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Restrictions on OTC prescribing have saved less than a third of the money that NHS England forecast

Restrictions on prescribing items available over the counter has saved £32m since March 2018, less than a third of the “up to almost £100m” NHS England originally said could be saved.

otc medicines cough


The March 2018 NHS guidance limited the routine prescribing of OTC products for 35 conditions

NHS England has saved an estimated £32m since restrictions on prescribing items that are available over the counter (OTC) were introduced in March 2018, it has emerged. This is less than a third of the “up to almost £100m” that NHS England said the restrictions could save when they came into force.

The figure was given on 20 August 2020 by health minister Lord Bethell in response to a written parliamentary question. The estimate, Bethell said, was correct as of 10 July 2020.

When the guidance was announced, in March 2018, an NHS England press release said the move could free up “up to almost £100m for frontline care each year”.

In April 2019, data showed that in the nine months following introduction of the guidance, £25.9m was saved

The NHS guidance limited the routine prescribing of OTC products for 35 conditions, such as indigestion, cradle cap, haemorrhoids, head lice, mild acne and “minor conditions associated with pain”.

A public consultation on the guidance led to concerns being raised by the Royal Pharmaceutical Society (RPS) and other organisations about the effect that the prescribing restrictions would have on patients who could not afford to pay for them. 

NHS England responded to these concerns by including a number of exemptions in its guidance for patients whose ability to manage self-care is compromised because of “medical, mental health, or significant social vulnerability”.

NHS England said that the figure of £32m fell within its expected range for savings. It added that the figure is the cost before discounts, and does not take into account factors including dispensing fees, or adjustment for income obtained where a prescription charge is paid or where the patient has a pre-payment certificate.

All savings, it added, are re-invested in patient care.

Claire Anderson, chair of the RPS’s English Pharmacy Board, said that “any further proposals on changes to prescribing must ensure that patients can still get access to the medicines they need”.

“Pharmacists play an important role in ensuring the NHS gets the most from its medicines budget and giving expert advice to patients,” she added. 

“The expansion of the Community Pharmacist Consultation Service could see more referrals into pharmacy for minor ailments, which will be key to managing demand across the NHS.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208291

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