Depression omitted from new medicine service extension despite increase in antidepressant prescribing during pandemic

The new medicine service has been expanded to cover 16 therapeutic conditions but depression, and its associated use of antidepressants, has not been included.

Depression has not been included in a significant expansion to England’s new medicine service (NMS), despite a rise in antidepressant prescriptions during the COVID-19 pandemic.

Details of the third year of the five-year Community pharmacy contractual framework (CPCF), announced on 23 August 2021, revealed that the NMS will expand from September 2021 to cover 16 therapeutic conditions — including osteoporosis, gout, heart failure and glaucoma — but depression, and the associated use of antidepressants, is not on the list.

NHS England spent an additional £139m on antidepressant prescriptions during 2020, according to prescribing data from the NHS Business Services Authority. In April 2020, at the peak of the COVID-19 pandemic, antidepressant prescriptions cost the NHS £35m — more than double the cost recorded during the same month in 2019.

The Royal Pharmaceutical Society (RPS) has previously called for community pharmacists to be able to support people with mental health conditions by including antidepressants in a service such as the NMS, and the Pharmaceutical Services Negotiating Committee (PSNC) has also lobbied for antidepressants to be part of the service.  

A spokesperson for the PSNC said: “Expansion of the NMS to include antidepressants is still something that PSNC would support”, adding that the organisation was “looking forward to the outcomes of NHSE&I [NHS England and NHS Improvement] pilots of the NMS in further therapeutic areas”. The pilots are currently being carried out through the Pharmacy Integration Fund.

In its 2018 report ‘No health without mental health: How can pharmacy support people with mental health problems?‘, the RPS spoke of the “lack of parity of care seen in mental health services”, referencing in particular the fact that “mental health conditions are not included in the funding of community pharmacy services, such as medicines use reviews or the NMS”.

Thorrun Govind, chair of the RPS English Pharmacy Board, said the exclusion of mental health medicines from the expansion of the NMS was a “significant omission, especially considering the impact of the pandemic”.

“We want to see people with mental health problems benefit from the service like other patients. This is a missed opportunity to provide care to people with mental health conditions and better integrate pharmacists into the patient pathway.”

The Department of Health and Social Care has been contacted for comment.

Read more: Formal referrals from pharmacy to mental health specialists are needed following COVID-19 pandemic says RPS

Last updated
The Pharmaceutical Journal, PJ, August 2021, Vol 307, No 7952;307(7952)::DOI:10.1211/PJ.2021.1.102007

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