GP prescribing could become commercially biased if clinical commissioning groups buy in support from drug companies, a report commissioned by the King’s Fund has warned.

The Quality of GP Prescribing, published last week, suggested GPs could be “more open to working closely with drug companies” to manage medicines’ use, with the companies potentially offering discounts or preferential deals as part of the arrangement.

It warns: “This may not be truly cost-effective – generic prescribing may not be the preferred approach”.

The report’s lead author Dr Martin Duerden, a GP and assistant medical director at Betsi Cadwaladr Univeristy Health Board in North Wales, told HSJ he was concerned that clinical commissioning groups would not continue to fund clinical pharmacists who act as prescribing advisers to practices.

“That’s when you could get pharmaceutical companies coming in and filling the gap. It does create real conflicts of interest around things like drug choice,” he added.

The report - which was produced as part of the King’s Fund inquiry into the quality of primary care - highlighted a 2003 study by Liverpool University academics who found 49 per cent of GPs cited the pharmaceutical industry as the main influence on which new drugs they prescribed. This compared to just 17 per cent who used academic and professional literature as their main source of information.  

Chair of the Royal College of GPs Claire Gerada told HSJ there had always been the potential for GPs to be influenced by drug companies and welcomed the report for raising the issue.

However, chair of the National Association of Primary Care Jonny Marshall said GPs shared the values of the NHS and the NHS constitution and often worked with drug companies successfully following guidelines laid out by the Association of the British Pharmaceutical Industry.

The report found some primary care trusts had prescribing rates for up to 16 times higher than other for certain drugs and warned variations in prescribing practice were likely to become “more pronounced” if, as expected, there were more CCGs than PCTs.

Dr Duerden said he was also concerned the smaller size of CCGs relative to PCTs might leave them without the “critical mass” needed to deal with big acutes and improve the transfer of information between secondary and primary care essential to improve prescription management.