NHS Highland statement of guiding principles for prescribing

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NHS Highland statement of guiding principles for prescribing

  1. Prescribing should be based on safety, efficacy and cost-effectiveness.
  2. Medicines should be prescribed only when they are necessary and, in all cases, the benefit of administering the medicine should be considered in relation to the risk involved.
  3. The Highland Formulary should constitute the core of all prescribing. It is based upon current evidence, national guidance, local expertise and patient acceptability.
  4. Cost-effectiveness matters. As a guiding principle, the most cost-effective medication should be prescribed for a patient. Specifically, prescribers should not prescribe drugs, medicines or appliances whose cost or quantity, in relation to any patient, is in excess of that which is reasonably necessary for the proper treatment of that patient. Such prescribing denies resource for other essential services.
  5. The ‘approved’ (non-proprietary or generic) name of a medicine should be used unless there are important differences in formulation and/or bioavailability. Where a generic product is not considered suitable and it is desirable to recommend a particular brand of a drug, this is specified in the Highland Formulary.
  6. Prescribers should always prescribe within their clinical competency.
  7. When prescribing, clinicians must avoid making assumptions about people with protected characteristics eg gender, age, black and ethnic minority people, and must be alert to any specific considerations required.

Unnecessary or cost-ineffective prescribing cannot be justified:

  • unnecessary prescribing exposes patients to risk without benefit
  • cost-ineffective prescribing deprives patients in need of new, effective but expensive medicines with the potential to extend life and/or improve quality of life.