Targets force hospitals to tackle prescribing costs

Efficiency targets will force hospitals to adopt the same cost-effective prescribing measures that GPs have been using for years, the DoH's pharmacy czar says.

Hospital prescribing: QIPP has put costs under the spotlight (Photograph: SPL)
Hospital prescribing: QIPP has put costs under the spotlight (Photograph: SPL)

GP reported earlier this month that secondary care doctors were failing to match GPs' efforts to contain drug costs, with prescribing in hospitals rising three times faster than in primary care (GP, 4 November).

RCGP chairwoman Dr Clare Gerada wrote on Twitter that hospital doctors did not have the same focus on prescribing costs as GPs. 'Ask a specialist to prescribe cheaper generics (and) they look at you with disdain,' she said.

Jonathan Mason, the DoH's national clinical director for primary care and community pharmacy in England, said medicines management teams needed to take lessons learned in primary care into hospitals.

'Medicines management advisers have years of experience of identifying outliers with regard to prescribing and challenging such variability with the GPs concerned,' he said.

'They are involved in working with secondary care pharmacists to tackle interface issues, for example agreeing joint formularies to ensure that hospitals prescribe more cost-effectively,' he added.

Mr Mason said a focus on secondary care prescribing costs was being driven by the need to achieve 4% efficiency savings under the quality, innovation, productivity and prevention (QIPP) agenda.

'QIPP has increased focus on appropriate use of NICE-recommended drugs. The greater number of area prescribing committees has prompted more interface working.'

Interface working in medicines management involves ensuring hospitals do not prescribe medicines that they receive at a discount but which are expensive in primary care.

'Hospitals may have to prescribe a more expensive alternative if the cost to the overall health economy is lower in the long run,' Mr Mason said.

A recent NHS Information Centre report said: 'Unlike primary care prescribing data, there is no central NHS collation of information on medicines issued and used in NHS hospitals.'

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