Guidance issued to ensure rebate schemes are lawful
Primary care rebate schemes (PCRS) are lawful, but only if clinical decision making is not influenced by financial incentives to prescribe a medicine, according to released by NHS London Procurement Partnership (LPP).
Due to a large volume of queries relating to the schemes, the LPP sought advice on the legality of the arrangements, which are contracts offered by pharmaceutical companies or third parties that give financial rebates on GP prescribing costs for a particular brand name medicine.
"We were also concerned that a PCRS should offer genuine benefits to the NHS and patients, and not become an administrative burden", said Jas Khambh, pharmacy and medicines use and procurement lead for primary care at LPP.
Following the legal advice and a stakeholder consultation the LPP has now issued principles that can be used to scrutinise and properly implement the schemes, which are not unlawful provided they meet certain requirements. In broad terms any rebate scheme must be compatible with the effective, efficient and economic use of NHS resources.
Financial considerations come second
Mrs Khambh said: "What is clear is that a prescriber’s first responsibility is to act in a patient’s best interests. Financial considerations come second." She also made it clear that agreement to take part in a scheme should happen at a statutory organisational level, not at a GP practice level.
Rebate schemes promoting unlicensed medicines must not be entered into and where there is more than one indication for a medicine the scheme should not be linked to a specific use; "the clinical decision should inform the financial/procurement decision and not vice versa," say the principles. Furthermore, a right to terminate the contract on notice should be written in the contractual agreement. Also, there must be no requirement to collect or submit data to the manufacturer and the agreement must comply with the Data Protection Act.
Citation: Electronicjuice DOI: 10.1211/PJ.2013.11116590
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