This document analyzes initiatives in Scotland to enhance prescribing efficiency for cardiovascular drugs, proton pump inhibitors, and atypical antipsychotics. It finds that education, economics, and engineering measures successfully increased the use of generic omeprazole, simvastatin, and ACE inhibitors, controlling expenditures. However, the availability of generic risperidone did not increase its use relative to other atypical antipsychotics, limiting potential savings. The analysis suggests multiple demand-side measures are needed across therapeutic classes to maximize efficiency gains from lower-cost generics.
Anatomic Therapeutic Chemical Classification, Defined daily dose, Drug utilis...Dr.Amreen Saba Attariya
detailed information about Anatomic Therapeutic Chemical Classification, Defined daily dose, Drug utilisation, DU90%, WHO Collaborting Centre for drug statistic methodology, DDD/1000inhabitants/day, DDD/100beddays, DDD/1000inhabitants/year, Pediatric DDD, ATC & DDD in drug utilisation research, Electronic Prescribing, Guidelines for ATC classification & DDD assignment 2016
Defined daily dose-DDD
B Pharm, Pharm D and medicine syllabus
Useful for examination and regulatory function information
Useful for Pharmacovigilance interview and medical coding also.
Good Luck and all the best!!!
Introduction to Premarketing Phase
Limitation of Premarketing Phase and Importance of Phase IV period
Definition of DUS
History of DUS
Objectives of DUS
Types of Drug Use Information
Drug Utilization Cycle
This timely presentation addresses the changes that are proposed under NICE's new value-based assessment (VBA) approach to assessing health technologies. It reviews NICE's current approach and decisions to date for all technologies and separately for orphan and cancer drugs. VBA's proposed calculations for burden of illness and societal impact use estimates of 'shortfall' are illustrated in the presentation. Also discussed are changes in QALY thresholds.
Anatomic Therapeutic Chemical Classification, Defined daily dose, Drug utilis...Dr.Amreen Saba Attariya
detailed information about Anatomic Therapeutic Chemical Classification, Defined daily dose, Drug utilisation, DU90%, WHO Collaborting Centre for drug statistic methodology, DDD/1000inhabitants/day, DDD/100beddays, DDD/1000inhabitants/year, Pediatric DDD, ATC & DDD in drug utilisation research, Electronic Prescribing, Guidelines for ATC classification & DDD assignment 2016
Defined daily dose-DDD
B Pharm, Pharm D and medicine syllabus
Useful for examination and regulatory function information
Useful for Pharmacovigilance interview and medical coding also.
Good Luck and all the best!!!
Introduction to Premarketing Phase
Limitation of Premarketing Phase and Importance of Phase IV period
Definition of DUS
History of DUS
Objectives of DUS
Types of Drug Use Information
Drug Utilization Cycle
This timely presentation addresses the changes that are proposed under NICE's new value-based assessment (VBA) approach to assessing health technologies. It reviews NICE's current approach and decisions to date for all technologies and separately for orphan and cancer drugs. VBA's proposed calculations for burden of illness and societal impact use estimates of 'shortfall' are illustrated in the presentation. Also discussed are changes in QALY thresholds.
This presentation describes the objectives, approach and application of Drug Utilization studies in Pharmacotherapeutics. This emphasizes on how to conduct a drug utilization studies.
Anatomical Therapeutic Chemical Classification System and Defined Daily Doses...Balwant Meshram
The Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) is the WHO recommended measuring unit which is being used for drug utilization studies. This system is internationally accepted and the users are also increasing. While measuring the drug use, the classification system and unit of measurement, both are important.
At the 34th Spanish Health Economics Association annual meeting, Jorge Mestre-Ferrandiz reviewed the results of the discussions of an expert panel about the role of HTA for biosimilars. Representatives from the three UK HTA agencies, the MHRA, and academia discussed which HTA methods are most appropriate for biosimilars in specific situations.
