To ask Her Majesty's Government whether they intend to make generic substitution of all medicines mandatory in primary care; and, if not, what mechanism will enable a primary care medical practitioner and pharmacist to ensure that a specific patient will receive a branded prescription, if that is their opinion of the patient's best interests. [HL4120]

The pharmaceutical price regulation scheme announced that, subject to discussion with affected parties, the department will introduce generic substitution in primary care. Initial discussions on this complex issue are taking place with key stakeholders and interested parties.

Patient safety will be paramount in taking forward the work on generic substitution. It has long been the department's policy to encourage generic prescribing where possible, for reasons of good professional practice and because of the opportunities for more effective use of National Health Service resources.

However, it has always been recognised that there are circumstances in which it may be clinically appropriate to prescribe a particular brand of drug even where a generic is available if the prescriber considers it essential for the patient to receive that specific product. This position will need to be considered under any new specific proposals made as part of the work on generic substitution.

Therefore, generic substitution of all medicines in primary care would not be mandatory. Provision will be made to allow the prescriber to opt out of substitution where, in his clinical judgment, it is appropriate for the patient to receive a specific branded medicine. Provision may also be made to exclude certain categories of medicines for clinical reasons in the interests of patient safety.