The Pharmaceutical Journal
Vol 270 No 7239 p321
8 March 2003

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Prescription volume is set to increase by an extra 14 per cent, says PPA head

The chief executive of the Prescription Pricing Authority, Nick Scholte, has warned that by the time repeat dispensing is established across the country, prescription volume is likely to have increased by 14 per cent on top of the current 6 per cent a year growth rate.

A spokesperson at the PPA told The Journal that the figure was arrived at by analysing the impact of changing two- and three- month quantities for most products on repeat prescriptions into one-month prescriptions in every practice and primary care trust. Then new information gathered from repeat dispensing pilots was applied, such as the proportion of patients willing to take advantage of the repeat service.

Speaking at a PPA conference in London last week, Mr Scholte emphasised the need for the way in which prescriptions are handled, from writing to reimbursement, to be modernised. He said that the PPA processed over 600 million items last year and will find it both difficult and costly to cope with further growth unless the prescriptions service is re-engineered.

According to Mr Scholte, two major steps are required: first, the paper prescription needs to be replaced with electronic messages and second, the reimbursement and remuneration frameworks need to be simplified so that the processes of data entry and of interpreting and validating prescriptions can be automated.

With regard to the reimbursement framework, "the rules are so complex that a simple reading of the Drug Tariff will not necessarily tell you what you want to know," said Mr Scholte. One possible solution is to move away from the concept that the amount reimbursed should vary according to manufacturer or pack size. Instead, medicines could be reimbursed on the basis of a unit price per pill. The PPA intends to work with the Pharmaceutical Services Negotiating Committee to explore the feasibility of such new approaches, he added.

Mr Scholte believes that the current remuneration regime acts as a constraint on pharmacists increasing the range of services they provide to patients. "It is time to look at a simpler remuneration framework which properly rewards pharmacy for the services it provides to the NHS, perhaps at different levels according to the quality or diversity of the services on offer," he said.

Lord Hunt, Parliamentary Under-Secretary of State for Health, also speaking at the conference, agreed that the Government needs to drive pharmacists towards a higher quality of service. "I think that the forthcoming discussions between the Department of Health and the profession will be interesting in that regard," he said.

Dr Gordon Geddes, head of technical services, PSNC, told The Journal that he believed any increase in the number of prescriptions due to the repeat dispensing scheme would be covered by additions to the global sum.

According to John D'Arcy, chief executive of the National Pharmaceutical Association, the Department of Health needs to recognise that community pharmacy workload will increase and reflect that in resource allocation. "We should not just look at resources and take a negative view. We need to recognise how strategically important it is for pharmacists to get involved with repeat dispensing, which is the precursor to other roles in medicines management and supplementary prescribing," he said.