Patients in England are set to lose access to a raft of prescription drugs. If you believe the headlines, this is terrible news, and people stand to miss out on treatments for disorders ranging from pain and depression to osteoarthritis and cancer, because the National Health Service will no longer prescribe the drugs.
And more cuts are on the way. In the new year, NHS England is set to announce the details of another cull to 鈥� limiting access to treatments for more common ailments, such as eye drops and laxatives.
It鈥檚 not as bad as it seems. In fact, the new guidance is overdue. The 18 drugs that have been listed under 鈥渄o not prescribe鈥� are there for a reason 鈥� they are either too expensive, ineffective or downright dangerous.
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Take co-proxamol, for example. This painkiller combines two drugs: paracetamol and dextropropoxyphene, which can affect breathing and heart function. People can accidentally overdose on the drug because there isn鈥檛 much of a difference between a therapeutic dose and a lethal one. And between 1997 and 1999, co-proxamol was .
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The UK Medicines and Healthcare Products Regulatory Agency , but it is still prescribed on an off-label basis, and continues to cost the NHS around 拢9 million per year. The new recommendations to no longer prescribe the drug, and to take existing users off it, seems an obvious step.
Then there are the overly expensive medications. Doxazosin, for instance, is used to treat prostate enlargement. The slow-release form of the drug costs about six times that of the form that works immediately, but there is no evidence that it has any additional benefits to a person taking it. Considering that the NHS currently spends 拢7.7 million prescribing slow-release doxazosin, it makes total sense to swap to the cheaper version of the drug.
The guidelines list 16 other examples of drugs that should no longer be prescribed for similar reasons. Among them are homeopathic treatments 鈥� highly diluted substances that are no more likely than a sugary sweet to cure your ills. Plenty of research has dismissed homeopathy, so why is the NHS spending more than 拢92,000 of public money per year on such 鈥渢reatments鈥�?
NHS England is also proposing that doctors cut back on prescriptions for minor conditions that can be treated with cheap medicines available over the counter at pharmacies. This will specifically apply to conditions that are minor, that a person can treat by themselves, and that clear up within a short period of time.
Treatments for dandruff, cold sores, ear wax, mild acne, sunburn, mild migraine and vaginal thrush are all listed for the chop. The fact that such treatments are currently offered on prescription might come as a surprise to those who routinely buy ear drops and spot creams from their local pharmacist 鈥� where they are often far cheaper than the 拢8.60 per item prescription charge in England. The organisation believes that such cutbacks could save some 拢190 million per year.
Here, though, NHS England will have to be careful. The ethos of the NHS is to offer treatment free for all at the point of delivery, and the organisation will have to ensure that any changes won鈥檛 mean that some poorer individuals can鈥檛 afford the care they need. Its preliminary recommendation points out there will be exceptions to the rule, including those that aren鈥檛 able to get to a pharmacy, those with disabilities or dementia, and people who might be denied the sale of medications in a pharmacy, such as pregnant women and children. Most of these groups are currently eligible for free prescriptions. A consultation is under way, and the final document is due in 2018.
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