NHS costs Flashcards by sophie hayton

the cost of the NHS is ______. value?

increasing

currently around £13 billion

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hospital use accounts for around ____ of the total cost at list price. this is also _____

50%

increasing

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why are costs in hospital increasing?

more complex conditions
more complex formulations and drugs
consultants will Rx more complex drugs than GP

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what type of drugs have the greatest increase in volume of prescribing?

antidepressants

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generic drugs are dispensed _______ than branded

more, about 72%

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what types of drugs have the net ingredient cost?

diabetes

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why are drugs increasing?

higher life expectancies 
chronic conditions 
more diagnosis's 
increasing knowledge 
new drug development 
diagnosis is improving 
lifestyle
preventative medicines 
treatment guidelines

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NHS spends ______ on branded medicines in the UK compared to generic

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What is a way to control the costs of medicines?

reduce/ control the cost of supply

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why can reducing the cost of supply not be straightforward/ easy?

industries do contribute to the economy- we want them to succeed
therefore need a balance between industry viability and NHS expenditure

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what is the Voluntary scheme for branded medicines ricing and access? (VPAS)

agreement between DHSC and association of the British pharmaceutical industry

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what does VPAS replace?

the pharmaceutical price regulation scheme- there was issues with this

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when is the VPAS starting?

January 2019

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what does the VPAS entail?

agreement that branded medicines bill will not grow by more than 2% in the next 5 years

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why does this 2% cap help

so the NHS knows they won’t spend loads of money?

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what do the industries get in return?

a commitment from NHS England to increase uptake of NEW medicines for the five highest health gain categories

what are these five highest health gain categories?

we dont know them yet

what else do these branded medicines get with the VPAS?

all new medicines will be routinely appraised by NICE- didn’t happen before so GPs wouldn’t use them

who does the VPAS scheme support?

small and medium sized companies through exemption and payment relief to encourage innovation and growth

does the VPAS put any cap on the price of new active substances

NO, the industry can se the price as long as they stay under the 2% cap for the following 5 years

consequences of the voluntary scheme?

get best medications to patients quickly
faster adoption of the most clinically and cost effective medicines
maintain affordability of branded medicines
delivering safe and effective medicines at reasonable prices
support industry

how does the NHS control costs of generic medicines?

through the drug tariff as there’s so many of them

3 Types of cost control on supply side of NHS medicines?

profit control on manufacturers for BRANDED
price fixing of retailers’ reimbursement- GENERIC
discount adjustment scale- clawback

what is clawback?

pharmacies get wholesalers discount, so the NHS clawback for of the discount they expect you to get

another way of controlling the cost of NHS medicines bill in primary care- instead of supply?

control demand- repress demand

how does the NHS control prescribers?

black list selected list schemes- Rx things only for certain people advisory committee on borderline substances- only for certain conditions formularies- DPF, NPF NICE guidelines generic Rxing instead of brands

what's the low priority prescribing project?

NHS England guidance to GPs and CCGs to remove 18 ineffective, unsafe and low clinical value treatments

examples of these treatments

dietary supplements herbal treatments homeopathy

how much does the LPPP save the NHS?

£141 Million a year

what is the impact of deregulation of prescription medicines? aka making them OTC

patients have a greater access allows pharmacists to recommend a greater range no cost to NHS

Factors affecting the impact of deregulation?

- licensing of products- some are only licensed OTC for certain conditions - consumer awareness of product - patient exemption- so why would they go pay for it

fixed charge for England, Scotland NI and Wales for NHS Rx charge PER ITEM

E- £9.00 S- na NI- na W- na

how can non exempt people reduce their costs?

Prepayment certificate- 12 month certificate is £104.00

__/10 Rx's are free

how can costs reduce patient adherance?

``` delaying getting Rx till paid prioritise items borrowing money dont get Rx at all dont consult GP reduce dose frequency ```

what does the Kings fund propose?

reducing Rx charges to £2.50 per item, but abolishing medical exemptions and the low income scheme so everyone pays

does the king fund change the prepayment certificate

no, retained £104

how much money would the kings fund raise?

£1 billion

other ways to further reduce the drugs bill?

WASTE Further POM to P switches improving public health