Drug Utilization in a regulated EnviormentAlok Anand
Tracking drugs across the supply chain in a regulated environment. This white paper brief on would be drug utilization approach of Life Science Industry. This white paper is just a step forward to show future life science industry process automation
Current Approaches in European Drug related Health Care Policy: Relative Effe...Johan Strömquist
Key note speech held by Prof Bengt Jönsson from Stockholm School of Economics and Chairman of the NDA HTA Advisory Board, at the ZonMw Congres Goed Gebruik Geneesmiddelen, 31st January 2013, on the topic of dealing with decision making under uncertainty for the reimbursement of medicines
Proposals for Updating the PMPRB BIA Guidelines-PhD thesis results presentati...Naghmeh Foroutan
Proposals for Updating the Canadian Patented Medicine Prices Review Board Pharmaceutical Budget Impact Analysis Guidelines for New Drug Submissions to Public and Private Payers
https://www.researchgate.net/project/Updating-the-PMPRB-Budget-Impact-Analysis-guidelines-for-new-drug-submissions-in-Canada-version-2018-2019
Medicines optimisation, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
This presentation describes the objectives, approach and application of Drug Utilization studies in Pharmacotherapeutics. This emphasizes on how to conduct a drug utilization studies.
Anatomical Therapeutic Chemical Classification System and Defined Daily Doses...Balwant Meshram
The Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) is the WHO recommended measuring unit which is being used for drug utilization studies. This system is internationally accepted and the users are also increasing. While measuring the drug use, the classification system and unit of measurement, both are important.
At the 34th Spanish Health Economics Association annual meeting, Jorge Mestre-Ferrandiz reviewed the results of the discussions of an expert panel about the role of HTA for biosimilars. Representatives from the three UK HTA agencies, the MHRA, and academia discussed which HTA methods are most appropriate for biosimilars in specific situations.
Drug Utilization in a regulated EnviormentAlok Anand
Tracking drugs across the supply chain in a regulated environment. This white paper brief on would be drug utilization approach of Life Science Industry. This white paper is just a step forward to show future life science industry process automation
Current Approaches in European Drug related Health Care Policy: Relative Effe...Johan Strömquist
Key note speech held by Prof Bengt Jönsson from Stockholm School of Economics and Chairman of the NDA HTA Advisory Board, at the ZonMw Congres Goed Gebruik Geneesmiddelen, 31st January 2013, on the topic of dealing with decision making under uncertainty for the reimbursement of medicines
Proposals for Updating the PMPRB BIA Guidelines-PhD thesis results presentati...Naghmeh Foroutan
Proposals for Updating the Canadian Patented Medicine Prices Review Board Pharmaceutical Budget Impact Analysis Guidelines for New Drug Submissions to Public and Private Payers
https://www.researchgate.net/project/Updating-the-PMPRB-Budget-Impact-Analysis-guidelines-for-new-drug-submissions-in-Canada-version-2018-2019
Medicines optimisation, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
The Regulatory Policy Institute, based in Oxford, holds an annual conference on competition and regulation. At this year’s conference, OHE’s Jon Sussex described how the prescription medicines market in England is regulated for innovation.
The regulatory problem for the pharmaceutical market is different from that for utilities markets, transport, financial services and indeed markets for all other types of goods and services. The source of the regulatory problem for prescription medicines in the NHS is that the consumer (patient) neither decides which medicine is prescribed nor is responsible for paying for it. For other goods and services, the consumer decides and pays, as well as consumes. In the pharmaceutical market under the NHS, it is the payer who effectively decides the value of an innovation, not the patient.
The cost and risk in drug development are high. To determine how best to target its R&D efforts, the pharmaceutical industry needs clear signals about what innovation the health care payer, the NHS, values. The recent history of such signalling has been dominated in England by the actions of the National Institute for Health and Care Excellence (NICE), whose assessments also have considerable influence internationally. Moreover, although England represents only 2% of the world pharmaceutical market, its prices are use as a reference for pricing in other markets.
