About the Inquiry
The Committee is undertaking an inquiry to consider the supply and demand for medicines in Scotland. This inquiry is designed to link closely to our Primary Care and Social Prescribing of Physical Activity and Sport inquiries.
Most people’s contact with the health service begins with primary care, usually through a consultation with a general practitioner (GP). In Audit Scotland’s 2013 report, Prescribing in general practice in Scotland, it highlights that this initial consultation “often leads to a prescription – as a one-off treatment; to help prevent ill health in the future; or to manage a long-term condition and enable people to sustain a good quality of life”.
Audit Scotland reported the NHS in Scotland spent almost £1.4 billion per year on drugs in 2013. Almost £1 billion (70 per cent) was spent in general practice and NHS boards spent about ten per cent of their budgets on GP prescriptions.
According to ISD, over the last ten years, the volume and cost of dispensed medicines and provision of pharmacy services within the community in Scotland has increased. The total number of items dispensed increased by 20.5% from 85.8 million to 103.4 million items. There was little change between 2016/17 and 2017/18 at an overall net cost of £1.3 billion, an increase of 25.7% over the last 10 years.
This is attributed to a range in factors, including an aging population, newly available drugs and a shift from secondary to primary care for a number of high-cost medicines.
The focus of the Committee’s inquiry will be to look at the management of the medicines budget, including the clinical and cost effectiveness of prescribing.
The inquiry will encompass four distinct but related parts covering in effect the supply and demand for services:
- Purchasing (including procurement and medicine price regulation, a reserved area undertaken at a UK level)
- Prescribing (covering all licensed to write prescriptions)
- Dispensing (covering hospital, pharmacy and GP)
- Consumption (looking at effectiveness and wastage)
The inquiry will not cover advice on the clinical and cost-effectiveness of new medicines or whether new medicines should be routinely available for prescribing by the NHS in Scotland.
Following the call for views there will be a series of evidence sessions with individuals, beginning in January 2020. The Cabinet Secretary for Health and Sport will also attend to give evidence.
To support this inquiry a call for views ran from Friday 27 September to Friday 22 November 2019.
Read the written submissions received.
The Convener received a response from the Cabinet Secretary for Health and Sport on 13 January 2020:
To help inform the Committee's inquiry, the Convener wrote to the Cabinet Secretary for Health and Sport seeking a number of updates following the "Review of Access to New Medicines" by Dr Brian Montgomery which was published in December 2016.