Australia turns to drug company representatives to cut prescribing
Bob Burton, Canberra
In a bid to cut the rising costs of government subsidised drugsa
rise partly caused by inappropriate prescribingthe
Australiangovernment has opted to enlist the sales force of
pharmaceuticalcompanies.
The decision has astonished consumer groups but been welcomed by its
proponent, the Australian Pharmaceutical ManufacturersAssociation.
According to last week's Budget papers, savings will be achieved by ensuring
that restrictions on the government's pharmaceuticalbenefits scheme,
under which the government subsidises the costsof approved drugs,
will be communicated to doctors through drugcompany
representatives.
The association volunteered to ensure that companies undertook the task
because it was alarmed by government insistence oncutting the costs
of the scheme and by demands from consumer groupsthat companies curb
their marketingcampaigns.
"We felt we could tidy up concerns about inappropriate prescribing pretty
quickly and easily, so there could be no argumentthat doctors
weren't aware of the pharmaceutical benefits schemerestrictions,"
said Alan Evans, the association's chief executiveofficer.
Nicola Ballenden, senior policy officer at the Australian Consumers
Association, is amazed at the decision. "It is a littlelike putting
the fox in charge of the chickenshed."
Exactly how the programmeestimated
to save £55.5m (US$81m; 88m) over four yearswill
operate is still being discussed. "Thedetail has yet to be agreed
with the manufacturers," said a spokesmanfrom the Department of
Health and AgedCare.
The pharmaceutical benefits scheme is 50 years old. For manufacturers the
subsidy scheme guarantees access to a larger marketmostlypoorer consumerswhile
allowing the government to negotiate discountedprices.
Over the last decade annual expenditure on the scheme grew by 250% to the
current £1.7bn. Last financial year the cost grewby 20% partly
driven by approval for listing of bupropion (Zyban)for tobacco
addiction and celecoxib (Celebrex) forarthritis.
The proposal from the manufacturers' association was attractive to the
government as a way to directly influence doctors withoutemploying
more staff. "The industry measure is an attempt by governmentto take
advantage of the marketing capacity of the industry,"said a health
departmentspokesman.
Ballenden argues that a better option would be to ban the marketing of new
drugs until the National Prescribing Service, whichmany doctors rely
on for advice, has issued its prescribing guidelinesfor the drugs:
"We know that with Celebrex there was a big dropoff in prescribing
when the National Prescribing Service guidelinescame
out."
Another budget decision requires doctors to use prescribing software in which
cheaper generic drugs are set as the defaultoption.
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