How NICE expresses the value of medicines can be viewed as a mean of regulating innovation. NICE always has based its decisions about value on the incremental cost to the tax-funded health and social care services of the additional quality-adjusted life years a new medicine offers to patients. During the last year, NICE has been consulting on ways to broaden its assessment of value, particularly on whether to take account of the burden of disease and wider societal impacts beyond QALYs. The decisions have not yet been made and the signal to potential pharmaceutical innovators remains fuzzy.
Webinar 3: Alternative Approaches to Innovative Drug Pricing – 12:00pm on Wednesday, May 13, 2020. The third webinar will review Canada’s approach to managing drug prices with approaches used in other jurisdictions. A panel will discuss experiences with oncology therapies, rare disease drugs, and therapies for pandemics and other urgent situations as points of reference toward evolving alternatives to the proposed PMPRB guidelines.
Panel:
Martina Garau, Director, Office of Health Economics, UK;
Sandra Anderson, Senior VP, Innomar Strategies
PG Forest, Director, School of Public Policy, University of Calgary
Durhane Wong-Rieger, President & CEO, CORD
Moderator: Bill Dempster, 3Sixty Public Affairs
OHE Lunchtime Seminar with Associate Professor Paula Lorgelly, Deputy Director, Office of Health Economics
From the Antipodes to the Motherland: reflections on HTA decision makers as budget takers and budget makers
Reimbursement and pricing strategies for drugs for ultra rare diseases: What can Canada learn from experiences across the pond?
Tania Stafinski, University of Alberta
Rare Disease Day Conference 2020 March 9-10
Shelagh Morris, Allied Health Professions Officer of the Department of Health, talks about supplementary prescription. COT Annual Conference 2010 (22-25 June 2010)
This is a presentation to the Australian Society for Antimicrobials (ASA) meeting in Melbourne, 27th February 2020. The presentation draws on research by OHE, funded by the Wellcome Trust, on innovative HTA methods and contracting for antibiotics. It proposes a subscription model delinking the use of new antibiotics from payments to developers for making the products available. It provides an update on UK (NICE and NHSE) plans to introduce a subscription model and suggests that Australia could also pilot such an approach.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Takeaways from a roundtable held on June 1st about patient-centred pharmacare in Canada
● Reports from patient groups and other subject matter experts
● A cohesive vision and set of values for national pharmacare in Canada
View the video: https://youtu.be/HMy_gsTDkfI
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Improving care in County Durham under the STOMP agenda - A 5 year review.pdfHealth Innovation Wessex
The Health Innovation Network Polypharmacy programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Improving care in County Durham under the STOMP agenda - A 5 year review, can be viewed here.
For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/
Monitoring the effectiveness of risk minimisation in patients treated with pi...Valeria Antonella Aguirre
1. BACKGROUND
2. OBJECTIVES
3. METHODS
3.1 SOURCE POPULATION AND STUDY POPULATION
3.2 STUDY DESIGN AND STUDY PERIOD
3.3 EXPOSURE
3.4 ENDPOINTS
3.5 ANALYSIS PLAN
4. LIMITATIONS
5. QUALITY ASSURANCE, FEASIBILITY AND REPORTING
5.1 DATA STORAGE
5.2 METHODS FOR QUALITY ASSURANCE
5.3 DATA QUALITY
5.4 FEASIBILITY AND TIMELINES
5.5 REPORTING AND DISSEMINATION OF RESULTS
5.6 AMENDMENTS
5.7 INDEPENDENT REVIEW OF STUDY RESULTS
6. ETHICAL ISSUES
7. DATA SOURCES
8. REFERENCES
Biologics in Asthma: Generics, reimbursement, and market potential Pharma Intelligence
While asthma has traditionally been considered a well-established market, there are still a number of key unmet needs that could drive further development, particularly among biologics.
