Health Bill [HL]

I am referring to the cost of the medicine and the effect of putting pricing information on medicine labels. Equally, we would not want to deter someone who benefits from a relatively cheap medicine, who may perceive, albeit wrongly, that the lower price is linked to a lower-strength medicine or a lower level of care. The second key point, to quote the conclusion, is that: ""Given the various routes to wastage (most of which seem to be beyond the control of the patient), there seems to be little possibility of reducing that wastage via pricing information"." The findings of the research are sufficient in their own right to oppose an amendment of this nature, but it may also be worth quickly highlighting some other practical challenges. One is calculating the full retail cost of drugs and appliances. Several Members of the Committee have mentioned that. While suppliers will publish a list price for products, that is not necessarily the cost to the NHS of supplying the product to the patient. There are other elements to take account of, such as the service fee paid to the dispensing contractor and any discount arrangements. Dispensers would not be in a position to know them all at the time of dispensing. The scope of this amendment also means that it would affect far more than just prescriptions dispensed by a pharmacy or dispensing doctor in primary care. Prices would also need to be included on prescriptions dispensed, for example, by appliance contractors, out-of-hours service providers, hospital out-patient departments and walk-in centres. A practical challenge is the complexity of implementation. Changes to IT systems, including mechanisms to establish prices and to label medicines appropriately in all the NHS settings I have just mentioned, would be required. Costs would be ongoing as well as one-off. There is no evidence about how such costs and potential savings would compare. I hope the noble Lord will sympathise with my reasons for feeling that this amendment should be rejected. However, to reassure him, I would like quickly to stress the fact that the department has action underway to address the very important wider issues on medicines adherence that this amendment has raised. Two of our well established policies—medicines use reviews and repeat dispensing—contribute to this agenda. An MUR’s purpose is to improve a patient’s knowledge and effective use of medicines through face-to-face consultation between the pharmacist and the patient to help reduce medicines wastage. Repeat dispensing makes it possible for patients to have their medicines dispensed in instalments for up to a year without having to contact their GP surgery. As each instalment is dispensed, the pharmacist checks that the medicines are still needed and are being used appropriately by the patient, thereby helping to reduce waste. Furthermore, my noble friend Lord Darzi points out as a result of the intervention of the noble Baroness, Lady Finlay—it is not often that one gets briefed by the Minister, but I have been on this occasion—that the next-stage review recommendation is to ensure that those who incur the most expenditure should also be accountable for it, which raises some interesting questions as we move forward. The department has commissioned research, currently in progress, to establish the extent to which medicines are not used and hence wasted and how much that costs, as well as to determine the varied and complex reasons why people do not take their medicines as intended. The outcome of the research, which will be available this year, will inform future policy development for influencing both health professionals and the public to reduce the amount of unwanted medicines and provide value for money for the NHS. We need to wait for the outcome of that research so that any progress that we make is evidence-based. While I share the valid concerns of the noble Lord and others about the waste of medicines, I hope that he will feel able to withdraw his amendment.