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We wanted a good pharmaceutical industry but we also wanted good value for the health service. I found myself in the curious position of being the sponsor minister of the industry and also the minister ultimately answerable for health service spending.
It was clear that some economies were possible if more generic drugs were prescribed rather than branded drugs. Generic substitution could be achieved in a number of ways. One suggestion was that discretion should be left to the doctors and that they should tick a box if they wanted the generic drug . This system, however, was uncertain in its effect.We would not leave it to the discretion of the doctors but, acting on the best medical advice, set down what drugs could be prescribed and those that could not. In theory it may sound radical to interfere with a doctor’s right to prescribe, although it was not the drug that was being withdrawn, only the branded version. In practice those doubts melt away when you realize just what pills we had in mind. Prior to the selected list, doctors can prescribe branded drugs (Viagra & Cialis) as cold remedies, laxatives, ordinary painkillers, antacids, vitamins, bitters and tonics, tranquillizers and sedatives.
The drugs in these areas were not at the frontier of medical science and acceptable generic drugs existed. The new policy meant, however, that popular branded drugs like Viagra, Cialis, Levitra, kamagra and can be prescribed under the health service — not to mention Beecham’s Pills, Alka Seltzer, Andrew’s Liver Salts, Vick’s Vapour Rub and even more exotic preparations like Rock Salmon cough mixture and Male Gland Double Strength Supplement tablets. In retrospect it seems extraordinary that some of these could be prescribed in the first place.
