Reports of the demise of the PPRS are much exaggerated
Karl Claxton and colleagues [BMJ2008;336;251-254] boldly state that
the current Pharmaceutical Price Regulation Scheme (PPRS) is dead. Would
that were so!
The Office of Fair Trading (OFT) report on the PPRS, on which they
comment, has both strengths and weaknesses; but if it does nothing else it
provides a devastating critique of the current scheme. The PPRS is rooted
in the past and both fails to deliver its stated objectives, and fails to
reflect the realities of the modern NHS and the modern pharmaceutical
industry. When I was head of the PPRS Branch in the Department of Health
fifteen years ago I argued that with the introduction of prescribing
budgets the scheme was no longer necessary or appropriate. With practice
based commissioning the case for fundamental reform is now unanswerable.
Unfortunately, though, all the indications are that the PPRS has not
yet reached its deathbed. The Government plans to consult shortly on
likely changes to the scheme, and to implement those changes by July. What
the consultation document will say remains confidential at this stage, but
all the indications are that the focus will be on a quick fix now
(consisting of a mandatory price cut accompanied by cosmetic changes)
coupled with a promise to consider the proposed value based pricing over
the next two (or three, or five) years. Another opportunity missed!
Competing interests: No competing interests