Nav: Home

Prescription costs increase for low-value treatments despite reduction in numbers

May 22, 2018

Despite a fall in prescription numbers for low-value treatments, the overall cost of prescribing these items in English primary care has risen, according to new research published by the Journal of the Royal Society of Medicine. NHS England has identified low-value treatments deemed to be ineffective, over-priced and of low clinical value, in order to increase value from the £17.4bn NHS medicines bill. The researchers found a strong association between practices with a higher proportion of patients over 65 and low-value prescribing. They also found prescribing behaviour clustered by Clinical Commissioning Group (CCG), the NHS bodies responsible for planning and commissioning health care services in their local area.

The researchers, from the Nuffield Department of Primary Care Health Sciences, University of Oxford, assessed the current use of low-priority treatments identified by NHS England, their change in use over time and the extent and reasons for variation in prescribing.

In addition to the national results presented in the paper, the researchers also shared all data on prescribing at all individual NHS practices. This is published through an interactive website, OpenPrescribing.net, which can be used by GPs, local commissioners, and even patients, to see where there are possible savings opportunities for individual prescribers.

Lead researcher Dr Ben Goldacre said: "There were almost one million fewer prescriptions for low-value items between July 2016 and June 2017, compared with the previous year. Despite the consistent downward trend in items, costs have risen, increasing by £4.5m when comparing 2016/17 with 2015/16.

The researchers found that while the cost per item has remained stable for most low-value treatments, for three items identified by NHS England, liothyronine (for hypothyroidism), trimipramine (an antidepressant) and co-proxamol (a painkiller), the cost has risen dramatically, by £73, £168 and £71 per prescription, respectively.

Dr Goldacre said: "Co-proxamol, liothyronine and trimipramine illustrate a concerning phenomenon, where despite successful efforts to limit prescribing numbers, costs have risen sharply." Giving co-proxamol as an example Dr Goldacre explained: "It's expensive because it was removed from the drug tariff, meaning that any prescriptions for it have to be sourced as a 'special' order. There is limited regulation of the cost of such special orders, making real world cost savings on such drugs difficult until there are a very small number of total prescriptions."

The researchers found that the strongest association with the level of prescribing cost at practice level was with the proportion of patients over 65, although they noted that this is perhaps not surprising given that older patients are generally more likely to receive prescriptions.

Commenting on the large degree in variation according to CCG, Dr Goldacre said: "This is likely to be due to differences in policy between different CCGs and practices, rather than clinical need."
-end-
Notes to editors

Trends and variation in prescribing of low-priority treatments identified by NHS England: a cross-sectional study and interactive data tool in English primary care (DOI: 10.1177/0141076818769408) by Alex J Walker, Helen J Curtis, Seb Bacon, Richard Croker and Ben Goldacre, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Wednesday 23 May 2018.

The link for the full text version of the paper when published will be:

http://journals.sagepub.com/doi/full/10.1177/0141076818769408

For further information or a copy of the paper please contact:

Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44-0-1580-764713
M: +44-0-7785-182732
E: media@rsm.ac.uk

The Journal of the Royal Society of Medicine (JRSM) is a leading voice in the UK and internationally for medicine and healthcare. Published continuously since 1809, JRSM features scholarly comment and clinical research. JRSM is editorially independent from the Royal Society of Medicine, and its editor is Dr Kamran Abbasi.

JRSM is a journal of the Royal Society of Medicine and it is published by Sage Publishing.

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company's continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. http://www.sagepublishing.com

SAGE

Related £ Articles:

Every £1 spent on public health in UK saves average of £14
Every £1 spent on public health returns an extra £14 on the original investment, on average -- and in some cases, significantly more than that -- concludes a systematic review of the available evidence, published online in the Journal of Epidemiology & Community Health.
£4.5m 'Lab in a bubble' project could improve cancer care
A £4.5million University of Strathclyde project to produce bubble-sized 'laboratories' could boost cancer treatment, medical imaging and industrial processes.
EPSRC commits £15 million for formulation manufacturing research
New research projects that aim to improve the complex formulation processes used to manufacture products such as toothpastes, inhalers, films that coat solar cells and pharmaceuticals are to receive significant funding from the Engineering and Physical Sciences Research Council.
£6.8 million grant to develop next-generation lithium batteries
A new research consortium involving Professor Saiful Islam from the University of Bath's Department of Chemistry has been awarded £6.8 million by the Engineering & Physical Sciences Research Council (EPSRC) to explore and develop next-generation lithium batteries.
£2 million grant to reduce major aquaculture diseases
The University of Exeter and the Centre for the Environment, Fisheries and Aquaculture Sciences (Cefas) are leading on a £1.97M BBSRC-Newton Fund project to develop and apply new molecular biology techniques to reduce the impact of major diseases in aquaculture for the improvement of the livelihood of small-scale farmers in India, Bangladesh and Malawi.
£10 million grant awarded for Barts Heart Centre
Queen Mary University of London and Barts Health NHS Trust have received £10.2 million from Barts Charity for the creation of a world-class cardiovascular academic medical center at the Trust's Barts Heart Centre, St.
Johnson announces £20 million for manufacturing hubs
Two £10 million manufacturing research Hubs that will address major, long-term challenges facing the UK's manufacturing industries, and capture opportunities from emerging research were announced today by Universities and Science Minister Jo Johnson.
Multi-million pound project to use nanotechnology to improve safety
The University of Southampton has been awarded a multi-million grant from Lloyd's Register Foundation to find new ways of using nanotechnologies to improve safety at sea, on land and in the air.
£5.4 million for research to discover next-generation biomaterials
A new £5.4 million grant for research aimed at accelerating the discovery and application of new advanced materials in health care was announced today by the Engineering and Physical Sciences Research Council.
The £6.5 million Track to the Future rail project underway
The University's Institute of Railway Research will constructing new test facilities to focus on developing switches and crossings that 'last longer and require much less maintenance.'

Related £ Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#529 Do You Really Want to Find Out Who's Your Daddy?
At least some of you by now have probably spit into a tube and mailed it off to find out who your closest relatives are, where you might be from, and what terrible diseases might await you. But what exactly did you find out? And what did you give away? In this live panel at Awesome Con we bring in science writer Tina Saey to talk about all her DNA testing, and bioethicist Debra Mathews, to determine whether Tina should have done it at all. Related links: What FamilyTreeDNA sharing genetic data with police means for you Crime solvers embraced...