28 March 2003
Increases in spending on drugs threatens to destabilise primary care trusts and must be brought under control, the Audit Commission warned this week.
The alert came as the Liberal Democrats published figures showing that strategic health authorities in England are predicting NHS organisations will have deficits totalling £400m by the end of this month, much of it due to the escalating costs of drugs.
Primary care prescribing cost £5.5bn in 2001/02, £540m more than was spent the previous year. The commission said this figure is expected to rise by around 12% in 2002/03, when general NHS spending will rise by 8.8%.
With competing priorities, such as waiting time reductions, PCTs were finding it difficult to fund prescribing spending and most were facing a shortfall, the commission added.
Much of the increase in drugs spending was due to government initiatives that aim to standardise treatments. Around £240m was accounted for by rises in just four of the 200 sections of the drugs bible, the British National Formulary (BNF). These were drugs for cholesterol regulation (statins), diabetes, hypertension and psychoses – medicines that are directly linked to the Department of Health's National Service Frameworks on coronary heart disease and diabetes, as well as guidance from the National Institute of Clinical Excellence.
'The rise in prescribing spending could bring a potentially serious finance and performance risk, impacting on PCTs' ability to stay within their resource limits and to properly fund other services,' the commission said.
PCTs could save £130m a year in their prescribing by reducing the use of drugs with limited clinical value and clamping down on over-prescribing, it added.
LibDem health spokesman Dr Evan Harris claimed there was a 'deepening crisis' in NHS funding. 'Prescribing more statins is vital but the initiative has not been fully funded. So even though GPs are still not treating as many patients with statins as could benefit, the cost has broken the bank,' he said.
However, the department said the £400m figure was based on predictions made after six months of the financial year, and the true picture would not emerge until the audited accounts had been published.
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