The Medicines and Healthcare Product Regulatory Agency (MHRA) has granted the first licence for an e-cigarette brand to be available on prescription on the NHS.
The licence has been awarded to British American Tobacco for its ‘E-voke’ device, which is not currently on sale but which could now be marketed as a potential solution to quit smoking. According to the company’s spokeswoman, the product uses cartridges containing pharmaceutical-grade nicotine.
The decision to prescribe e-cigarettes has been given the green light by the Department of Health today and could potentially open up doors to future brands, particularly after an independent review published by Public Health England (PHE) advised NHS staff to welcome e-cigarettes as a smoking cessation aid.
A department spokesperson argued that the best thing to do is still quit entirely, but that “many people have found [e-cigarettes] helpful for quitting”, with PHE research suggesting the rechargeable devices are 95% safer than regular tobacco.
It is believed that the prescription will cost the health service around £20 per kit and £10 per week for each patient’s cartridges, although this is expected to spur long-term budget savings. Roughly 60% of the population in England are exempt from prescription charges, which do not exist at all in Scotland, Wales and Northern Ireland.
The debate over the safety and effectiveness of e-cigarettes is longstanding. Shortly after PHE’s research into the device, researchers from the London School of Hygiene & Tropical Medicine and the University of Liverpool argued that the study has been flawed and not based on reliable evidence.
Writing in the British Medical Journal, the researchers claimed the headline figure for the PHE report came from a single meeting of 12 people, involving several known e-cigarette champions and sponsored by companies with links to the tobacco industry.
Today, Dr Tim Ballard, vice-chair of the Royal College of GPs, said more research should be carried out before e-cigarettes are absorbed by the health service, claiming it would be “unreasonable for the NHS to be asked to actually fund lifestyle choices for people”.
“Potentially, there may be a place for the prescription of E-voke as part of a smoking cessation programme, but GPs would be very wary of prescribing them until there was clear evidence of their safety and of their efficacy in helping people to quit,” he added.
A spokesman for the Royal Pharmaceutical Society was quoted as agreeing with Ballard, noting that while the device can be useful, more research is still needed.
He said: “More high-quality, peer-reviewed studies on safety and efficacy should be completed in order to provide health professionals with evidence-based assurance, particularly if they are to be included in the publicly funded smoking cessation programmes.”
But the device has long been indirectly endorsed by the NHS, including by being listed as one of its official ‘stop smoking’ treatments: “Over recent years, e-cigarettes have become a very popular stop smoking aid in the UK. Evidence is still developing on how effective they are, but many people have found them helpful for quitting.”
The Action on Smoking and Health (Ash) campaign group has also supported today’s move, with chief executive Deborah Arnott saying e-cigarettes are a “much safer alternative source of nicotine for smokers”.
“It is good news that an electronic cigarette has received a licence from the medicines regulator, as we know that they have been effective in helping smokers quit, and the cost, as part of a quit attempt, will be far lower than treating the diseases caused by smoking,” she added.
The company said in a statatement: “Nicovations Limited, part of British American Tobacco’s Next Generation Products division, has been granted a licence by the Medicines and Healthcare Products Regulatory Agency for its rechargeable electronic cigarette, e-Voke. E-Voke uses cartridges containing pharmaceutical grade nicotine. We are now reviewing the commercialisation and consumer resonance of e-Voke.”