Pharmaceuticals, drugs and therapeutics committees and economic evaluations

<p>Drugs and Therapeutic (D & T) Committees are now an established and important part of the UK medicines prescribing<p><p>system.

<p><p><p>The first committee dealing with pharmacy matters set up within an NHS institution was established in 1948, after which there was a steady growth in numbers until 1968 and a more rapid increase thereafter. One explanation for the accelerated growth rate is the investigations leading up to the release in 1970 of a DHSS circular 'Measures for Controlling Drugs on the Ward'. This process increased awareness in prescribing issues and the need to monitor use of pharmaceuticals. Initially these institutions were most common and widely accepted in teaching hospitals and large hospitals, with the 1975 survey by Brown, Barrett and Herxheimer finding that committees existed in 72 per cent of teaching and large non-teaching hospitals, but in only 30 per cent of smaller hospitals. One might speculate that it was the economies of scale of large institutions that enabled them to support a D & T Committee with greater ease.They became more common in the 1970's, until by 1983 a survey by George and Hands was able to conclude that D & T committees by then existed in most of the UK. They were concentrating on a range of general drug policies and were also producing formulary lists, to control their districts' stocks and to achieve effective use of drugs.

<p><p><p>One incentive to these efforts is that drugs have always been a high profile element in health services expenditure, despite<p><p>the relatively low proportion of resources that they actually consume. In the case of the NHS they generally account for only around 10 per cent of national expenditure, although this still amounts to a large cash sum, around £2.68 billion for GP<p><p>prescribing alone in 1990-91.