Formularies not always the key
(Published 15 December 05)

Marketers need to understand the complexities of prescribing to make an impact.

Nearly one third of Primary Care Trusts (PCTs) in the UK do not have a drug formulary, according to new research from NHS information specialists, Health Direction.

The revelation will make worrying reading for pharmaceutical marketers who see their sales reps' ability to convince PCTs that thier drug should be placed on a PCT formulary as crucial in the changing NHS marketplace.

With decisions about which drugs can be prescribed gradually moving away from GPs, the industry's focus has shifted to organisations such as PCTs and the National Institute of Health and Clinical Excellence to promote recommended treatment procedures and drug regimes. Health Direction say the findings of its 'Sophistication Index' database which uses live NHS data to measure the extent to which PCTs have made progress, are a warning that pharma marketers need to understand the complexities of prescribing to really make an impact.

"Drug compnaies are completely passionate about the fact that there should be a formulary and their products should be on the formulary but quite often that's not really the be all and end all," said Health Direction information director, Sue Knox.

"It's more about the cohesiveness of the medicines management support team and how well they engage with their practices. There are other considerations such as the prescribing budget, whether a team is over- or under-spending, the size of the team and the strength of a PCT's primary-secondary care relationship."

She added that some PCTs might announce that they do not have a formulary because they want GPs to prescribe products appropriately: "It's not so much about what drug they use but rather about using it with the right patients at the right time."

The report warns that prescribing structures with the National Health Service may vary even more drastically than pharmaceutical marketers have previously thought. Data compiled from the Sophistication Index showed that the ratio of generics to branded drugs prescribed by different PCTs fluctuated widely. In 32 percent of PCTs, generics accounted for between 72 and 78 per cent of prescribed drugs, while for 39 per cent of PCTs, this figure rose to between 79.5 per cent and 86 per cent.

The Health Direction research found that only 8 per cent of PCTs had done 'extensive work' looking at the prescribing of non-steroidal anti-inflammatory drugs (NSAIDS) while 37 per cent had done 'little work'.

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