The Pharmaceutical Journal
Vol 270 No 7243 p465
5 April 2003

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Audit Commission health bulletin (PDF 530K)

NSFs are driving prescribing costs to outstrip primary care budget increases

National service frameworks are the main driver behind prescribing cost increases which outstrip primary care budget increases.

An Audit Commission health bulletin on primary care prescribing says that four types of drug — lipid regulators, antihypertensives, antipsychotics and diabetes treatments — accounted for more than half the total cost increase in primary care prescribing last year. From 1998–99 to 2001–02 the cost of primary care prescribing rose by 29 per cent, compared with a 21 per cent increase in primary care budgets. Drug costs are forecast to have risen by 12 per cent in 2002–03 with only a 10 per cent increase in drug budgets. This leaves primary care trusts having had to find £110m from elsewhere to cover the extra drug spending.

The solution lies in better prescribing and medicines management, the Audit Commission believes, with savings of up to £130m in the next three years being possible. However, it warns that effective prescribing is often more expensive and that rises in prescribing costs in any particular area should not be assumed to equate to an improvement in the quality of prescribing.To help, the commission and the Prescribing Support Unit are developing a national savings database to calculate the potential savings available to each primary care trust.

Meanwhile the Audit Commission is expanding its primary care prescribing review to look at the impact of the pharmacy plan, medicines management and the development of community pharmacists' roles. A report is due to be published in the summer, and will be supported by an improved cost drivers database, benchmarking data and examples of good practice.

Parliamentary Under-Secretary of State for Health David Lammy commented: "Increased prescribing of the best drugs saves lives. It is money well spent. The Audit Commission's conclusions about prescribing do not reflect PCTs' overall financial picture. This year PCTs got an average 10 per cent increase. This is an increase in their total budgets. Within that, some spending will rise by more than 10 per cent — for example on the best drugs — and some spending will be well below 10 per cent. It is a matter for each PCT."

The report is available from the Audit Commission (tel 020 7828 1212) or as a PDF (530K).

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