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市場調查報告書
ＮＨＳ 重覆提供藥劑之現況
Reissuing pharmaceuticals in the NHS: Challenging the chain of trust
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本報告已在2011年07月19日停止出版。
Abstract
Reasons to purchase
The UK Department of Health (DoH) has introduced a key policy concerning the
reissuing of patients own pharmaceuticals on admission into hospital,
determining that this will save money and improve quality of care.
This report examines and questions the introduced DoH policy to show how it
may represent a significant challenge to the integrity of the Chain of Trust,
which offers protection to both manufacturers and patients.
Report scope
- What is the pharmaceutical chain of trust?
- The introduced DoH policy on re-issuing medicines
- Questions regarding the introduced policy
- How does the introduced policy of selected re-issuing impact upon the
basis of pharmaceutical regulation in the UK?
- Is cost-saving a valid (and ethical) basis for revising pharmaceutical
regulation?
- Re-issuing in the absence of enabling legislation
This report examines and questions the introduced DoH policy on reissuing
medicines in the NHS to show how it may represent a significant challenge to
the integrity of the Chain of Trust, which offers protection to both
manufacturers and patients.
Who should buy the report
This report is essential reading for:
- Pharmaceutical manufacturers either manufacturing in or supplying to the UK
- Product developers
- Decision makers involved in drug safety
- Policy makers
- Charities involved in donated pharmaceuticals
- Companies and institutions considering donating pharmaceuticals
Table of Contents
- 1 Introduction
- 1.1 What is the pharmaceutical chain of trust?
- 2 The introduced policy
- 2.1 The inspection process
- 3 Interrogating the principles and process of the introduced policy
- 3.1 Questions regarding the introduced policy
- 3.1.1 What are the existing regulatory policies?
- 3.1.2 Is the DoH re-issuing policy consistent with the regulatory
position(s)?
- 3.1.3 Are there regulatory precedents to sanction the re-issuing of
medicines recovered from domiciliary storage?
- 3.1.4 Is the limited re-issuing policy logically consistent?
- 3.1.5 How is the selective re-issuing of medicines in NHS hospitals
presently justified?
- 3.2 Questions of the relationship between the hospital trust and the
patient 14
- 3.2.1 Who is protected by the recommendation for re-issuing 'only with
the agreement of the patient'?
- 3.2.2 Is the hospital trust offering a uniform standard of care to all
NHS patients?
- 4 Selected re-issuing of medicines vs the basis of pharmaceutical
regulation in the UK
- 4.1 How does the introduced policy of selected re-issuing impact upon
the basis of pharmaceutical regulation in the UK?
- 4.1.1 Allowing inspection and re-issuing
- 4.1.2 Prohibiting re-issuing
- 4.2 Pilot project proposal
- 4.3 Is cost-saving a valid (and ethical) basis for revising
pharmaceutical regulation?
- 4.4 Conclusions
- 5 Re-issuing in the absence of enabling legislation
- 6 Consultation with key stakeholders prior to introducing the reissuing
policy
- 6.1 Prior consultation with patients/consumers
- 6.2 Prior consultation with pharmacists (as represented by the RPSGB)
- 6.3 Prior consultation with pharmaceutical manufacturers
- 6.3.1 If the pharmaceutical industry were aware of the DoH policy
- 6.3.2 If the industry were not aware (and consenting) of the DoH policy
- 6.3.2.1 Regulation
- 6.3.2.2 Liability
- 6.3.2.3 Public perception
- 7 Concluding remarks
- 8 Appendices
- 8.1 References
- 8.2 Abbreviations
- 8.3 Glossary
- 8.4 Biography: Dr Geoff Crumplin
List of Tables
- Figure 1.1 The pharmaceutical chain of trust
- Figure 2.1 The DoH re-issuing model
- Figure 4.1 Proposed model for re-issuing medicines recovered from
domiciliary storage to charitable donation
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