NHS cost control mechanism Flashcards
what is the NHS drug bill?
the amount of money that is spent of drugs by the NHS before discount
how much money was spent by the NHS on drugs in 2017-18?
£18.2 billion
how many diabete prescriptions were dispensed in community?
45 million; 50% rise over 6 years
what are the reasons for an increased drug bill?
- Increase in treatments available
- New and expensive treatments
- Increase in preventative medicine
- Publication of treatment guidelines
- Larger and more ageing population
- Rise in obesity and alcohol consumption
- Rise in lifestyle related disease e.g. diabetes and CHD
- Improvement in diagnosis
what is the 2019 voluntary scheme for branded medicines pricing?
- Agreement between DHSC and the Association of the British Pharmaceutical Industry (ABPI) on getting the best value and most effective medicines into use more quickly
- Replaces the Pharmaceutical Price Regulation Scheme (PPRS)
- Commenced Jan 19 for 5 years
what are the voluntary scheme terms?
- Agreement that branded medicines bill will not grow by more than 2% in next 5 years (capped)
- Commitment from NHS England to increase uptake of new medicines for the five highest health gain categories to benefit patients
- All new medicines and significant indications routinely appraised by NICE
- Scheme supports small and medium sized companies through exemptions and payment relief to encourage innovation and growth
- Freedom to set list prices is maintain for new active substances (NAS)
what are the potential scheme consequences?
- To simplify, streamline and improve access, pricing and uptake arrangements for cost effective medicines
- Faster adoption of the most clinically and cost effective medicines –to improve patient outcomes
- Maintain affordability of branded medicines
- Deliver value for money for the NHS by securing the provision of safe and effective medicines at reasonable prices
- Support the life sciences industry across the UK and future innovation- benefit economy
how much of prescriptions do generic medicines make up?
2/3rd
what are the three type of cost controls on the supply side of NHS medicines?
- Profit control on manufacturers (branded products)
- Price fixing of retailers’ reimbursement (generic products)
- Discount adjustment scale (“clawback”) (all dispensed medicines)
how does the NHS contorl costs of generic medicines?
through the drugs tariff
what controls are put on the prescriber?
- blacklist – cannot be prescribed
- SLS
- ACBS
- Appliances
- Reagents
- DPF – dentist restriction on NHS script
- NICE
- National Service Frameworks
- Formularies joint secondary care/primary care
- Generic prescribing
what did nhs england remove to lower cost?
dietary supplements
herbal treatments and homeopathy
this saved £141 million a year
what does deregulation of prescriptions medicines do to the consumer?
• Provides patients greater access to wide range of medicines
• Allows pharmacists to recommend greater range of therapeutic options
• No cost to NHS
• Factors affecting impact of deregulation
– Licensing of product
– Consumer awareness of product
– Patient exemption
what are the current prescription charges?
- Fixed NHS charge per item dispensed (regardless of cost, number or volume of medicine)
- From April ’19, fixed charge is in:
i. England £9.00
ii. Scotland Nil
iii. N Ireland Nil
iv. Wales Nil - Prepayment certificates (PPCs)
i. Provide ceiling on NHS Rx cost
ii. A 12 month certificate is £104.00 and saves money if need 11 items or more per year.
what are the exemption groups from prescription charges?
- Age: < 16 or >60
- 16-18 and in full-time education
- Condition: pregnant or up 12 months post-natal
- Clinical condition and have a valid medical exemption certificate (MedEx) : permanent fistula, endocrine insufficiency, epilepsy, housebound, cancer
- Low Income: recipient of income support, family credit etc