In this complimentary webinar, our Datamonitor Healthcare analyst will discuss current and pending biologics being used to treat chronic asthma, including pricing and reimbursement issues, performance projections, targeted patient groups, and the impact of generics on the market.
View and listen to full webinar for free here https://www.youtube.com/watch?v=bNlUE-VH6Tc
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...HTAi Bilbao 2012
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Health Technology Assessment
Jackie Tran, MD
University of Medicine and Dentistry of New Jersey, USA
HTAi 9th Annual Meeting, Bilbao
Integrated Care for a Patient Centered System
25 June, 2012
Health Technology Assessment (HTA) Report: Interventions to increase particip...HTAi Bilbao 2012
Health Technology Assessment (HTA) Report: Interventions to increase participation to organised cancer screening programs
Ministry of Health Grant for Applied Research
Giorgi Rossi P, Camilloni L, Ferroni E, Jimenez B, Furnari G, Guasticchi G, Borgia P.
Laziosanità – Agenzia di Sanità Pubblica della Regione Lazio
Social values international programme: integrating research and policy to ens...HTAi Bilbao 2012
Social values international programme: integrating research and policy to ensure fair allocation of health care resources .
HTAi Conference 2012 Panel Session
Joint chairs
Professor Peter Littlejohns and Professor Albert Weale
Challenges in commissioning research on what works in integrated careHTAi Bilbao 2012
Challenges in commissioning research on what works in integrated care.
Tara Lamont, Scientific Adviser
NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC)
www.netscc.ac.uk
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPT...HTAi Bilbao 2012
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING FOR CHRONIC PATIENTS
Estibalitz Orruño1, Marie-Pierre Gagnon2-3, José Asua4, Eva Reviriego1
1 Basque Office for Health Technology Assessment (Osteba), Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.
2 Faculty of Nursing Sciences, Université Laval, Québec, Canada.
3 Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada.
4 Direction of Knowledge Management and Evaluation, Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATI...HTAi Bilbao 2012
METHODS, MATHEMATICAL MODELS, DATA QUALITY ASSESSMENT AND RESULT INTERPRETATION: SOLUTIONS DEVELOPED IN THE IFEDH FRAMEWORK
G. Zauner
dwh Simulation Services
Vienna , Austria
How to promote the prescription of evidence-based non-pharmacological treatme...HTAi Bilbao 2012
How to promote the prescription of evidence-based non-pharmacological treatments in France?
HTAi 2012, Bilbao
Clémence Thébaut, Olivier Scemama, Françoise Hamers, Catherine Rumeau-Pichon
Department of economic and public health evaluation
Hospital-based HTA: does it impact on medical technologies’ expenditure and c...
