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    Richmond House 79 Whitehall London SWIA 2NS Telephone 0171 210 3000
           From the Minister of State


26 NOV 1998

Dear Mr Medawar

Thank you for your letter of 20 October to Frank Dobson about medicines considered to be less suitable for prescribing, which are now flagged more clearly in the British National Formulary.

The Department of Health welcomes and has taken an active role in the British National Formulary's initiative of highlighting drugs which are considered to be "generally less suitable for prescribing". The aim of this designation is to indicate to doctors that there are other drugs which in most cases may be more suitable. However, you rightly identify that depending on the individual circumstances of the patient, there may still be a legitimate role for the drugs. Only the doctor, in full knowledge of the patient and their condition, is in a position to decide on the most appropriate treatment for that patient.

Many of these drugs are already included in the performance management indicators for prescribing, notably that for drugs of limited clinical value. However, we will consider whether further changes to the PACT information system would be a useful addition for health authority advisers and practices.

The Government continues to encourage doctors to prescribe medicines which are clinically and cost-effective. We recognise the difficulties faced by doctors trying to keep up with increasingly complex developments in drug treatment and have implemented a number of mechanisms to support doctors in this quest. These include:



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