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Medicines Optimisation - generic prescribing

 

In England, 81% of all drugs in primary care are already prescribed generically, generating significant savings for the NHS.  Building on what’s been achieved with generic prescribing in recent years, the NHS Business Services Authority has developed a dashboard providing rapid access to data, highlighting areas where savings can be realised and helping prescribers and commissioners to deliver even better value care.

The new dashboard highlights the variation in generic prescribing across various geographies, from national down to GP practice level, for 20 carefully selected medicines which:

  • avoids the need to create complicated tags and spreadsheets,
  • are all suitable for generic prescribing, according to criteria developed by the UK medicines information service (UKMI);
  • are deemed by experienced pharmacists to have the least potential for clinical controversy;
  • have the highest remaining potential to generate savings through increased generic prescribing (according to national data for January to March 2017);
  • are all suitable for inclusion in prescribing decision support software.

The dashboard draws on patient-level prescribing data and the analytical flexibility of the latest version of ePACT to highlight relevant variation in a way that will help prescribers and medicines optimisation leads to target further improvement activity more efficiently than has previously been possible from the Potential Generic Savings report that has been available via the NHSBSA’s Information Services Portal (ISP).

The data underlying the dashboard will be refreshed on a quarterly basis.

Potential benefits

If it were clinically appropriate for all of these medicines to be prescribed generically, a national total of £17.9m could be released for reinvestment in the NHS.

If generic prescribing rates for these medicines in every CCG matched the average of their best five comparable CCGs, a national total of £4.2m could be released for other patient care.

Key benefits to CCGs and GP practices include:

  • easy identification of quick wins;
  • better value care for patients, releasing resources for investment in other aspects of patient care;
  • highlighting variation between GP practices and CCGs, to facilitate continuous improvement;
  • all medicines on the list are suitable for inclusion in prescribing decision support software.

     This dashboard is designed to provide insight into the savings that could be achieved changing f from proprietary to generic prescribing for the 20 drugs identified at a national level as having the    greatest potential to release additional resources through increased generic prescribing.

The dashboard presents data across a range of reporting levels from National to Practice level to show how the savings relate to individual organisations.

The intention is to provide a list of drugs that can be described as therapeutically equivalent when prescribed generically rather than by brand.  The generic drugs on this dashboard have been chosen using criteria from the UKMI Q&A 247.3.  The Generic Prescribing Guidelines produced by the Greater Manchester Medicines Management Group (GMMMG) are also a very useful source of information.

It is still possible that patients will express a preference for the branded version of a particular medicine.  Such preferences should be dealt with on a case-by-case basis. 

For medicines with relatively low current levels of generic prescribing in their locality, CCGs may wish to consider notifying community pharmacies of their intention to increase generic prescribing, so they can plan accordingly.

Interpretation of the reports

The reports show the current prescribing of the proprietary products alongside the potential savings if these items were prescribed generically.  The current overall prescribing of the generic products is also displayed to show how often these items are already being prescribed generically.

The number of patients has been included to give an idea of the number of patients that would be impacted by any changes and to allow resources to be targeted cost-effectively. 

Please note that patients may appear in the counts for multiple different medicines.

For those who have registered, you can access the Potential Generic Savings dashboard via ePACT2.