Government plans to have branded versions of drugs routinely swapped for generic equivalents must not be allowed to compromise patient safety, the NHS Confederation has warned.

Later this year the DH will launch a formal consultation over proposals to make the automatic substitution of branded medicines for generic versions compulsory in UK pharmacies. Under the proposed changes, pharmacists would be obliged to dispense a cheaper generic drug against a prescription for a branded product - potentially without informing the prescriber.

The proposal is part of a drug pricing agreement between the government and the pharmaceutical industry, originally scheduled to begin in January 2010.

A DH spokesperson said it was unknown how much generic substitution would potentially save the NHS, and that cost estimates should be available after the consultation process.

However, DH spokespeople have previously been quoted

as predicting that the move could save the NHS in the region of £72m over the next three years.

While there will be cash savings on drug spending, there is also the potential that patients may be adversely affected by subtle differences between versions of drugs - possibly leading to admissions or other unplanned contact with health professionals.

Primary Care Trust Network director David Stout said any system that allowed clinical judgement to be overridden was a “potential cause for worry” and pharmacists should inform clinicians if they dispensed a different drug version to the one prescribed.

“The final decision over which medication a patient receives should lie with the clinician,” he told HSJ.

“Although the sensible use of generic prescribing is encouraged and supported to make better use of the healthcare system, to have a system that didn’t allow for clinical judgement to be exercised may be going too far,” he said

The DH spokesman said: “We want to make sure we engage with all stakeholders in the best way possible and we therefore intend to formally consult in the autumn on our proposals for implementation.”