Prescribing costs in primary care
The National Health Service spends £8 billion a year on prescription drugs in primary care in England. This has grown 60% in real terms over the last decade and the trend continues to be upward. This report examines how the money could be spent more efficiently, without compromising clinical outcomes. It looks principally at the scope for more cost-effective prescribing; supporting the GPs and PCTs in getting better value for money; and the wastage of drugs. For four groups of drugs (which account for 19% of the total drugs bill), it finds a wide disparity in prescribing behaviour. It estimates that if all PCTs attained the standard of the best 25%, £200 million could be saved. The analysis shows that there are several mechanism to improve value for money. They include: personalised communication with GPs from local experts, financial and practical incentives, and involving the whole primary and local care community in decisions about drug policy. Wastage of drugs is a problem but the level is not monitored and the uptake of initiatives to reduce the amount of waste is low. Assessing whether local prescribing volumes are consistent with clinical need is complex, but combining prescription data with local prevalence data can provide benchmark information.
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ACE inhibitors Area Prescribing Committees benchmarking branded British National Formulary Business Services Authority cent of GPs cent of respondents cholesterol clopidogrel cost Department of Health Derbyshire doctors Drugs and Therapeutics drugs bill drugs wastage effective efficiency of prescribing efficiency savings efficient prescribing England focus groups GP practices GP survey GPs responding GPs we surveyed hospital indicated influence on GPs influencing GPs Keele University medication medicines use reviews million money in prescribing National Audit Office NHS Business Services NHSBSA nurses patients pharmaceutical companies pharmaceutical industry pharmacists Practice Based Commissioning prescribing advisers prescribing behaviour prescribing budgets prescribing decisions prescribing efficiency prescribing issues prescription items prevalence primary care drugs proton pump inhibitors qualified in 1960 RAND Europe renin-angiotensin drugs repeat dispensing repeat prescription September 2006 simvastatin sources of prescribing statin prescribing Strategic Health Authority therapeutic area Therapeutics Bulletin treatment value for money value-based pricing volume World Health Organisation