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Re: Shortages of Medicine Supply (1st Aug 12 at 10:03pm UTC)
http://www.pharmatimes.com/mobile/12-07-31/New_NHS_competitive_procurement_probe.aspx
New NHS competitive procurement probe - Lynne Taylor Pharma Times

A new study is to examine the role and limitations of competitive procurement of health services, with a particular focus on whether - and how - it stimulates innovation in service provision.

This new investigation follows on from the work of the Office of Health Economics (OHE)'s Commission on Competition in the NHS, whose report, published at the end of January, recommended "careful" expansion of competition between providers of NHS-funded health care in England.
The Commission found that, on the best available evidence, competition at regulated prices has improved the quality of some NHS services. Competition can help the integration of care, and there is no evidence that competition hampers integration, it said.

The new study is being undertaken by the OHE in partnership with the NHS Confederation. They point out that while competition - or at least the credible threat of it - either through the Any Qualified Provider (AQP) model or competitive procurement, is sometimes claimed to be an important source of innovation and performance improvement, empirical testing of that claim is lacking.

The OHE Commission report had concluded that, while competition in the NHS is controversial, it can, in the right circumstances, be used to stimulate the provision of better health care than is achieved without competition. However, it emphasised: "this does not mean that competition is desirable or feasible for all NHS services or for none - the question is for which services and where competition would benefit patients."

Among the Commission's conclusions were that AQP arrangements allowing patients - helped by their GPs - to choose where to get their health care are suitable in some cases, while in others, competitive procurement by local NHS commissioning bodies on behalf of the populations they serve will be more appropriate.

Routine collection and publication of patient outcome measures should continue to be expanded to enable evaluation of the effects of competition, the OHE Commission also recommended.

The new OHE/NHS Confederation study will aim to establish: - the extent of discretionary competitive procurement of health services by Primary Care Trusts (PCTs) in England over the last three years; - why it has been selected as a route to innovation and improved quality and value for money; - the role and type of new entry (if any); - any early evidence on impact; and - where competitive procurement is considered unlikely to be appropriate, and why not.

The work will combine an analysis of the NHS Supply2Health database and a survey of PCT clusters, and seek information on: - the rationales for the competitive procurements of health services that have been undertaken; - the expected or actual role of new entry, and any early evidence of impacts emerging; and - views on where such an approach to improving quality and value for money is considered inappropriate, and why.
The study will be led by John Sussex, deputy director at the OHE, working with Professor Maria Goddard, director of the Centre for Health Economics at the University of New York.

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Re: Shortages of Medicine Supply (28th Aug 12 at 10:12am UTC)
Scorecards' to end inequality over NHS drugs
Measure aims to tackle regional disparity of medicines and treatments

http://www.guardian.co.uk/society/2012/aug/28/scorecards-nhs-inequality-over-drugs
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Re: Shortages of Medicine Supply (19th Jan 13 at 11:51pm UTC)
http://www.pharmatimes.com/mobile/13-01-18/Don_t_exaggerate_cost_impact_of_NHS_drugs_waste_experts_warn.aspx

PharmaTimes - Don't exaggerate cost, impact of NHS drugs waste, experts warn
Lynne Taylor



The National Audit Office (NAO) estimated some years ago that around 10% of NHS medicines dispensed in the community in England are wasted, at a cost of around £1 billion a year, but the real annual cost is no more than £350 million, according to a new report.

The true wastage total in England is only about 4%, and 50% of this is in fact unavoidable, because it stems from factors such as patients' conditions changing, research by University College London (UCL) School of Pharmacy and the York Health Economics Consortium has found. Therefore, the savings to be made from further improving the NHS record in reducing medicine wastage in England are, in reality, unlikely to be greater than £100 million, says a new policy briefing issued by the UCL School of Pharmacy.

The briefing acknowledges that £100 million is "an appreciable" amount, but points out that this is still less than 0.1% of the £110 billion annual cost of the NHS in England, and also that, despite recent advances in areas such as cancer and HIV care, overall hospital and community prescription drugs have fallen as a proportion of NHS spending during the last decade. Because of the "genericisation" of medicines, these costs now stand at about 10% of total NHS costs, which is about the same percentage as in the mid-1960s.

