SW Locality PBC Consortium Notes re Prescribing Data

Transcription

1 SW Locality PBC Consortium Notes re Prescribing Data Enclosed data is for SW Locality PBC Consortium practices from current 12 months as at Mar 07 Top 50 by cost identified Areas that could achieve quick wins regarding costs identified GREEN areas where there has already been a lot of work, support materials are available and the focus would be upon maintaining good prescribing patterns AMBER areas where there will be focus during 2007/08, support materials being developed RED areas not included elsewhere that the consortium could also consider actioning Current Issues Savings/balanced budgets have to be achieved in a number of areas included prescribing prior to consortia being able to keep any savings; this raises a number of issues regarding prescribing - 700,000 of cost savings have already been subtracted from the practice prescribing budget for 2007/08, this consists of 400,000 for savings generated by pan-london procurement of epoetin through secondary care and 300,000 of savings generated in PPI prescribing further information to follow - Individual consortia may achieve savings within their budgets but could be penalised by prescribing from other consortia - To ensure practices are not penalised for treating high cost patients a top slice will be put aside to share the financial risk across the whole PCT Suggestions Agree as a consortium that you will ensure that you meet MM targets set around cost efficiencies in this year s MM Plan (TBC) in conjunction with maintaining or improving around areas already looked at e.g. statins, and looking at one or more other areas such as Other preparations Agree an action plan with other consortia in the PCT to achieve maximum effect Purchase the software programme Scriptswitch to assist in achieving agreed actions Future Considerations Regarding Medicines Management Case management focussing on repeated acute admissions due to medicines management issues Consortia will probably be charged for MM Team support in future years as it is outside core roles and backfill will be required. Ruth Lacey SW Locality Prescribing Adviser Lambeth PCT March 2007

2 Top 50 by cost for SW Locality PBC Consortium - using current 12 months as at Mar 07 BNF Name Total Items Total Act Cost Comments Atorvastatin 9, ,396.37Part of MTF - ongoing action recommended Fluticasone Propionate 3, ,400.38Respiratory area of focus for MM Plan 0708 Glucose Blood Testing Reagents 6, ,704.72Part of MM Plan ongoing action required Amlodipine 18, ,851.22Part of MTF - ensure continued generic prescribing Other Preparations 1 13, ,175.34Possible area of action Olanzapine 1, , Clopidogrel 2, ,725.34Part of MM Plan ongoing action required Enteral Nutrition 2, ,104.33Part of MM Plan 0708 Losartan Potassium 3, ,331.38Part of MM Plan 0708 Salbutamol 16,225 89, Epoetin Beta ,620.99London wide secondary procurement proposed - part of cost efficiencies 0708 Budesonide 1,613 85,334.26Respiratory area of focus for MM Plan 0708 Beclometasone Dipropionate 6,544 85,120.33Respiratory area of focus for MM Plan 0708 Lansoprazole 10,247 83,290.78Review of treatment doses & switch to CE Caps part of MM Plan Darbepoetin Alfa , Omeprazole 7,556 78,793.18Review of treatment doses & switch to CE Caps part of MM Plan Simvastatin 18,103 78, Doxazosin Mesilate 5,686 68, Combined Ethinylestradiol 30mcg 7,105 64, Candesartan Cilexetil 3,811 62,564.78Part of MM Plan 0708 Proguanil Hydrochloride With Atovaquone 1,160 61,512.44LSL exception re antimalarials Diclofenac Sodium 7,269 58, Metformin Hydrochloride 11,572 58, Alendronic Acid 2,808 56, Goserelin Acetate ,086.18

