The soaring cost of prescriptions to the health service has put the price of medication firmly in the spotlight, with Falkirk patients being urged to do their part to keep costs down by not ‘stockpiling’ medicines.
Falkirk Health and Social Care Partnership faces a £20 million budget deficit over the next three years and the cost of drugs is just one part of the challenge, members of Falkirk Council heard at their final meeting of the year.
The partnership’s annual report noted that prices per item across Forth Valley have risen from £11.07 to £11.36, and volumes have risen from approximately 540,000 items per month to 559,000.
Read more: Falkirk patients urged to look at options as demand rises for GP appointments
Facing an estimated overspend of £2.4 million on prescriptions, members heard this is an “area of focus” for the partnership.
The interim head of Primary Care for Falkirk Health and Social Care Partnership, Tom Cowan, told members that the rising prices had many causes, including international market volatility, market pricing, and the sudden demand for new drugs that have been made available.
But there are also drugs that have been reviewed and found to have little to no clinical value, while some brands remain more expensive than generic alternatives that do exactly the same job.
And there are moves being made to take “a more rigorous approach” to reduce unnecessary prescribing.
Mr Cowan explained that the continuing pressure on GPs, facing overwhelming workloads, was making it difficult for them to have proper conversations with people who could move to different, cheaper or even no medication.
He told members: “In the ten minutes that people have with a GP, it’s very difficult to influence change in someone’s historic regime or their history with certain medications or their knowledge of certain brands etc. and then holding a line on non-clinically proven medicines or try to shift them on to alternatives.”
Making the guidance more rigorous, he said, “would protect GPs from being the sole focus of anxiety and unhappiness” as patients are told they need to swap brands or stop taking medication altogether.
But he said the partnership does recognise how difficult and upsetting this could be, so promised there will be a “campaign of education and information” on the issue.
One of the biggest ways people could help to reduce the deficit, he said is not stockpiling medicines or taking ones they won’t use.
“It would be fair to say that the most expensive medications are those that don’t get used because that’s a complete waste from beginning to the end of the process,” he said.
The campaign will also encourage people not to take prescriptions for things like paracetamol which can be bought over the counter.
Baillie James Kerr said he recognised the problem, saying: “It’s the repeat prescriptions that people get – I think of my late mother- and father-in-law, where their cupboard was full of drugs – but how do we stop that?
“I’m sure everyone in this room knows people who have cupboards full that they will never use.”
Mr Cowan agreed, saying: “I can see a lot of people nodding and I know myself from my own family experience.
“My late Dad was like a branch of Boots the Chemist – other brands are available – because of the amount of gathered medication.”
He said it was important to understand why many people feel anxious about not having medication that would see them through times they couldn’t get to the doctor or pharmacies might be closed.
And he acknowledged that the pressure on GPs is making it almost impossible for doctors to routinely review medication to make sure there are no issues.
He said: “My mother ended up for innumerable years on a medication that should have been stopped about 20 years before and eventually had a very harmful effect on her because nobody at any stage thought to check.
“And I know that seems like a distant past now but there is still an element here of the impact we are able to make through pharmacotherapy.”
While he stressed that GPs are very heavily regulated, he admitted that the financial pressure facing health services is also making it difficult to get funding for a full-scale review of pharmacotherapy.
One of the solutions, he said, is having pharmacists working within medical practices to help review people’s medication, which has been introduced as part of the Primary Care Improvement Plan.
But he added: “Unless we can create some capacity in our GPs and associated professionals we are struggling to get to that point where we can be more informed about what people really need and keeping on top of reviews.”
He added that it was also important to have a network of support in place so that GPs could find an alternative to medication for people who are struggling with mental well-being.
“There has to be a network of support that feels realistic and available and accessible to people so that not getting the prescription they thought they were getting isn’t a drop into anxiety or uncertainty, it’s a move into something that is just as reliable, more robust and long-term, better for them.”
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