UK MPs' Report Slams PPRS, Limited List

The UK House of Commons All-Party Health select Committee report on the National Health Service drugs budget, published last week, urges the adoption of a national Prescribing List to remedy the "defects" of the existing Limited List for NHS prescribing "and provide a major incentive to better prescribing."

The report strongly criticizes the way in which the Limited List was introduced, and says that if it is retained, it should be operated with much greater flexibility, sensitivity and openness. The Committee did not accept industry claims that the List has damaged research; "our own enquiries established that its effects on useful R&D have been minimal," said chairman Marion Roe, but nor did it accept that doctors should have absolute freedom to prescribe. "There should be no freedom to prescribe incompetently or inappropriately," she said.

The report says a National Prescribing List would build on the Limited List's virtues but avoid its defects. Covering all therapeutic categories, it would automatically include all drugs from the time of launch for five years. After that, each drug would be reviewed, and if found to be less effective or dearer with no therapeutic advantage, it would be removed from NHS prescribing. A comprehensive national formulary would thus be built up over 10 years, said Mrs Roe, safeguarding both the principle that no patient should be denied a drug for which there is genuine need, and also the stability which companies need by giving them five years in which to establish their product's value.