Chamber and committees

The Scottish Medicines Consortium is a consortium of NHS boards. It brings together Area Drug and Therapeutics Committees to ensure that all NHS boards receive the same advice on the clinical and cost effectiveness of new drugs at the time of their launch, and does not need to be a statutory body.

The information requested is given in the following table:Most Commonly Prescribed Drugs by Volume and (Number of Items Dispensed) During 2001-02

	Number of Dispensed1 Items	Gross Ingredient2Cost (£)
Diazepam	737,895	959,170
Amitriptyline	525,485	1,127,664
Fluoxetine	500,390	4,636.70
Paroxetine	468,847	12,437,001
Temazepam	455,686	753,203
Citalopram	375,172	8,036,725
Zopiclone	253,914	1,040,088
Nitrazepam	231,916	351,461
Venlafaxine	231,483	9,090,742
Sertraline	210,468	5,561,565
Dothiepin Hydrochloride	208,268	826,899
Chlorpromazine Hydrochloride	149,266	334,755
Trazodone Hydrochloride	139,465	2,194,398
Zolpidem	92,997	380,306
Risperidone	88,745	3,880,327
Chlordiazepoxide	88,345	230,615
Lithium Carbonate	79,611	201,283
Lofepramine	76,710	944,607
Mirtazapine	73,834	2,112,260
Olanzapine	67,171	7,016,214

Notes:1. Data refer to prescriptions dispensed in the community but do not take into account medicines dispensed by hospitals or hospital-based clinics.2. The cost given is the cost of items before addition of any pharmacy fees and deduction of any discount and patient charges.

The Scottish Medicines Consortium is a consortium of NHS Board Area Drug and Therapeutics Committees. While the Health Technology Board for Scotland (HTBS) provides administrative, technical and communication support to the consortium, the consortium is not a part of HTBS.

Information on the total number and cost of NHS prescriptions dispensed by community pharmacists, dispensing doctors and appliance suppliers is collected centrally and is publicly available on the Information and Statistics Division website:http://www.show.scot.nhs.uk/isd/primary_care/pservices/pcare_pservices.htm.The data are shown for the most recently available year broken down by dispensing NHS board. These data do not include prescriptions for medicines dispensed by hospitals or hospital-based clinics. They also do not include over-the-counter medicines purchased without a prescription.

I fully appreciate the particular difficulties being faced by the wider Ayrshire economy, and am confident that the local agencies will meet these challenges through their shared long-term economic development strategy to boost the local economy and create jobs for local people. This strategy was agreed in principle by the Local Economic Forum on Friday 8 November and focuses on the key objectives of boosting the economy; increasing connectivity to markets; developing a positive workforce; reducing unemployment in Ayrshire, and promoting a pride in Ayrshire.

We are not aware of any such trials being carried out.

The Scottish Executive is not aware of any studies being conducted with selective serotonin re-uptake inhibitors in children in Scotland.

The regulation and safety of medicines is reserved and is the responsibility of the Medicines Control Agency (MCA). The following information has been provided by the MCA:In order for a pharmaceutical company to gain a licensed indication for the use of its product in children or adolescents, they are required to submit clinical data to the MCA on safety, quality and efficacy to support the indication in the same manner and to the same standards that would be expected in adults. This is the same for all drugs including anti-depressants and anti-psychotic drugs.There is general concern about the lack of medicines licensed specifically for use in children. It is a widely held view that it is unethical for children not to have access to medicines of the same standards of safety, quality and efficacy as the rest of the population. Until comparatively recently, perceived ethical concerns and practical difficulties created problems in conducting trials in children which has prevented the development of medicines for them.In the UK there is extensive prescribing "off-label" of medicines for children i.e. outside the terms of the licence. Off-label prescribing occurs where the clinician believes it is justified and is a matter for clinical judgement, informed by specialist guidance produced by and available to the profession. A doctor may therefore prescribe a medicine for a child that is licensed only for adults.A number of measures have been taken at national level within the existing legal framework. The MCA has developed a strategy to improve the availability of medicines licensed for use in the treatment of children and in 2000, the Committee on Safety of Medicines (CSM) - an independent expert advisory body - established an expert working group to take this issue forward.The European Commission has also recognised the need to address this issue and a consultation exercise on their draft proposals was completed in April 2002. The UK gave broad support to the proposals, which combined incentives to the industry with regulatory requirements, and draft European legislation is expected to emerge shortly.

The regulation and safety of medicines is reserved and is the responsibility of the Medicines Control Agency (MCA). The following information has been provided by the MCA: AntipsychoticsThe following "typical" antipsychotics are authorised for the treatment of psychotic disorders (e.g. schizophrenia and autism) in children: chlorpromazine, haloperidol, levomepromazine/methotrimeprazine, pericyazine and trifluoperazine. For these older drugs, the dosage recommendations are mainly based on long established use in clinical practice. Another well-established anti-psychotic, prochlorperazine, is authorised for use in children in nausea and vomiting only. None of the newer "atypical" anti-psychotics is authorised for use in children.Anti-depressantsCurrently, no medicines are authorised for the treatment of children and adolescents with depression.Two of the newer selective serotonin uptake inhibitor (SSRI) anti-depressants, fluvoxamine and sertraline, have been authorised for use in children suffering from obsessive compulsive disorder (OCD) and the dosage recommendations are based on clinical trial data. These data are held on file by the marketing authorisation holder and the competent authority.Three of the older tricyclic anti-depressants, amitriptyline, imipramine and nortriptyline, are authorised for use in children with nocturnal enuresis (bed-wetting). For these long-established medicines, dosage recommendations are mainly based on prescribers' experience in marketed use, rather than the robust clinical trial data that would now be required for the licensing of new medicines.

Free local off-peak concessionary bus travel for elderly and disabled people has been delivered through enhancements to the 16 existing concessionary fares schemes operated by local authorities in Scotland.A research project has been commissioned by the Executive to monitor travel behaviour both before and after the enhancements came into force in order to accurately gauge their impact.