Presentation scotland bbg logo
1. The influence of different initiatives to enhance
prescribing efficiency for CV drugs, PPIs and
atypicals in Scotland; implications for the future
Marion Bennie, Iain Bishop, Brian Godman and
Stephen Campbell
1 Bilbao 2012
2. There is increasing focus on drug expenditure.
Analysis of reforms provide future direction
Healthcare expenditure represents a significant proportion of
national expenditure
Pharmaceutical expenditure typically the largest component in
ambulatory care - up to 60% of total healthcare expenditure in
some countries
Alongside this, national health services in Europe strive to
maintain comprehensive and equitable healthcare, which has
resulted in multiple reforms to obtain low prices for generics
and enhance their prescribing vs. originators (ATC Level 5) and
patented products in a class (ATC Level 4)
However, intensity of reforms can vary across classes and
countries. Analysis of reforms within and across countries
including atypicals can provide guidance for the future
2 Bilbao 2012
3. Study objectives and methodology
Objectives
Analyse whether prescribing efficiency for PPIs and statins
extended beyond 2007 in Scotland
Analyse influence of reforms to enhance atypical antipsychotic
prescribing efficiency
Contrast with other classes including PPIs, statins and ACEIs/
ARBs and suggest additional reforms if needed
Methodology
Retrospective observational DU study of the influence of
reforms on PPI and statin utilisation and expenditure 2001 to
2010, ACEIs/ ARBs 2001 to 2007, and atypical antipsychotics
2005 to 2010, using NHS Scotland Warehouse data
Clozapine not included as reserved for resistant patients
Demand side measures collated under the 4 Es
Reforms taken from previous publications as well as in-house
data, and validated
3 Bilbao 2012
4. The definition of the 4Es and examples include:
4 E category Definition Examples
Education Programmes that Examples include:
influence • simple distribution of printed treatment guidance
prescribing through • intensive strategies such as educational outreach visits
dissemination of building on guidance for instance from Drugs and
material, which can Therapeutic Committees
be passive or active • Subsequent monitoring of prescribing against agreed
guidance or guidelines coupled with feedback
Engineering Organizational or Examples include:
managerial • price: volume agreements for existing drugs
interventions • disease management programmes
• prescribing targets, e.g. the % of prescriptions for generic
omeprazole versus all PPIs and % generic simvastatin
versus all statins and goals for INN prescribing when this
is not obligatory or enforced
Economics Financial Examples include:
interventions • patient co-payments for more expensive drugs than the
(positive and current reference molecule
negative) • positive and negative financial incentives for physicians
• devolved budgets to physicians
Enforcement Regulations Examples include:
including those • mandatory generic substitution in pharmacies
enforced by law • prescribing restrictions such as prior authorisation
schemes, e.g. atorvastatin in Austria; alternatively
prescribing restrictions with follow-up only where
concerns, e.g. Norway and Sweden
4 Bilbao 2012 Ref: Wettermark, Godman et al 2009; Godman, Shrank et al 2010,2011; Godman, Wettermark, Bishop et al 2012
5. NHS Scotland, Health Boards and SIGN have
introduced multiple demand-side measures in recent
years. These include the following for PPIs and CV
drugs:
Measure Examples of initiatives categorised under the 4Es
Education • Physicians typically trained in medical school to prescribe by INN name with follow up in the
community coupled with IT systems. Follow up includes decision support software as well as
monitoring the prescribing of generics, which is seen as good-quality prescribing. This has
resulted in current INN prescribing rates averaging over 80% across all products, rising to
over 98% for generic simvastatin and generic lisinopril
• National guidance and guidelines (SIGN) for dyspepsia
• National guidance and guidelines (SIGN) for primary and secondary prevention including
patients with diabetes
• Regional formularies for PPIs and statins such as the Lothian and Greater Glasgow
formularies advocating generic omeprazole and generic simvastatin; the latter as 40mg
generic simvastatin
• General monitoring of prescribing, benchmarking and academic detailing
Engineering • Better Care Better Value’ indicators to enhance the prescribing of low cost statins and PPIs
versus single sourced statins and PPIs
• Quality targets for statin prescribing as part of Audit Scotland in 2003
• Quality and Outcome Framework targets including those for diabetes, hypertension, stroke
