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Health Insight August 2001: The use of drugs: good news, bad news


Research has revealed a marked reduction in the number of people trying to commit suicide using paracetamol, since new laws controlling the sale of the drug were introduced. In September 1998, packs of the painkiller were cut in size. Packs now contain a maximum of thirty-two tablets when sold from pharmacies, and only sixteen when sold over the counter in other shops. A Scottish study shows hospital admissions for paracetamol overdose are down by nearly twenty per cent. The research group of public health experts analysed cases of ‘deliberate self-harm’ with paracetamol, which resulted in admissions to Scottish hospitals in the period 1985 to 1999.

A discussion paper on the future of generic (non-brand name) medicines within the NHS has been launched by health minister Lord Philip Hunt. Generic medicines account for around half of all drugs dispensed in primary care. In recent years, concerns have been raised over their spiralling costs and availability. To combat this, a maximum price scheme was introduced in August 2000 for generic medicines, which led to £240m of cost savings in 2000–01. The new discussion paper will look at the long-term supply and reimbursement of generic medicines for the NHS. It includes proposals aimed at securing better value for money for the health service and ensuring a reliable supply of medicines for patients. The government’s proposals arose from a commissioned review carried out by Oxford Economic Research Associates (OXERA) to assess existing drug supplies and reimbursement arrangements, and identify possible alternatives. The government’s proposals and OXERA’s report can be seen on www.doh.gov.uk/generics.

Lord Philip Hunt has also announced a new independent advisory committee on anti-microbial resistance as part of the government’s response to the House of Lords Committee’s report, ‘Resistance to Antibiotics’, published in 1998. The committee is chaired by Richard Wise, Professor of Clinical Microbiology at City Hospital, Birmingham and scientific adviser to the House of Lords Select Committee. Professor Wise said, ‘Overuse of antibiotics is at the heart of the resistance problem. A number of antibiotics are used for the treatment of simple infections which are caused by viruses, not influenced by antibiotics. There is a need to reduce this inappropriate use. Controlling the spread of these resistant organisms around both hospitals and the community is another major challenge. Antibiotic resistance is everybody’s problem and will need a concerted and long-term strategy if we are not to return to the “pre-antibiotic era”.’

Many people with schizophrenia are being denied access to the latest drugs, according to a report by the Zito Trust. Research by the trust found that some areas of the country were almost ten times more likely than others to prescribe newer ‘atypical’ anti-psychotic drugs, despite a growing body of evidence that atypicals are the best way to treat schizophrenia. Michael Howlette, director of the Zito Trust, said, ‘Our report shows that the majority of people with schizophrenia are being denied access to the best and most appropriate treatments, and, instead, are subjected to the disfiguring and stigmatising side-effects of the older drugs.’ Dr Martin Deahl, consultant psychiatrist at St Bartholomew’s Hospital in London, said, ‘It is no longer simply enough for an anti-psychotic drug to control hallucinations and delusions. Drug treatment today must have a side-effect profile that is acceptable to patients, so that we can be sure they will take it … We are operating a “fail-first” policy that amounts to no more than a denial of care.’ The report is published at the same time as the drugs watchdog the National Institute for Clinical Excellence (NICE) is reviewing atypical anti-psychotics.

The first twenty-six pilot schemes to help patients get the most out of the medicines they take have been unveiled by health minister Hazel Blears. The National Medicines Management programme will mean that people can get more help from pharmacists on using their medicines. Pharmacists will also offer GPs support on prescribing. The initiative, set out in the NHS Pharmacy Programme, means that by 2004 every primary care group and trust in England will have a scheme in place. Hazel Blears said, ‘Thirty million pounds is being invested in these schemes and other work to improve how NHS medicines are used over the next two years. The sites I have approved today will get funding of up to £75,000 each in the coming year to support their work.’

Proposals to relax the rules on promoting prescription drugs could increase the NHS drugs bill, according to the Consumers’ Association (CA). The EC proposals would relax the rules on promoting drugs for AIDS, diabetes and asthma by allowing pharmaceutical companies to create interactive patient information websites and advertise their treatments for those conditions. However, the drugs industry says the proposals are not designed to allow drug advertising, but to enable people to obtain information about products if they want it. The CA is concerned that advertising would not raise awareness of a wide range of health conditions and treatments. The most advertised drugs would become the most popular - even if a competitor or generic drug performs better. Clara Mackay, principal policy adviser at the CA, said, ‘Governments must put the consumer first – particularly on crucial areas such as public health.’

Sources: BBC Online, Press releases (DoH)

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