An historical survey of UK government measures to control the NHS medicines expenditure from 1948 to 1996.

Since the inception of the National Health Service in 1948, successive British governments have taken various measures to restrain the growth of the medicines bill. A total of 10 different measures have been introduced with very limited success. The most effective measures have been those directed at increasing the level of generic prescribing; such measures mean that the patient is treated with older, off-patent medicines which, although cheap, are not necessarily cost effective or the most clinically effective. Possible future directions for curtailing expenditure include controlling the price of off-patent branded medicines to the level of generic products, and the initiation of a government policy to actively encourage prescribing of newer medicines where these are shown to be more clinically effective or more cost effective.