Generic medicines are drugs that are no longer protected by patent, and so can be copied by other manufacturers at a lower cost.

This makes them attractive to the NHS, because they are generally less expensive than newer, branded products, saving money while retaining the active ingredients and efficacy of successful drugs.

The prescribing of generic medicines in Britain is high — far higher than in many other EU countries — and increasing.

More than 55 per cent of all prescriptions for NHS patients in England are now written generically — compared to about 35 per cent in the mid-1980s — but in some GP surgeries, generic prescribing is more than 90 per cent.

But if drug companies can form cartels to elevate the price of generic medicines, then this cost-saving effect can be nullified.

At the end of the 1990s suppliers are thought to have orchestrated a dramatic hike — worth up to £200 million a year — in the prices of dozens of usually cheap generic drugs.

Fears over such an arrangement prompted the case against the five companies and nine individuals accused of conspiring to defraud the NHS on the supply of Warfarin, a blood-thinning drug, and Penicillin-based antibiotics.

The NHS has already recovered £34 million through an ongoing civil lawsuit against four of these firms, but now the Serious Fraud Office seems powerless to convict any price-fixing through the criminal courts, if it occurred prior to the 2002 Enterprise Act.

The NHS’s own watchdog, the Counter Fraud and Security Management Service, has been widely praised since it was established 10 years ago — by 2005 it had saved the health service more than £670 million.

Fraud investigators have looked into the sale of a further 30 drugs, including the beta-blocker atenolol, the hypothyroidism pill thyroxine, and blood pressure pills bendrofluazide and frusemide.

But they have sought settlements out of court where possible, as the money spent on expensive High Court legal action could instead be used to fund an arguably more pressing need — patient care.

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