and CHD
• Therapeutic switching by Health Board pharmacists when working with GPs
Economics • Practice based financial incentives
• Payment by results
5 Bilbao 2012
6. Scottish Intercollegiate Guidelines Network (SIGN)
Scottish Intercollegiate
well respected in Scotland and Internationally
Guidelinesapplicable
Clinical guidelines Network (SIGN)
to NHS in Scotland
Guidelines developed by
multidisciplinary, nationally
representative groups
Enhanced “buy in”
Originally criticised for not
costing consequences of
guideline implementation
Now include cost effective
drug choices to enhance
their usage with all key
stakeholder groups
expected to follow the
guidance
6 Bilbao 2012
7. Multiple supply- and demand-side measures
have enhanced efficiency for PPIs and CV drugs
PPIs
Typically generic omeprazole first line (98% total omeprazole)
Expenditure in 2010 56% below 2001 levels despite 3 fold increase in
utilisation - helped by generic omeprazole 9% of pre-patent loss
prices in 2010. Expenditure will fall further with generic esomeprazole
Statins
Typically generic simvastatin first line (98% total simvastatin)
Increasingly 40mg - recommended following Heart Protection Study
and to achieve QoF targets
Expenditure in 2010 only 7% above 2001 levels despite 6.2 fold
increase in utilisation since 2001, helped by generic simvastatin only
3% of pre-patent loss prices. Expenditure now falling with generic
atorvastatin
ACEIs/ ARBs
Both seen as equally effective – fewer side-effects with ARBs
Prescribing targets for ACEIs/ ARBs in 2003 to limit ARB prescribing
Only 20% increase in expenditure 2007 vs. 2001 despite 159%
increase in volume
7 Bilbao 2012
Ref: Vončina, Strizrep, Godman et al 2011; Bennie, Godman, B
8. Combined activities increased use of omeprazole. Without
measures PPI expenditure GB£159mn higher in 2012
Generic omeprazole
reimbursed
8 Bilbao 2012
Ref: Bennie, Godman, Bishop et al 2012
9. Measures also increased use of simvastatin. Without
these, statin expenditure GB£290mn higher in 2010
Generic simvastatin
reimbursed
9 Bilbao 2012
Ref: Bennie, Godman, Bishop et al 2012
10. Intensive education, economics and engineering
measures successful in Scotland to enhance ACEIs
10 Bilbao 2012
Ref: Voncina, Strizrep, Godman et al 2011
11. In contrast, stabilisation in overall use of risperidone
since oral generic launched in April 2008 ....
Generic oral risperidone
11 Bilbao 2012
12. In more detail, again stabilisation in utilisation of
risperidone versus other atypical antipsychotics ....
Generic risperidone
12 Bilbao 2012
13. .. appreciably limited savings from the availability of
oral generic risperidone at 16% of pre-patent loss
prices in 2010
Generic oral risperidone
13 Bilbao 2012
14. Multiple measures are needed to enhance
prescribing efficiency confirming others
Multiple supply- and demand-side measures have appreciably
enhanced prescribing efficiency for the PPIs, statins and ACEIs/
ARBs in Scotland, providing direction to other countries for
areas for disinvestment with growing economic pressures
However, there has been no increased utilisation of risperidone
since the availability of oral risperidone at appreciably lower
prices than patent protected atypical anti-psychotics
This reflects a more complex disease area with no opportunities
for switching. In addition, again emphasising specific measures
are needed to enhance prescribing efficiency with limited
‘hawthorne’ effect
Specific measures now include prescribing targets for oral
versus patented dispersible risperidone
14 Bilbao 2012
15. Opportunities with data from health authority
sources, e.g. NHS Scotland, to inform decisions
Linking changes in prescribing patterns with health policy and
other initiatives, including quality initiatives, from those
implementing and analysing the changes, enhances the
robustness of the data and discussion on future measures
NHS Scotland (over 90% of the population with unique identifiers)
Estimates of incidence and prevalence (drug specific to a given
condition) and linkage with other registers
Prescribing history broken down by age, sex and deprivation
Extent of co-prescribing, e.g. statins in patients over 40 with
diabetes
Actual sequencing of drug use, e.g. Extent of therapeutic
switching
Extent of persistence rate/ switch rate in practice
Link with other datasets such as Hospital admissions, A & E, and
out-patients (event linking for pharmacovigilance studies)
Actual usage of drugs in children for potential paediatric licences
15 Bilbao 2012
16. Thank You
Any Questions!
iain.bishop@nhs.net; NSS.ISD-SPECIFY@nhs.net;
Brian.Godman@ ki.se; godman@marionegri.it;
mail@briangodman.co.uk
16 Bilbao 2012