NHS costs Flashcards
the cost of the NHS is ______. value?
increasing
currently around £13 billion
hospital use accounts for around ____ of the total cost at list price. this is also _____
50%
increasing
why are costs in hospital increasing?
more complex conditions
more complex formulations and drugs
consultants will Rx more complex drugs than GP
what type of drugs have the greatest increase in volume of prescribing?
antidepressants
generic drugs are dispensed _______ than branded
more, about 72%
what types of drugs have the net ingredient cost?
diabetes
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
NHS spends ______ on branded medicines in the UK compared to generic
MORE
What is a way to control the costs of medicines?
reduce/ control the cost of supply
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
what is the Voluntary scheme for branded medicines ricing and access? (VPAS)
agreement between DHSC and association of the British pharmaceutical industry
what does VPAS replace?
the pharmaceutical price regulation scheme- there was issues with this
when is the VPAS starting?
January 2019
what does the VPAS entail?
agreement that branded medicines bill will not grow by more than 2% in the next 5 years
why does this 2% cap help
so the NHS knows they won’t spend loads of money?
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
9
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