The report dismisses allegations that poor prescribing, unnecessary dispensing and inappropriate use of medicines by patients are leading to levels of wastage that are undermining NHS finances. "There is in fact no evidence that NHS medicines users behave less responsibly than those who pay for treatments, or that levels of drug wastage are higher in Britain than in other relatively rich countries," it says.
And, to suggestions that that one reason for alleged inappropriate use of medicines by patients could be that most NHS prescription drugs are supplied free of charge, it points out that "it has been observed that charges can lead to vulnerable people to stop taking therapies."

However, the School of Pharmacy/York analysis also found that NHS England could make cost savings and health gains of around £500 million a year from better use of supplied medicines in just five therapeutic areas. This finding underlines the importance of investing in better delivery of pharmaceuticals and health care by pharmacists and taking medicines to optimal effect, rather than concentrating narrowly on reducing drug waste, says the report.

Also, while there is evidence that many members of the public would like to see returned medicines re-issued, the costs of doing this safely would normally be greater than the supply cost of the medicines involved, it says. Outside hospitals, it is usually more cost-effective to incinerate returned medicines and to purchase new supplies for use domestically or abroad.
To put this in perspective, a typical medicine in England costs a little under £10 for a month's supply, while employing a health professional in the NHS often costs £10 for 10 minutes' working time, the report points out.

"Such figures highlight the relative importance of using labour prudently in the pursuit of better public health, and wherever possible recognising the abilities of NHS service users to take more independent control over the use of their medicines, as well as adopting healthy lifestyles in order to protect their health," it says.
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Re: Shortages of Medicine Supply (20th Jan 13 at 9:31pm UTC)
http://www.pulsetoday.co.uk/pharmacy-drugs-access-scheme-to-be-rolled-out-to-12500-pharmacies/20001540.article#.UPxgovI093A
Pharmacy drugs access scheme to be rolled out to 12,500 pharmacies - Pulse By Madlen Davies

Pharmacy leaders have given the green light to offer a scheme to 12,500 pharmacies from next month giving patients access to 13 medicines - such as salbutamol inhalers - without an individual prescription, despite GPs saying they had ‘significant concerns’.

The National Pharmacy Association confirmed the rollout of the scheme after the body was forced to rethink the scheme following an intervention from the chief pharmacist at the Department of Health.

In December, the antibiotics trimethoprim, doxycycline and ciprofloxacin were removed from the scheme after a meeting between chief pharmacist Dr Keith Ridge and the NPA about the effect on antimicrobial resistance.

Pulse has learnt the scheme will go ahead from the 1 February, including 13 drugs, such as azythromicin, sildenafil, the emergency contraception pill, anti-malarials, salbutamol and calcipotriol cream.

A spokesperson from the NPA said: ‘The scheme will be rolled out to NPA members from 1 February, though we don’t expect all members to take it up.’

But Dr Daryl Freeman, a GPSI in Norfolk, said she had ‘significant concerns’ about patients obtaining these medicines without a prescription.

She said: ‘I have significant concerns about all those medicines being included, apart from the emergency contraceptive pill. Calcipotriol cream is not something you need urgently, or is difficult to get from the GP surgery.

‘There are often underlying medical issues - such as diabetes - for erectile dysfunction, so we shouldn’t be handing out Viagra without the checks a GP would run. For salbutamol inhalers, there are widely-discussed issues about control and ensuring the patients are being monitored.

She added: ‘Azythromicin isn’t the most commonly used antibiotic, so why is it included? Antibiotics shouldn’t be made more widely available. It doesn’t make sense when GPs and healthcare professionals are being sent emails every day saying “Please monitor your antibiotic prescribing”.

‘It’s giving really mixed messages. It’ll make it more difficult for us when we turn around to patients and say “No, you’ve got a viral illness so I can’t give you antibiotics.”’
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Re: Shortages of Medicine Supply (10th Dec 14 at 1:06pm UTC)
Do you regularly take a prescription drug?
Some 50% of women and 43% of men in England are taking at least one prescription medication, leading to claims that the UK is a nation of 'pill-poppers'. The most commonly prescribed medicines were statins, analgesics and antidepressants.

http://www.theguardian.com/commentisfree/poll/2014/dec/10/do-you-regularly-take-prescription-drug
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