UK Industry Views MPs' Report On NHS Drug Bill

The introduction in the UK of a National Prescribing List, or national formulary, as recommended by the House of Commons All-Party Health select Committee in its report on the National Health Service drugs budget (Marketletter July 25), "would certainly not help the Department of Health or the Department of Trade and Industry in their endeavors to attract inward investment into the UK from American and Japanese companies," says a spokesman for the Association of the British pharmaceutical Industry.

The ABPI also says the establishment of such a List could lead to the withholding of new medicines from the UK market, on the basis that companies would not take the risk of their products being blacklisted after only five years. Few new products recoup the investment on their research and development within five years, says the association, which goes on to point out that companies introducing products in, say, the year 2000 would be expected to compete in terms of price with products introduced 10-20 years earlier.

Commenting on the Committee's assertion that doctors would remain free to prescribe blacklisted or non-listed medicines privately, the ABPI says that this presupposes that manufacturers would be prepared to keep those products on the UK market, even though they would not be reimbursable under the NHS. If companies were to withdraw blacklisted products from the UK, doctors would be unable to prescribe them privately. Moreover, it notes, the report claims that doctors might, in exceptional circumstances with the permission of a Family Health services Administration pharmaceutical adviser, override a National Formulary. But, the ABPI points out, this would not be feasible if the blacklisted products had been withdrawn in the UK.