but by 2006 this had increased by 55 percent to 752 million. Over the same period, the primary care drugs bill increased from about $8 billion to more than $16 billion: a 60 percent jump in real terms. This growth, says the report, has been driven by new treatments being approved, more opportunities to treat disease using existing meds, plus earlier treatment of some conditions.
Industry fired back. "The assertion that NHS doctors prescribe too many branded medicines is contradicted by the fact that 82% of all prescriptions are written generically and the UK is bottom of the league compared with other, similar, countries in prescribing modern medicines,â€ says the Association of the British Pharmaceutical Industry. The group also notes that the $1.7 billion spent on marketing should be seen within the context of overall NHS expenditure on meds of around $22 billion and pharma's not-insignificant of more than $6 billion a year investment in R&D for new meds.
â€œWould any other industry be expected to spend an average of Â£500 million on developing a new product and then be criticised for telling people about it?â€ notes the ABPIâ€™s Director General Richard Barker.
Docs were similarly offended. The British Medical Association had this to say: "GPs in the UK are among the highest prescribers of generic medication in Europe and the level of generic prescribing in the UK is close to the maximum achievable. Yet there are times when it is not always appropriate to prescribe generic drugs - GPs have to decide what is in the best interests of an individual patient and prescribe accordingly."
â€œCiting how much pharmaceutical companies spend is not evidence of GPs being swayed by their advertising. In a free and open market GPs sift the masses of data they receive from journals, PCT prescribing advisers, experts, postgraduate education and pharmaceutical companies." The BMA also noted that, while one in five of the 1000 doctors surveyed by the NAO felt more swayed by industry marketing, it also highlighted that four out of five GPs rely on official NHS sources for their prescribing info.