Education And Debate

An integrated national pharmaceutical policy for the United Kingdom?

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7275.1523 (Published 16 December 2000) Cite this as: BMJ 2000;321:1523
  1. Tom Walley, professor of clinical pharmacology (twalley@liv.ac.uk)a,
  2. Alan Earl-Slater, visiting lecturerb,
  3. Alan Haycox, senior lecturera,
  4. Adrian Bagust, senior research fellowa
  1. a Prescribing Research Group, Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GF,
  2. b Department of Commerce, University of Birmingham, Birmingham B15 2TT
  1. Correspondence to: T Walley
  • Accepted 20 July 2000

The UK government wishes to have “joined up” policies to integrate areas such as health and social care. Although many of these policies impinge on pharmaceuticals (box below), there is no coherent, integrated, national pharmaceutical policy. As a result, some policies affecting pharmaceuticals seem to contradict or undermine others. Pharmaceuticals raise issues which are not evident in other areas of health provision:

  • Pharmaceuticals are regulated by law for safety, efficacy, and quality

  • Drugs have become increasingly expensive, both individually and in total, but the value derived from some of this expenditure is open to question

  • Drugs are promoted actively by a powerful industry that is also a major employer and exporter in the United Kingdom

  • Drugs are affected by policies in almost every area of health care.

We believe that there should be a single, clear policy on pharmaceuticals that unifies the various strands of relevant existing policies. In this article we try to describe what such a policy might look like.

Summary points

  • Medicines are important in NHS treatment and they are expensive

  • The pharmaceutical industry is important for the NHS and for the UK economy

  • The United Kingdom has no single, coherent, pharmaceutical policy

  • Recent difficulties have arisen in part from the lack of such a policy

  • The establishment of the NICE and other recent policies on quality could provide the basis of a national pharmaceuticals policy

Some existing UK policies affecting pharmaceuticals1

Medicines Act 1968, and revisions

Intellectual property rights

Advertising of drugs

Prescription charges

Profit controls

NICE

Computer assisted prescribing support systems—for example, PRODIGY

Generic prescribing targets set by central government

Commercial competition

Trade and parallel imports

Selected list

Drug tariff

Pharmaceutical price regulatory system supporting industry while controlling profits

Consumer Protection Act

Product liability directive

Recent problems

The lack of a single policy on drugs has caused problems, and attempts to resolve these have …

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