Int J Pharm Pract 2000:8:27-32
Mount Pleasant Health Centre, Mount Pleasant Road, Exeter, England EX4 7BW
David Russell, MRCP, MRCGP, general practitioner
Manjo Luthra, BSc, MMedSci, health services researcher
Liz Plastow, RMN, MSc, research nurse
Ruth Airdrie, MPharm, MRPharmS, pharmaceutical advisor
Martin Marshall, MD, FRCGP general practitioner
Correspondence:
Ms Luthra
researchmphc@talk21.com
Original Papers
Cost-effective prescribing in general practice: Patients' attitudes to financially motivated prescribing changes
DAVID RUSSELL, MANJO LUTHRA, LIZ PLASTOW, RUTH AIRDRIE and MARTIN MARSHALL
Objectives - To assess the patient acceptability of a personalised letter suggesting a change of repeat medication to a generic or cheaper equivalent brand, to determine the resulting cost savings and to investigate patients' attitudes to cost-effective prescribing.
Method - Patients identified from their records as receiving a predefined group of repeat prescriptions for medication that could be prescribed more cheaply were sent a letter from their own general practitioner asking them to consider changing their prescription. They were given the option to agree to the change, to refuse or to discuss the change with their doctor. Qualitative semi-structured interviews were conducted with a purposeful sample of those who agreed and those who refused the suggested change.
Setting - Two fundholding practices in the south west of England with a combined list size of 15,500.
Key findings - The letter was sent to 323 patients, of whom 252 responded (78 per cent). One hundred and eighty-two patients (72.2 per cent) agreed to the suggested change, 37 (14.7 per cent) refused and 33 (13.1 per cent) wished to discuss the suggestion with their doctor. Eleven of the last group subsequently agreed to change, resulting in a total of 193 (76.6 per cent) agreeing to the change and 59 (23.4 per cent) refusing to change. Four months after the change was made, four patients (2 per cent) had reverted to their previous prescription. The changes resulted in an annual saving to the practice of £10,038 (1.1 per cent of total prescribing budget). The total cost of conducting the changes (including staff time) was £1,800.
Conclusion - Changing repeat medication to equivalent generics or cheaper brands can result in significant cost savings in general practice, and a short personalised letter is an effective and acceptable way of achieving the change.