Homeopathy among 18 treatments scrapped from prescriptions

NHS England has recommended that 18 treatments, including homeopathy, be blacklisted
NHS England has recommended that 18 treatments, including homeopathy, be blacklisted

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.

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7 Comments
Question: 
Do you agree that the 18 items should be scrapped from prescriptions?

James Mac, Community pharmacist

Also the cheek of calling it a "patient centred view"... typical rps... let's see them refer to something that costs money, rather than saves it, as positively

James Mac, Community pharmacist

They should have gone after some of the  baby foods IMHO. Paracetamol etc. it goes without being said should not be reimbursed unless the person could reasonably not be expected to afford it, e.g. if they're on tax credits, benefizzles, etc.

Dee Childs, Dispenser Manager/ Dispensing Assistant

Do we think liothyronine is being blacklisted for the reasons stated...or could it be purely price??? says the old cynic in me!

Z ZZzzzz, Information Technology

I think there has been a change of mind on that one over the weekend. But the govt should force the price down to what other countries seem to be paying. I read some are paying around £5.

Z ZZzzzz, Information Technology

At long last for Co-proxamol. If a blacklist committee is to be set up again after all these years, I'm available!

Meera Sharma, Community pharmacist

Perfectly acceptable and agree with the blacklisting as well - taken a lot of time from CCGs to get this done. As for the OTC consultation, again, perfectly in agreement - there is no excuse to having to prescribe calpol and paracetamol when the NHS is facing such unprecedented financial crisis!

Michael Franks, Community pharmacist

No argument with the red items at all. Also would ban perindopril Argenine. as well. Cialis once a day has other uses so one indication could be banned and so marked SLS for the alternative less used indication . now available as a generic perhaps black list the branded version.

 

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