Prescribing & Medicines Management
Issue no 2, p3
March/April 2003

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Better prescribing could solve PCT drug budget overspends

Better prescribing and medicines management in primary care could help to close the growing chasm between prescribing costs and PCT prescribing budgets, the Audit Commission suggests.

According to its latest bulletin on primary care prescribing nearly half of the £540 million rise in prescribing costs faced by PCTs has been due to increases in just four categories of drugs. Soaring prescribing rates for statins, antihypertensives, diabetes drugs and antipsychotics drove PCTs' prescribing costs in 2001/02 beyond their budget uplifts, putting pressure on other budgets. Although better patient care due to implementation of NICE guidance and NSFs in coronary heart disease, diabetes lay behind the rise, the Commission is concerned that the £250 million extra spent on these drugs may well outstrip any uplift to prescribing budgets allocated to PCTs.

Yet improved efficiency in prescribing could save more than £130 million during the next three years, which would help offset the increases. The Audit Commission and Prescribing Support Unit are developing a national prescribing savings database to calculate the potential savings for each PCT.

Commission chairman James Strachan said: "As prescribing costs rise rapidly it is vital that every penny is spent well. All PCTs should review their performance to see how they can free up the funds to ensure people get the medicines they need."

Health minister David Lammy welcomed the increase in prescribing of statins, and said the Government would continue to encourage doctors to follow NSF and NICE guidance. "Government guidance makes it clear that PCTs should set aside realistic resources from these allocations to ensure as many patients as possible can better access medicines through the primary care route," he said.

Meanwhile the Audit Commission is expanding its primary care prescribing review to look at the impact of Pharmacy in the Future, medicines management and development of community pharmacists' roles. The report is due out in summer 2003, and will be supported by examples of good practice.