The Pharmaceutical Journal
Vol 271 No 7257 p41
12 July 2003

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PPA study (PDF 85K)

Most endorsements do not change payments made

Most endorsements made by pharmacists make no difference to the reimbursement they receive for a prescription. This is the conclusion of a new study from the Prescription Pricing Authority.

Researchers at the PPA analysed a sample of 1,031 items on 506 randomly selected prescription forms. For each, they examined what was written on the form by the prescriber and what was added by the dispensing contractor. They then assessed the extent that the added information was used in calculating payments.

A significant level of over-endorsing by contractors was found. A total of 2,440 pieces of information were added against the 1,031 items but only 14 per cent were used in reimbursement and remuneration calculations. "These findings suggest that in 86 per cent of cases recording and processing the additional information adds no value to the process," the PPA concludes.

The PPA report breaks down endorsements by category. It found that two-thirds of endorsements about pack size were unnecessary. Pack size was added in 74 per cent of cases but only 26 per cent of the items had more than one pack size available.

Addition of name, manufacturer and supplier is not necessary for generic items in part VIII of the Drug Tariff or for proprietary items. However, they were added in 46 and 43 per cent of items, respectively.

Endorsing product presentation, strength and quantity is only needed when they have not been specified by the prescriber. Only one or two items required this information to be added but it had been endorsed in roughly a third of cases.

The PPA researchers also conducted a second piece of research involving a much larger sample of prescriptions. They assessed the impact of additional information on calculating payments in 54,000 items that were either in part VIII of the Drug Tariff or were proprietary products. The difference in the total payments for these prescriptions when additional information was included or not was £977, which was just 0.17 per cent of the total cost.

The PPA concludes: "For the majority of prescriptions where proprietary items or generic items falling within Part VIII of the Drug Tariff are prescribed, dispensing endorsements do not significantly affect the reimbursement or remuneration price paid to the dispensing contractor."

However, the Pharmaceutical Services Negotiating Committee advised pharmacists not to stop endorsing but to ensure that prescriptions are only endorsed with necessary information. The PSNC and PPA will be preparing guidance for contractors on endorsing within the next few weeks.

The research is available as a PDF file (85K).

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