Fees for prescribing pharmaceutical products – interim statement - June 2007

Extract from GPC...

The GPC recently issued guidance on fees for prescribing pharmaceutical products (below at appendix 1).

Since it was distributed we have had a number of queries regarding the use of agencies for particular products that both dispensing doctors and pharmacies call upon.  These agencies have expert knowledge on a range of products such as stoma bags, and GPs or pharmacists provide them directly with a prescription for which they get some of the fee that the agency gets when seeking reimbursement for it through the PPA.  This fee goes to the GP or pharmacist for providing time and advising the patient on how exactly to use the products and ensuring it meets their needs.

The GPC strongly supports the principle that doctors must be properly rewarded for their professional time and professional activity.  Where a GP or practice carries out work in connection with the provision of drugs or appliances and that work is shared with another person or organisation we accept that it is appropriate for the fees to be shared to reflect the division of work.

The GPC is working on and hopes to produce in the next year extended guidance on issues around conflicts of interest.
 
APPENDIX 1 - Fees for prescribing pharmaceutical products

GPC advice
The GPC has become aware of a scheme whereby a pharmaceutical company is offering practices a 15%-20% fee for prescribing/supplying their range of appliances and wound care products.  Practices who sign up with them must put a company poster up in their waiting room.

The GPC is very concerned that some doctors are not aware of the ethical and professional implications of participating in such a scheme.

We would like LMCs to remind all practices that the GMC’s Good Medical Practice states:

• ‘You must act in your patients’ best interests when making referrals and providing or arranging treatment or care. So you must not ask for or accept any inducement, gift or hospitality which may affect or be seen to affect your judgement. You should not offer such inducements to colleagues.’

The GMC’s Good Practice in Prescribing Medicines (part of Good Medical Practice) states:

• ‘You should respect patients’ freedom to choose where to have their prescribed medicines dispensed.  You should not prescribe differently for patients to whom you also dispense for your own or your employers’ commercial or financial benefit.’

Please note, prescribing doctors are also dispensing doctors when it comes to prescribing through the Personally Administered Drugs system.

The GPC unequivocally advises GPs not to involve themselves in arrangements which pay a fee for prescribing products.

The Association of the British Pharmaceutical Industry (ABPI) recently updated its Code of Practice for the Pharmaceutical Industry and it states:

• “No gift, benefit in kind or pecuniary advantage shall be offered or given to members of the health professions or to administrative staff as an inducement to prescribe, supply, administer, recommend, buy or sell any medicine……’

Doctors are encouraged to report companies that breach the rules governing relations between prescribers and pharmaceutical companies to the Prescription Medicines Code of Practice Authority (which enforces the ABPI Code of Practice).

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