Int J Pharm Pract 2002:3:11-16
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Oxford Road, Manchester, England M13 9PL
Ellen I. Schafheutle, PhD, MRPharmS, research associate
Karen Hassell, PhD, senior research fellow
Elizabeth M. Seston, MA Econ, research associate
Peter R. Noyce, PhD, FRPharmS, professor of pharmacy practice
Correspondence:
Dr Schafheutle
Original Papers
Non-dispensing of NHS prescriptions in community pharmacies
Ellen I. Schafheutle, Karen Hassell, Elizabeth M. Seston and Peter R. Noyce
Objective — To explore non-dispensing of National Health Service (NHS) prescriptions in community pharmaciesMethod — Prospective study on prescription items that were presented and not dispensed. Pharmacy staff recorded reasons for non-dispensing of NHS prescription items and process outcomes, including substitution through other means
Setting — Sixteen community pharmacies in the North of England
Key findings — Data are available on 587 items (514 patients). Two main reasons for non-dispensing were identified: those related to the cost of the prescription charge (n=308) and those unrelated to cost (n=279). The latter generally suggested a prescribing issue involving the general practitioner's (GP's) computer system. Cost-related reasons included cheaper availability of over-the-counter (OTC) products (78.6 per cent) and incidents where customers were unwilling or unable to pay the prescription charge (20.1 per cent). Unsurprisingly, cost-related reasons were encountered almost exclusively for patients who were non-exempt from prescription charges, while non-cost reasons were more commonly seen for exempt patients. As a result of non-dispensing because of cost, 242 OTC products were sold, 97.0 per cent of which contained the same active ingredient as had been prescribed by the doctor. There were 62 incidents where a prescribed item was not dispensed, or substituted, because of cost, and more than one-third of these items (n=22) could be considered to be clinically important
Conclusion — In addition to issues of GP prescribing, the cost of the prescription charge was identified as a major factor in non-dispensing. Many of the items were substituted by cheaper OTC products, yet some clinically important drugs were not dispensed or substituted, suggesting that a review of the UK charge system is appropriate