Prescriptions including drugs for erection problems and depression set to be banned: Is yours on the list?
Cumbrians have been warned that a host of prescription medicines - including painkillers and two types of anti-depressants - could be axed nationwide in a bid to save millions of pounds for the cash-starved NHS.
Residents across the county - including anyone who receives a prescription for one of the 18 drugs which face a ban - are being asked to submit their views on the issue before October 21.
Health bosses state medicines included are either not as effective as others on the market or do not provide value for money compared to other available products.
The list includes Coproximal, a painkiller no longer licensed in the UK but which still costs the NHS around £9 million a year; tadalafil, which costs £11.4 million a year and is used to treat erectile dysfunction, as well as immediate release Fentanyl for cancer patients, which costs around £11 million a year.
Glucosamine and chondroitin - supplements used to help ease osteoarthritis - and lutein and antioxidants, prescribed for people with macular degeneration, are also included in the consultation document, along with omega 3 fatty acid compounds, which are taken to improve heart health by people who have suffered a cardiac arrest.
Photo: Julien Behal/PA Wire
And gluten free foods, homeopathy and herbal treatments - items that are not routinely prescribed in Cumbria already - are also unlikely to be available on prescription in the future.
North Cumbria Clinical Commissioning Group medical director, Dr David Rogers, said: "We welcome the debate which has been sparked by this NHS England consultation.
"We know that people want the NHS to spend its limited financial resources carefully.
"Research is happening all the time and it is important that we are able, where possible, to give evidence-based guidance to prescribers if research indicates that the benefits claimed for the drug may not be as good as initially thought, or where there may be better treatments or cheaper treatment options that are just as effective."
Dr David Rogers.
"The scientific evidence on homeopathy has been clear for some time and as a CCG we do not fund homeopathy."
The NHS issues 1.1 billion prescription items every year at a cost of £9.2 billion pounds.
With more and more pressure on NHS resources, this latest move to consult on the abandonment of prescribing certain medications has been taken by clinical commissioning groups across the country and national body NHS England.
But the withdrawal of some drugs has already caused upset among patients who claim they were given no warning before their regular prescriptions were halted.
Lyothyronine, a substance also known as T3, is used by people with hyperthyroidism. The drug was subject to a price hike by its manufacturer earlier this year.
But users in Cumbria claim though expensive, the medication is essential and would need to be replaced with a cocktail of other drugs which may prove more expensive overall.
A petition against its withdrawal in the county currently has more than 2,000 signatures.
Dr Rogers added: "Some of the drugs being reviewed have been subject to large price increases and the NHS has a duty to review whether it is still appropriate and cost effective to continue to use these treatments.
“As a CCG we would always encourage patients to have some over the counter medicines in their homes, such as paracetamol, so that they can use these where appropriate to self-manage minor illness.
"Many of the medicines available over the counter are significantly cheaper for the public to buy than if they are provided via an NHS-funded prescription. For instance a packet of paracetamol can cost less than 20 pence over the counter.”
Anyone who would like to take part in the consultation can do so by visiting the NHS England website.
The full list of drugs facing the axe in the consultation:
:: Co-proxamol, a painkiller
:: Dosulepin, an anti-depressant
:: Prolonged release doxazosin, for hypertension
:: Immediate release Fentanyl, a painkiller for cancer patients
:: Glucosamine and Chondroitin, for osteoarthritis
:: Herbal treatments
:: Gluten free food
:: Lidocaine plasters, for neuralgia
:: Lyothyronine, for hyperthyroidism
:: Lutein and antioxidants, for macular degeneration
:: Omega 3 fatty acid compounds, for heart health
:: Oxycodone and Naloxone combination product, for severe pain and restless leg syndrome
:: Paracetamol and Tramadol combination products, a painkiller
:: Perindopril arginine, used in heart failure and other conditions
:: Rubefacients, a topical cream
:: Tadalafil, for erectile dysfunction and hypertension
:: Travel vaccines
:: Trimipramine, an antidepressant
A support group for thyroid patients in Cumbria is campaigning for their prescriptions to be reinstated after they were deemed 'unaffordable' and 'difficult to justify' by county health chiefs.
Members of Cumbria Advisory Thyroid Service were informed prescriptions for lyothyronine would no longer be dispensed after the price of the drug shot up.
The group has already collected more than 2,000 signatures in protest against the decision to withdraw the medication, also known as T3.
Most people with an under-active thyroid take a daily dose of thyroxine, known as T4, to reduce their symptoms.
A smaller percentage have also been prescribed T3 to help prevent the onset of a range of conditions including depression, anxiety, high blood pressure and high cholesterol.
The cost is reported to be £198.62 for 28 tablets - making the monthly bill for a twice-daily dose £397.24.
Moyra Marshall, CATS group leader, said she now fears people may opt to buy their own T3 over the internet from foreign suppliers.