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Homeopathy among 18 treatments scrapped from prescriptions

NHS England has announced that 18 treatments should be scrapped from prescriptions, including homeopathy, herbal remedies and fish oil.

Following a public consultation on 18 treatments, NHS said it will “press ahead” with guidance to GPs and clinical commissioning groups (CCGs) to end the routine prescribing of “ineffective, unsafe and low clinical-value treatments”, which it predicts will save £141 million a year.

NHS England has referred seven of the scrapped treatments to the Department of Health "for consideration for blacklisting", the commissioner told C+D today (December 1).

“The guidance launched today will support clinical commissioners in their work to prioritise effectively and make sure they are getting best value for their medicines spend,” NHS Clinical Commissioners (NHSCC) co-chair Graham Jackson said.

NHS England received 5,544 consultation responses through an online survey and 195 written submission between July 21 and October 21.

Dr Jackson said NHSCC is “pleased by the volume of responses to the consultation”.

NHS England also announced plans to launch a consultation on scrapping prescriptions for some over-the-counter (OTC) products, such as paracetamol and cough and cold remedies.

A “detailed follow-up consultation” on the initial list of conditions, such as cold sores and mouth ulcers, will be launched in the new year, it added.

Which 18 treatments have been scrapped from prescriptions?

(The seven treatments which NHS England has recommended should be blacklisted by the DH are highlighted in red)

  • Co-proxamol
  • Omega 3 fatty acid compounds
  • Rubefacients (excluding topical NSAIDs)
  • Glucosamine and chondroitin
  • Lutein and antioxidants
  • Homeopathy
  • Herbal treatments
  • Lidocaine plasters
  • Dosulepin
  • Oxycodone and naloxone combination products
  • Liothyronine
  • Doxazosin prolonged release
  • Perindopril arginine
  • Fentanyl immediate-release
  • Tadalafil once-daily
  • Trimipramine
  • Paracetamol and tramadol combination product
  • Travel vaccines – seven vaccines, which are not available on the NHS, but are sometimes prescribed in error: hepatitis B; Japanese encephalitis; meningitis ACWY; yellow fever; tick-borne encephalitis; rabies; and the Bacillus Calmette-Guérin (BCG) vaccine.

Source: NHS England

RPS pleased with patient-centred view

Royal Pharmaceutical Society (RPS) English board chair Sandra Gidley said she is “pleased” NHS England has taken a “patient-centred view on a number of the medicines included in the consultation”.

“We welcome the proposals to restrict prescribing of medicines where there are safer or more effective alternatives, to ensure the NHS can continue to gain best value from the medicines it funds,” Ms Gidley said.

"NHS England has listened to our concerns and incorporated these in the final guidance for CCGs."

However, Ms Gidley added that the RPS is “very concerned” about the proposals on restricting prescribing of “cost-effective and safe OTC medicines”, which could end up “exacerbating existing health inequalities”.

“Unintended consequences” of restricting OTC products

Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee, said the negotiator “emphasises the need for the development of clear communication materials for use at both local and national level, to provide consistent messages for patients”.

“Whilst the decision to issue guidance to prescribers and CCGs on the prescribing of low-value medicines is clearly of importance to community pharmacy, it is the ongoing consideration of future restrictions on the prescribing of OTC products that is of greater significance,” Mr Buxton said.

He added that PSNC is “concerned” about a range of “unintended consequences” that may occur as a result of these proposals.

In June, C+D hosted a roundtable – bringing together NHSCC co-chair Dr Jackson, Ms Gidley, CEO of charity Coeliac UK Sarah Sleet, and London contractor and CEO of City and Hackney local pharmaceutical committee Hitesh Patel – to discuss what the plans to scrap certain treatments from prescriptions could mean for pharmacists, patients, and the wider NHS.

Listen to the podcast below:

Do you agree that the 18 items should be scrapped from prescriptions?

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