3 Sildenafil 1,588 54,647.97Possible area of action Salmeterol 1,290 54, Nifedipine 3,941 52, Nicotine 2,569 51, Paracetamol 25,162 50, Venlafaxine 1,604 49,239.69Possible area of action Irbesartan 2,233 48,837.03Part of MM Plan 0708 Biphasic Isophane Insulin 1,228 46, Hepatitis A 2,515 45, Risperidone 1,140 45, Insulin Glargine , Rosiglitazone 1,101 43,368.49Possible area of action Insulin Aspart , Latanoprost 1,543 40, Buprenorphine Hydrochloride 1,277 38, Other Preparations ,066.04Possible area of action Perindopril Erbumine 3,214 37, Tolterodine 1,330 37, Gabapentin 1,307 36, Tiotropium , Co-Codamol (Codeine Phos/Paracetamol) 6,537 36, Orlistat , Esomeprazole 1,034 36,104.68Stepdown and switch to Lansoprazole or Omeprazole capsules part of MM Plan 0708 Bicalutamide , A0 Hydrocortisone 7,266 34, V0 Mesalazine (Systemic) , H0 236,070 3,778,649.54

4 Breakdown of other Preparations 1 BNF Name Total Items Total Act Cost Cost per Item Unspec Drug Code_ 1,001 56, Unspec Drug Code_(Discount Not Deducted) , E45_Crm 3,342 19, Diprobase_Crm 3,041 18, Liq Paraf/Wte Soft Paraf_(S) 50%/50% 1,335 5, Doublebase_Gel 800 4, Unguentum M_Crm 280 2, Oilatum_Crm (New Form) (Liq) 365 2, Aveeno_Crm 283 2, Liq Paraf/Isopropyl Myrist_Gel 15%/15% 384 2, Cetraben_Emollient Crm 384 2, Dermol 500_Lot 256 1, Diprobase_Oint 260 1, Liq Paraf/Wte Soft Paraf_Crm 10.5%/13.2% 190 1, Oilatum_Crm (New Form) 233 1, Dermol_Crm Keri_Therapeutic Lot 16% Gppe Crm_Aveeno Aveeno_Lot Hydromol_Crm Ultrabase_Crm E45_Lot Liq Paraf Light/Wte Soft Paraf_Crm 6/15% Dermol 200_Shower Emollient E45_Emollient Wsh Crm Oilatum_Jnr Crm (Liq) Lipobase_Crm Oilatum_Jnr Crm Eucerin_Dry Skin Soothing Lot P/Spy200ml Gppe Crm_Hydromol Kamillosan_Oint Eumobase_Conc Rehyd Crm Allergenics_Emollient Crm Liq Paraf_Lot 16% Aquabar_Aq Soap The 50:50_Oint Gppe Crm_Diprobase Neutrogena_Norwegian For Dermat Crm Glycerol_Crm 40% Chamomile Ext_Oint 10% Gppe Lot_Aveeno Oilatum_Lot Evening Primrose Oil_Crm 20% Sudocrem_First Aid Crm , ,175.34

5 Breakdown of Other Preparations 2 BNF Name Total Items Total Act Cost Cost per Item Fortijuce_Liq (7 Flav) 151 9, Neocate_Spec Diet Food Pdr 55 8, Neocate Advance_Pdr Sach 100g 23 2, Nutramigen 1_Pdr 72 2, Nutriprem 2_Pdr 100 2, SMA Wysoy_Pdr 154 2, KetoCal_Pdr 2 1, Infasoy_Pdr 67 1, Nutramigen 2_Pdr 23 1, Provide Xtra_Liq Supp (Flav) 8 1, Calogen (L.C.T.)_Emuls (Sbery) Calogen (L.C.T.)_Emuls (Unflav) Calogen (L.C.T.)_Emuls (Banana) Maxijul Super Solb_Pdr Duocal_Super Solb Pdr Gppe Pdr_Infasoy Liquigen_Emuls Nutriprem 2_Liq Gppe Pdr_Wysoy Duocal_Mct Phlexy-Vits_Pdr Sach 7g Farley's_Soya For Calogen (L.C.T.)_Emuls (Bs) Neocate Advance_Pdr Sach 50g (Flav) Gppe Pdr_Farley's Soya For Instant Carobel_Pdr Fortimel_Liq (Flav) Vitasavoury 200_Pdr (Chicken) Vitasavoury 200_Pdr (Mushroom) Maxipro Super Solb_Pdr Casilan 90_Whole Protein Pdr Maxijul_L.E. Pdr ,066.04

