Exclusive: Antidepressant spending per patient varies 13-fold across England

Official NHS prescribing data shows that the amount spent on antidepressants per patient with confirmed depression appears to vary almost 13-fold across England.

Depression: drug spending per patient varies widely across England
Depression: drug spending per patient varies widely across England

CCGs in some parts of the country appear to be spending almost 13 times the amount on antidepressants per patient that others spend, according to a GPonline analysis of antidepressant prescribing costs and depression prevalence across the country.

GP leaders stressed the results should be interpreted with caution, and were likely impacted by socioeconomic factors and availability of dedicated services in the area.

But the magnitude of variation in the results suggests there could be a postcode lottery of treatment, with some areas spending much larger sums on antidepressants for patients than others.

Map: Antidepressant spending per patient

Darker colours represent areas with a higher spend per patient with depression

The prescribing data, from the Health and Social Care Information Centre (HSCIC), cover the first quarter of 2015/16 (April-June) and show that CCGs spent a combined total of over £631m on antidepressants during this period.

Compared with the latest figures on depression prevalence from the QOF register, the data suggests that Sheffield, Somerset and Solihull CCGs are spending the least - less than £100 per patient with depression.

Meanwhile, Isle of Wight and Shropshire CCGs spend over £400 per patient, South Cheshire CCG spent over £540 and Slough CCG spent around £775. Average spend per patient across the country was £219.

Antidepressant prescribing

GPC clinical and prescribing subcommittee chairman Dr Andrew Green said: ‘Comparative data is always interesting but does have to be treated with caution, especially when two variables are combined, as that will magnify any variations to exaggerate differences.’

He added that some practices may not use ‘depression’ codes for all patients given antidepressants, which would lead to the number of patients diagnosed with depression being underestimated and artificially inflate the prescribing cost per diagnosed patient figures.

‘Prescribing costs will also be affected by other factors outside the control of the GP, including socioeconomic factors and the availability and quality of counselling and psychiatric services,’ he said.

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