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- Tom Walley, professor of clinical pharmacology (twalley@liv.ac.uk)a,
- Alan Earl-Slater, visiting lecturerb,
- Alan Haycox, senior lecturera,
- Adrian Bagust, senior research fellowa
- a Prescribing Research Group, Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GF,
- b Department of Commerce, University of Birmingham, Birmingham B15 2TT
- 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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