6 Breakdown of Fluticasone Items BNF Name Total Items Total Act Cost Cost per Item Seretide 250_Evohaler 250mcg/25mcg(120D) , Fluticasone/Salmeterol_Inh 250/25mcg120D , Seretide 250_Accuhaler 250mcg/50mcg(60D) , Seretide 125_Evohaler 125mcg/25mcg(120D) , Seretide 500_Accuhaler 500mcg/50mcg(60D) , Fluticasone/Salmeterol_Inh 125/25mcg120D , Fluticasone Prop_Inha 250mcg (120 D) CFF , Fluticasone/Salmeterol_Inh 250/50mcg 60D 166 9, Fluticasone/Salmeterol_Inh 500/50mcg 60D 86 4, Seretide 100_Accuhaler 100mcg/50mcg(60D) 96 4, Fluticasone/Salmeterol_Inh 50/25mcg 120D 121 3, Seretide 50_Evohaler 50mcg/25mcg (120 D) 92 2, Fluticasone/Salmeterol_Inh 100/50mcg 60D 58 2, Fluticasone Prop_Inha 125mcg (120 D) CFF 78 2, Flixotide_Evohaler 250mcg (120 D) 47 2, Fluticasone Prop_Pdr For Inh 250mcg(60D) 44 1, Flixotide_Accuhaler 250mcg (60 D) 41 1, Flixotide_Disk 500mcg Ref 13 1, Fluticasone Prop_Pdr For Inh 500mcg(60D) Flixotide_Disk 250mcg Ref Fluticasone Prop_Inha 50mcg (120 D) CFF Fluticasone Prop_Pdr For Inh 100mcg(60D) Flixotide_Evohaler 125mcg (120 D) Flixotide_Accuhaler 500mcg (60 D) Flixotide_Accuhaler 100mcg (60 D) Flixotide_Accuhaler 50mcg (60 D) Flixotide_Disk 500mcg & Diskhaler Flixotide_Evohaler 50mcg (120 D) Fluticasone Prop_Pdr For Inh 50mcg (60D) Flixotide_Disk 100mcg Ref Fluticasone Prop_Inh Soln 500mcg/2ml Ud Flixotide_Disk 100mcg & Diskhaler , ,400.38

7 Breakdown of Hydrocortisone Items BNF Name Total Items Total Act Cost Cost per Item Hydrocort_Crm 1% 1,629 10, Hydrocort_Oint 1% 762 5, Miconazole Nit/Hydrocort_Crm 2%/1% 1,506 3, Hydrocort_Crm 2.5% 137 2, Hydrocort_Oint 2.5% 168 2, Hydrocort_Crm 0.5% 352 1, Daktacort_Crm 543 1, Hydrocort/Clotrimazole_Crm 1%/1% 560 1, Hydrocort/Miconazole Nit_Oint 1%/2% Timodine_Crm Hydrocort_Oint 0.5% Daktacort_Oint Calmurid HC_Crm Canesten HC_Crm Hydrocort_Crm 0.1% Alphaderm_Top Steroid Crm Hydrocort/Crotamiton_Crm 0.25%/10% Urea/Hydrocort_Crm 10%/1% Eurax-Hc_Crm Eurax-Hydrocort_Crm Mildison Lipocream_Crm 1% Daktacort Hydrocort_Crm Nystaform-HC_Crm 0.5% Efcortelan_Crm 1% Canesten Hydrocortisone_Crm Econazole Nit/Hydrocort_Crm 1%/1% Vioform-Hydrocort_Crm Terra-Cortril_Top Oint Gppe Crm_Nystaform-Hc 0.5% Efcortelan_Oint 1% Vioform-Hydrocort_Oint Econacort_Crm Clioquinol/Hydrocort_Crm 3%/1% Efcortelan_Crm 0.5% Efcortelan_Oint 0.5% ,266 34,702.04