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Dispensed Prescriptions rise 70pc

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The number of prescriptions made outside hospitals in England has risen almost 70 per cent in a decade, according to the NHS Information Centre.

While in 2000 there were 552 million items prescribed, that rose to 927 million in 2010.

Drugs to counter cardiovascular disease, such as statins which lower cholesterol and ACE inhibitors which lower blood pressure, are now the most frequently prescribed.

Meanwhile, the drugs bill to tackle diabetes has risen rapidly. Experts say this is due both to a rise in the numbers of people with the disease – curreently estimated at about 2.5 million – and the fact a number of expensive new treatments have come on to the market.

Overall, the prescription drugs bill has risen 58 per cent between 2000 and 2010, from £5.59 billion to £8.83 billion – close to 10 per cent of the entire NHS budget.

The number of prescriptions per person has also risen sharply, from 11.2 in 2000 to 17.8 in 2010, which translates to an increase in the average cost per head from £113 to £169.

The Patients’ Association believes doctors are doling out drugs too easily, although others emphasise that the population is ageing – and older people need more drugs to keep them healthy.

NHS prescription

NHS prescription

Katherine Murphy, Chief Executive of the Patients’ Association said: “If patients are getting access to more of the medicines they need, in particular more specifically tailored medicines, we would welcome this move.

“However, we are concerned that with consultation times being so short, rather than being able to tackle the problems patients have, doctors may be simply prescribing medicines.”

The new figures were released a day after the Family Doctor Association warned that four in five GPs were prescribing drugs to patients that they suspected were addicted to them.

Many are also concerned about medicalising large sections of the population: some seven million now take statins alone.

However, Prof David Taylor of the School of Pharmacy at London University, defended the widespread use of preventative medicines for chronic diseases.

He said: “In my view it’s deeply desirable to use these drugs.”

Drugs like ACE inhibitors had transformed the treatment of heart failure, he said, while statins were proven to lower the risk of cardiac events.


He said the numbers of prescriptions had risen in part due to the ageing population, in part due to greater prevalence of lifestyle diseases, and in part due to smarter ways of prescribing that resulted in smaller doses of more drugs.

He also pointed out that the average cost of individual drugs was going down as more were going ‘off-patent’. That is borne out by the NHS figures, which show the cost per prescription has dropped from £10.12 in 2000 to £9.53 in 2010.

But Mike Holden, chief executive of the National Pharmacy Association, said there was “a huge amount of waste” in prescribing.

“Up to half of all medicines for long term conditions are not taken as intended by the prescriber,” he said.

“There is no doubt that much more value for patients and the tax payer could be extracted from this massive investment by supporting more effective medicines use.”

Paul Burstow, the Care Services Minister, said: “The big rise in prescribing revealed today largely reflects the impact of a growing and ageing population, as well as an increase in the prescribing of preventative medicines, such as low cost statins, for cardiovascular diseases.”

Doubts cast on TB blood test

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Blood tests designed to detect active TB are inaccurate and should be banned, the World Health Organization has said.

More than two million such tests are carried out annually, but the WHO says they are unethical and lead to misdiagnosis and the mistreatment of patients.

The organisation’s review of these tuberculosis test kits says they give wrong results in around 50% of cases.

The kits are mainly sold in the developing world.

However, most of the 18 kits on the market are produced in Europe and North America.

According to Dr Mario Raviglone, the director of the WHO Stop TB Department, the tests must be banned.

He said: “A blood test for diagnosing active TB disease is bad practice. Tests are inconsistent, imprecise and put patients’ lives in danger.”

The tests work by detecting antibodies or antigens in the blood that are produced in response to the bacterium.

But some of these commercial tests have what’s called “low sensitivity” which leads to large numbers of patients being told they do not have TB when they do.

Tuberculosis

Tuberculosis

Dr Karen Weyer, who is also from the WHO Stop TB department, added: “The evidence we reviewed over the past couple of months shows that one in two patients will be wrongly diagnosed, either [as] false negative or false positive.

“If it’s a false negative patients get the all clear when they in fact have TB, the disease continues to spread, and the patients may die.

“If, on the other hand, it’s false positive, patients are put on treatments unnecessarily while the true cause of their disease remains undiagnosed.”

“We would describe this as unethical – and we are making a very strong urge to governments to consider that TB is a threat and the use of these ineffective tests is also a threat.”

The WHO says that the tests which are manufactured in Europe and North America are prevented from going on sale where they are made due to regulations that call for extensive evidence of accuracy.


But this is not the case in the developing world – including in India and China.

Dr Weyer added: “One of the major problems is that these developing countries often have little or very weak regulatory mechanisms to make sure that tests are registered before they are used at country level.

“Another problem is that these tests are often used in the private sector, which is a difficult sector to regulate and as a result there is a wide misuse, I would say, of these inaccurate tests in the private sector in at least 17 countries that we are aware of.”

She said there was a need for a TB test that could be used “at the bedside”. But she added: “We don’t have a blood test for TB that can be used at the point of care level.”

The WHO says this call for a ban is a highly unusual move – It’s the first time the organisation has issued an explicitly negative policy recommendation against a practice that is widely used in tuberculosis care.

TB kills 1.7m people every year, and is the biggest cause of death of people living with HIV.