NHS Cost Control Flashcards
BNF section with leading net ingredient cost?
Diabetes drugs
- 44.6 million diabetes prescription items were dispensed in the community; a 50% rise over 6 years
Which drugs have the greatest increase in volume of prescribing?
Antidepressants
What was the change in dispensing of generics since 2001?
increase from 52% to 72%
Reasons for the increase in drugs bill?
- more treatments available
- new and expensive treatments
- increased preventative medicine
- publication of treatment guidelines
- larger and ageing publication
- rise in obesity and alcohol consumption
- rise in lifestyle related disease
- improvements in diagnosis, patients get treated earlier
Who controls the supply of medicines to the NHS?
manufacturers, importers, wholesalers, retailers
Who controls the demand of medicines in the NHS?
patients and prescribers
Cost control mechanisms: manufacturers
- 10b spend on branded medicines
- Countries without indigenous pharmaceutical industries main goal to minimise costs to level compatible with efficient supply system
What is the PPRS?
Pharmaceutical price regulation scheme
Indirectly controls prices of branded products
dispensed under NHS
by limiting the % of income allowed as profit from total UK sales of medicines to NHS (currently 21%) - also limits R&D and promotion
Principles of the PPRS?
- First established on voluntary basis in 1957 and is renewed every 5 years (most recent 2014)
- Agreement between DH and the Association of the British Pharmaceutical Industry (ABPI)
Objectives of the PPRS?
- Secure provision of safe and effective medicines for the NHS within affordable limits
- Promote a strong and profitable pharmaceutical industry (capable of R&D)
- Encourage efficient and competitive development and supply of medicines to pharmaceutical markets in UK and other countries
Effect of the PPRS on the pharmaceutical industry?
- does not reduce the size of the market, just controls profits made from the NHS
- Allows companies to compete freely with other manufacturers and agree NHS list prices
- Can negotiate individual prices with bulk purchasers, e.g.
hospital or
pharmacy chains
What medications does PPRS cover?
The PPRS covers all licensed, branded, health service medicines supplied by members of the scheme
What medications does PPRS not cover?
- sales of products on private prescription or other use outside the health service in the UK;
- products without a brand name (generics);
- branded products available without prescription (over the counter (OTC) medicines), except when these are prescribed
What are the types of cost control on supply of NHS medicines?
- profit control on manufacturers
- price fixing on retailers
- discount adjustment scale (clawback)
How are prescribing budgets arranged?
- hospital and primary care used to have separate budgets
- now one pot in CCGs to cover all prescribing costs
