Government rejects call to make OTC medicines free to reduce GP pressure

The Government has rejected a call to make over-the-counter (OTC) medicines free of charge to reduce pressure on GPs. 

In May last year, the previous Health and Social Care Committee recommended that OTC medication should become ‘free for people on low incomes, as part of the Pharmacy First scheme’. 

The aim was to ‘avoid patients continuing to use GPs for support’ because of ‘concerns about the affordability’ of such medication. 

But the Government has rejected this recommendation in its response today, saying previous research has shown that the policy ‘would not provide value for money for the taxpayer’. 

The Government did however highlight that there is ‘no charge’ connected with the Pharmacy First scheme, which treats seven common conditions in community pharmacy to reduce pressure on GPs. 

‘If the outcome of a Pharmacy First consultation is a supply of a prescription only medication for one of the seven conditions and the individual is exempt from paying a prescription charge (including through the NHS Low Income Scheme) the medication would already be supplied free of charge,’ the Government response said. 

In 2023, the patient watchdog made a similar recommendation, calling on NHS England to issue guidance encouraging GPs to offer people OTC medications on prescription based on socio-economic grounds.

The previous House of Commons health committee said in their report last year: ‘To avoid patients continuing to use GPs for support that could be offered in a community pharmacy setting because of concerns about the affordability of over-the-counter medication, we recommend that such medication is free for people on low incomes, as part of the Pharmacy First scheme.’

In its response, the Government said: ’NHS England has explored how to deliver the best value from the NHS spend on medicines. This included the prescribing or supply of over-the-counter medications. 

‘The report published in 2018, here, recommended that it would not provide value for money for the taxpayer to provide over-the-counter medication free of charge.’

In March last year, NHS England reiterated guidance asking GPs to limit prescribing of OTC medicines, in a bid to improve ‘value for money’.

The policy, which was first introduced in 2018, recommends that GPs do not prescribe OTC items for which there is ‘limited’ evidence of clinical effectiveness, or where the condition is self-limiting or would be appropriate for ‘self-care’.

The same health committee report also warned that Pharmacy First ‘will fail’ if patients ‘keep having to return to their GPs’, recommending that regulations are updated ‘within three months to allow community pharmacists to make dose and formulation substitutions for out-of-stock items and dispense what they have available’.

In response, the Government said today that ‘allowing pharmacists to take local action to alter prescriptions’ could have the ‘effect of creating a “knock-on” shortage of the alternative’ and therefore ‘exacerbate’ the supply problem.

However, the Government recognised that ‘there may be occasions where it is appropriate to enable further flexibility’ for pharmacists, without having to go back to the prescriber.

‘We are currently examining options with stakeholders, to assess where and how this could be appropriate, and how any associated risks could be managed,’ the response said.