Taking an active approach to medicines management

Getting the best value out of medicines and NHS resources is a key determinant of sustainable healthcare in the UK. As the next steps of the NHS Five Year Forward View (NHS, 2017) affirmed in March 2017, ‘every pound of waste saved is a pound that can be reinvested in new treatments and better care’. It is, therefore, no surprise that efforts to drive medicines optimisation are intensifying. The next steps review (NHS, 2017) urges clinical commissioning groups (CCGs) and medicines optimisation teams to ‘take action’ on medicines and products. Cheaper, clinically equivalent alternatives are available to many drugs, to ensure that prescribing budgets are spent on interventions that have the greatest impact on patient care.

However, revising the formulary—on its own—is not adequate. Formulary decisions need active implementation if they are to realise anticipated gains.

Despite the best efforts of medicines management to identify both the areas of prescribing that yield low clinical value and the potential cost savings of using cheaper clinically equivalent alternatives, the combination of limited resources and long-standing behaviours embedded in NHS culture often prevents these evidence-based evaluations from being maximised in clinical practice. With pressure on NHS resources continuing to escalate, we have now reached a critical juncture: if medicines management is to deliver the outcomes that its endeavours richly deserve, it is time to consider new models of working to help these teams optimise prescribing budgets.