NHS England (NHSE) has opened a consultation on proposals to extend the list of products that should not be routinely prescribed in primary care as it continues to search for ways to trim health service expenditure.
Eight more products have been put forward, five of which are considered to be of low clinical value including amiodarone, emollient bath and shower preparations for dry and pruritic skin conditions, dronedarone, minocycline for acne and silk garments.
A further three items were identified where more cost-effective alternatives are available, including aliskiren, blood glucose testing strips for people with type 2 diabetes costing of £10 for 50 strips and needles for pre-filled and reusable insulin pens costing £5 per 100 needles.
The cost of prescriptions dispensed in the community exceeded £9 billion in 2017, according to NHSE.
The three-month consultation which is open to clinical commissioning groups, relevant bodies, patients and the general public, closes on February 28 next year.
NHSE published guidance in 2017-18 on an initial list of 18 items that should not be prescribed in primary care because they either lacked robust evidence as to their clinical effectiveness or prompted safety concerns, were clinically effective but existed alongside more cost-effective items or were clinically effective but were considered “a low priority for NHS funding.”
The PSNC said: “In its proposals, NHS England has recognised the need to take account of clinical exceptions in limiting the prescribing of these products. (Its) Board was also keen to make clear that the proposals for the second group do not amount to a ban on prescribing but rather focus on encouraging prescribers to choose lower cost items by introducing a recommended upper cost limit.
“A further proposal is to update the current recommendations on rubefacients to exclude capsaicin cream, as this product falls within guidance from the National Institute for Health and Care Excellence.”
Earlier this year NHSE also recommended what it described as 35 “minor conditions” for which over-the-counter treatments should not be prescribed.
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