NHS proposes crackdown on erectile dysfunction drugs and suncream

Eli Lilly’s Cialis (tadalafil) erectile dysfunction drug should no longer be prescribed on England’s NHS, according to a new list of drugs that are no longer considered cost-effective.

Commissioners have said that cheaper generics of Pfizer’s Viagra (sildenafil) should be used instead of the branded product.

The crackdown could also see the NHS refuse to reimburse certain other products, such as suncream, which are also available over the counter in pharmacies.

The move is part of a review by NHS Commissioners, who have identified up to £400 million in savings from spending that has little or no clinical value.

The NHS hopes that the money saved can be spent on high priority areas, such as mental health and primary care.

According to NHS England, the medicines are ‘ineffective, unnecessary’ and inappropriate for prescription.

NHS Clinical Commissioners, representing health managers in charge of budgets, has drawn up an initial list of products that currently cost £128 million.

Some of them are often available over the counter at less than the prescription charge, they noted.

On the list are:

  • Products of ‘low clinical effectiveness’ (£37.98 million)
  • Co-proxamol analgesic, withdrawn in 2005 but still prescribed at high price (£8.32 million)
  • Omega 3 and fish oils (£5.65 million)
  • Lidocaine plasters (£17.59 million)
  • Rubefacients (£6.43 million)
  • A group of medicines where a more cost-effective alternative is available (£58.69 million)
  • Low priority products, including gluten-free foods and travel vaccines.

The group of medicines includes liothyronine for underactive thyroid, which, according to NHS England, is costly and has limited evidence to support its use. The majority of patients can also be controlled on cheaper levothyroxine.

Eli Lilly’s Cialis (tadalafil) should also not be prescribed, as generic Viagra is much cheaper and just as effective.

Also on the list is hypertension drug doxazosin, and the painkiller fentanyl – evidence of superiority over morphine is limited but it is much more expensive.

CCGs are also thinking of cracking down on drugs for upset stomachs, antihistamines, suncream, cold and cough remedies, heartburn and indigestion remedies.

Dr Graham Jackson, co-chair NHS Clinical Commissioners said:

“We need to be honest with the population – the NHS can and does provide high quality, cost effective care, but our ability to continue to do so will be restricted if we can’t prioritise those areas which will get the best outcomes for patients, whilst getting the best value for our limited NHS budget.

“The medicines spend is one where there is huge potential to unlock resources and redirect them to those higher priority areas like mental health and primary care. Through doing this we can deliver better outcomes for patients. The principles of this work will also support the much-needed, long-term transformation of the NHS.”



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