IJPP 2003, 11: 225-232
© 2003 Int J Pharm Pract
Received December 12, 2002
Accepted September 11, 2003
ISSN 0961-7671

School of Life and Health Sciences, Aston University, England

Keith A. Wilson, professor of pharmacy

Aston Business School, Aston University

Jill Jesson, lecturer in public management and sociology

Correspondence: Professor Wilson, Medicines Research Group, School of Life and Health Sciences, Aston University, Birmingham, England B4 7 ET.
E-mail: k.a.wilson@aston.ac.uk

Original Papers

Dispensing activity in a community pharmacy-based repeat dispensing pilot project

Keith A. Wilson and Jill Jesson

Abstract
Objective To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings.

Method Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their “repeat medicines list” and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes.

Setting 350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies.

Key findings There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists.

Conclusion The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients’ needs and their use of medicines might be cost neutral.