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.
Focus
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.
Timetable
Following the call for views, a series of evidence sessions to cover the four main parts of the inquiry have been scheduled as follows. The Cabinet Secretary for Health and Sport will also attend to give evidence on 10 March 2020.
Evidence
To support this inquiry a call for views ran from Friday 27 September to Friday 22 November 2019.
Read the written submissions received.
Correspondence
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.
The Convener received a response from the Cabinet Secretary for Health and Sport on 13 January 2020:
Following the evidence sessions on 21 January 2020, the Convener received additional information from Elizabeth Woodeson, Director of Medicines and Pharmacy, Department of Health and Social Care, UK Government, on 24 January 2020.
The Convener issued letters seeking further information following the evidence sessions on 21 January 2020:
- Letter to Alison Culpan, Scotland Director, Association of the British Pharmaceutical Industry - 5 February 2020 (115KB pdf)
- Letter to Warwick Smith, Director General, British Generic Manufacturers Association - 5 February 2020 (115KB pdf)
- Letter to Rose Marie Parr, Chief Pharmaceutical Officer, Scottish Government - 5 February 2020 (111KB pdf)
- Letter to Matt Barclay, Director of Operations, Community Pharmacy Scotland - 5 February 2020 (106KB pdf)
- Letter to Elizabeth Woodeson, Director of Medicines and Pharmacy, Department of Health and Social Care, UK Government - 5 February 2020 (64KB pdf)
- Letter to Jonathan Mogford, Director of Policy, Medicines and Healthcare Products Regulatory Agency (MHRA) - 5 February 2020 (113KB pdf)
- Letter to Lindsay McClure, Associate Director, Medicines Pricing and Supply, NHS National Services Scotland - 5 February 2020 (108KB pdf)
- Letter to Dr Alan Macdonald, Chair, Scottish Medicines Consortium - 5 February 2020 (110KB pdf)
- Letter to The Rt Hon Priti Patel MP, Secretary of State for the Home Department, Home Office - 6 February 2020 (81KB pdf)
The Convener received the following responses to the above letters:
- Letter from Matt Barclay, Director of Operations, Community Pharmacy Scotland - 20 February 2020 (144 KB pdf)
- Letter from Lindsay McClure, Associate Director, Medicines Pricing and Supply, NHS National Services Scotland - 24 February 2020 (492KB pdf)
- Letter from Elizabeth Woodeson, Director of Medicines and Pharmacy, Department of Health and Social Care, UK Government - 26 February 2020 (146KB pdf)
- Letter from Alison Culpan, Scotland Director, Association of the British Pharmaceutical Industry - 26 February 2020 (283KB pdf)
- Letter from Rose Marie Parr, Chief Pharmaceutical Officer, Scottish Government - 26 February 2020 (176KB pdf)
- Letter from Dr Alan Macdonald, Chair, Scottish Medicines Consortium - 26 February 2020 (444KB pdf)
- Letter from Warwick Smith, Director General, British Generics Manufacturers Association - 26 February 2020 (438KB pdf)
- Letter from the Minister of State for Crime and Policing - 3 March 2020 (79KB pdf)
- Letter from Jonathan Mogford, Director of Policy, Medicines and Healthcare Products Regulatory Agency (MHRA) - 4 March 2020 (42KB pdf)
The Convener issued letters seeking further information following the evidence sessions on 28 January and 4 February 2020:
- Letter to Matt Barclay, Director of Operations, Community Pharmacy Scotland - 17 February 2020 (117KB pdf)
- Letter to John Burns, Chief Executive, NHS Ayrshire and Arran - 17 February 2020 (110KB pdf)
- Letter to Gail Caldwell, Director of Pharmacy, NHS Greater Glasgow and Clyde - 17 February 2020 (116KB pdf)
- Letter to Professor Angela Timoney, Director of Pharmacy, NHS Lothian - 17 February 2020 (115KB pdf)
- Letter to David Coulson, Assistant Director of Pharmacy, NHS Tayside - 17 February 2020 (111KB pdf)
- Letter to Dr Scott Jamieson, Royal College of General Practitioners - 17 February 2020 (114KB pdf)
- Letter to Jonathan Burton, Chair of the Scottish Pharmacy Board, Royal Pharmaceutical Society in Scotland - 17 February 2020 (123KB pdf)
The Convener received the following responses to the above letters:
- Letter from Gail Caldwell, Director of Pharmacy, NHS Greater Glasgow and Clyde - 28 February 2020 (164 KB pdf)
- Letter from David Coulson, Assistant Director of Pharmacy, NHS Tayside - 2 March 2020 (1.05MB pdf)
- Letter from Professor Angela Timoney, Director of Pharmacy, NHS Lothian - 2 March 2020 (803KB pdf)
- Letter from Dr Scott Jamieson, Royal College of General Practitioners - 2 March 2020 (159KB pdf)
- Letter from Matt Barclay, Director of Operations, Community Pharmacy Scotland - 3 March 2020 (213KB pdf)
- Letter from John Burns, Chief Executive, NHS Ayrshire and Arran - 3 March 2020 (67KB pdf)
The Convener issued letters seeking further information following the evidence session on 18 February:
- Letter to Dr Sheuli Porkess, Executive Director of Research, Medical and Innovation, Association of the British Pharmaceutical Industry - 28 February 2020 (111KB pdf)
- Letter to Adam Stachura, Head of Policy and Communications, Age Scotland - 28 February 2020 (60KB pdf)
- Letter to Nicola Cotter, Head of GMC Scotland (General Medical Council) - 28 February 2020 (110KB pdf)
- Letter to Dr David Shackles, Executive Officer for Interface and Out of Hours, Royal College of General Practitioners - 28 February 2020 (62KB pdf)
- Letter to Jonathan Burton, Chair of the Scottish Pharmacy Board, Royal Pharmaceutical Society in Scotland - 28 February 2020 (62KB pdf)
The Convener received the following responses to the above letters:
Following the Cabinet Secretary for Health and Sport's evidence session on 10 March 2020, the Convener issued a letter seeking further infomation on a number of points:
The Convener received a response to the above letter on 6 November 2020:
The British Medical Association and the Royal College of GPs wrote to the Committee regarding the publication of its report:
The Cabinet Secretary for Health and Sport wrote to the Convener regarding a response to the supply and demand for medicines inquiry report.
The Committee received the following letter from NHS Scotland Directors of Pharmacy following the publication of the report:
Report
The Committee published its report on the Supply and Demand for Medicines in Scotland on 30 June 2020.
The Committee received a response to the report from the Cabinet Secretary for Health and Sport on 11 September 2020.
The Committee considered the above response at it's meeting on 29 September 2020 and agreed to issue a further letter seeking a response which addresses each recommendation within the report, as per existing protocol.
The Committee received the Scottish Government's response to the recommendations in the report on 23 November 2020.