Are there quantitative differences in the prescribing costs of dispensing and non-dispensing doctors?

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The Pharmaceutical Journal
Vol 277 No 7430 p695-697
9 December 2006

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Original papers

Are there quantitative differences in the prescribing costs of dispensing and non-dispensing doctors?

By Michael Wilcock, Jo Erwin and Jan Wankowski

Michael Wilcock, MRPharmS, is head of the prescribing support unit, Cornwall and Isles of Scilly Primary Care Trust (Central Cornwall PCT at the time of the study).

Jo Erwin, PhD, is honorary research fellow, Peninsula Medical School, Truro.

Jan Wankowski, MSc, is prescribing analyst, Cornwall and Isles of Scilly PCT (West of Cornwall PCT at the time of the study).

Correspondence to:
Michael Wilcock, Pharmacy Department, Royal Cornwall Hospitals NHS Trust, Truro TR1 3LJ

e-mail: mike.wilcock@centralpct.cornwall.nhs.uk

Abstract

Aim
To compare prescribing costs of non-dispensing and dispensing doctors, to ascertain significant differences in the use of specific categories of drugs and to identify other factors contributing to differences in overall prescribing costs.

Design
Quantitative analyses.

Subjects and setting
All 25 practices in West of Cornwall Primary Care Trust, categorised into dispensing or non-dispensing practices.

Results
There was no significant difference in aggregated prescribing costs for dispensing and non-dispensing practices, although dispensing practices had significantly higher costs for drugs used for musculoskeletal disorders and had larger savings available from increased use of generic drugs. Two variables from the set of independent variables were significantly associated with the variation between practices in their prescribing costs. These were the percentage of new drugs cost and the Index of Multiple Deprivation. This model explained 37% of the variability in average prescribing costs.

Conclusions
This analysis does not support the commonly held view that prescribing costs per patient for dispensing practices are substantially greater than for patients belonging to non-dispensing practices. Practice prescribing costs were positively associated with the percentage of new drugs prescribed and negatively associated with decreasing deprivation.