Stomach drug rules 'save £50m'

Doctors are advised to cut down on expensive drugs

Guidelines on indigestion and heartburn treatment could save the NHS millions, say the government advisory group behind them.

The National Institute for Clinical Excellence wants to cut the amount of an expensive indigestion drug prescribed on the health service.

But experts have warned that it may not be easy to make such pronounced savings.

As many as four in ten adults suffer from symptoms of dyspepsia, or heartburn.

Many of them are given high doses of drugs called Proton Pump Inhibitors (PPIs) when they visit their GPs - these are extremely effective at removing the symptoms.

However, the institute's experts argue that a great many patients would have been helped by cheaper antacid drugs, or could have had their doses of PPIs reduced with no return of symptoms.

Many GPs spend more on PPIs than any other drug they prescribe, and just by cutting back in this way, millions could be saved.

Patients currently on high doses can now expect these to be cut back in many cases.

Great savings

Dr Rupert Crispin, a Bognor Regis GP, said: "We've been looking at our own drug budget, and we think we could save between £30,000 and £40,000 a year this way.

"Having said that, there are a lot of other drugs coming along, such as Zyban, the smoking cessation drug, which will prove just as expensive."

However, Dr Richard Stevens, chairman of the Primary Care Society for Gastroenterology, was slightly more sceptical whether Nice's estimate of savings was achievable.

He said: "My understanding is that PPI use is still increasing at a great rate. Perhaps aiming for a decreasing rate of increase would have been more realistic."

He said: "This is a very common problem and a very effective drug."

Other parts of the guidance are likely to cost the NHS extra millions, particular advice suggesting that patients with confirmed ulcers should be tested for infection with a bacteria called H. pylori.

If routinely followed, this could place NHS testing facilities under great strain.

The Nice guidance was welcomed by Health Minister John Denham.

He said: "The guidance issued by Nice today means that patients can rest assured they will get the treatment that is right for them, wherever they live.

"And on top of this it will save the NHS money - as much as £50 million a year."

While it is not compulsory that Nice guidance be followed to the letter, it is likely that GPs will attempt to observe restrictions on PPI use, in order to save money on their drug budgets.