http://bmj.com/cgi/content/full/324/7348/1234/a
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In a bid to cut the rising costs of government subsidised drugs
a
rise partly caused by inappropriate prescribingthe
Australian government has opted to enlist the sales force of
pharmaceutical companies.
The decision has astonished consumer groups but been welcomed by its proponent, the Australian Pharmaceutical Manufacturers Association.
According to last week's Budget papers, savings will be achieved by ensuring that restrictions on the government's pharmaceutical benefits scheme, under which the government subsidises the costs of approved drugs, will be communicated to doctors through drug company representatives.
The association volunteered to ensure that companies undertook the task because it was alarmed by government insistence on cutting the costs of the scheme and by demands from consumer groups that companies curb their marketing campaigns.
"We felt we could tidy up concerns about inappropriate prescribing pretty quickly and easily, so there could be no argument that doctors weren't aware of the pharmaceutical benefits scheme restrictions," said Alan Evans, the association's chief executive officer.
Nicola Ballenden, senior policy officer at the Australian Consumers Association, is amazed at the decision. "It is a little like putting the fox in charge of the chicken shed."
Exactly how the programmeestimated
to save £55.5m (US$81m; 
88m) over four yearswill
operate is still being discussed. "The detail has yet to be agreed
with the manufacturers," said a spokesman from the Department of
Health and Aged Care.
The pharmaceutical benefits scheme is 50 years old. For manufacturers the
subsidy scheme guarantees access to a larger marketmostly
poorer consumerswhile
allowing the government to negotiate discounted prices.
Over the last decade annual expenditure on the scheme grew by 250% to the current £1.7bn. Last financial year the cost grew by 20% partly driven by approval for listing of bupropion (Zyban) for tobacco addiction and celecoxib (Celebrex) for arthritis.
The proposal from the manufacturers' association was attractive to the government as a way to directly influence doctors without employing more staff. "The industry measure is an attempt by government to take advantage of the marketing capacity of the industry," said a health department spokesman.
Ballenden argues that a better option would be to ban the marketing of new drugs until the National Prescribing Service, which many doctors rely on for advice, has issued its prescribing guidelines for the drugs: "We know that with Celebrex there was a big drop off in prescribing when the National Prescribing Service guidelines came out."
Another budget decision requires doctors to use prescribing software in which
cheaper generic drugs are set as the default option.
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Collections under
which this article appears:Organization
of health care Competing
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