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The Rt. Hon. Frank Dobson PC MP
Secretary of State for Health
Richmond House
Whitehall,
London SW1A 2NS 20 October 1998

Dear Mr Dobson,

The Joint Formulary Committee has just taken a very positive step in more prominently signalling in the new edition of the British National Formulary the drug products it rates "less suitable for prescribing". I know you will be concerned to see, from the attached tabulation, that GPs in England write about 30 million prescriptions a year for such products, costing the NHS over 100m per year.

I am writing to suggest one way in which the Department might consolidate this initiative. Perhaps you could encourage the Prescription Pricing Authority to modify the PACT printouts it regularly sends to doctors, to advise about the numbers and cost of the 'less suitable' drugs they are prescribing, with an indication of how their performance compares with the average. The point about these products is not that they are always going to be wrong for every patient, but that doctors should be especially ready to justify such prescribing when there may well be better alternatives - and that the NHS should positively encourage this.

For your interest, I am enclosing copies of letters I have written to Professor Sir Charles George, and to the Select Committee on Health.

Yours sincerely,
Charles Medawar

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