Last month the House of Commons health committee published its report on the NHS drugs budget.1 Its remit was to consider “whether the measures introduced by the government to control the NHS budget are leading to more appropriate and cost effective use of drugs in terms of current NHS resources and future patient needs.” Among a wide ranging set of recommendations,2 those for modifying the Pharmaceutical Price Regulation Scheme and the suggestions for a selected list scheme are especially valuable and well worth reading.

The Pharmaceutical Price Regulation Scheme indirectly controls the prices of most of the branded medicines sold to the NHS. It is based on profit targets negotiated confidentially between the Department of Health and individual companies, which must provide detailed annual financial returns. The scheme aims both to contain costs and to protect innovative research by the pharmaceutical industry. As the former Minister for Health, Dr Brian Mawhinney, told the committee, it is “inordinately complicated.” …