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New Year - same Price Concessions issues…

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Everyone at the Bennett Institute wishes you a very Happy New Year!

Unfortunately, the NHS is still having the same problems in sourcing generics. The PSNC have just announced the latest list of price concessions for December 2017. The list was slightly smaller than November’s, with 86 lines,but we are still estimating an monthly impact for the NHS in December of £27 million. This brings the total excess cost for the nine months to December to £285 million:

As always, we have used the latest available month’s prescribing data (in this case October 2017) to estimate the impact for November and December, and have now updated our calculations for October as an actual cost. (Nerdy calculation issue: we use an average of 7.41% discount, as per the NHSBSA website, to calculate the actual cost. It’s never going to be 100% accurate, as a) it’s only and average, and b) there are other things included in the actual cost calculation - but for this purpose it’s not far off).

CCG impacts for December and total to year so far

You can find all the data for each month for each CCG on a Google Sheet here. Below shows the “highlights” for December and the total so far this financial year.

Excess Actual Cost: Dec 2017 (estimated) Excess Actual Cost: Financial YTD (estimated)
NHS NORTHERN, EASTERN AND WESTERN DEVON CCG £473,525 £4,963,500
NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG £370,506 £4,027,033
NHS DORSET CCG £365,691 £3,954,643
NHS LIVERPOOL CCG £378,108 £3,876,664
NHS NENE CCG £343,057 £3,647,783
NHS BIRMINGHAM CROSSCITY CCG £346,881 £3,571,649
NHS MANCHESTER CCG £304,133 £3,373,884
NHS GLOUCESTERSHIRE CCG £321,733 £3,221,937
NHS OXFORDSHIRE CCG £271,005 £2,990,322
NHS NEWCASTLE GATESHEAD CCG £292,028 £2,921,922
NHS SANDWELL AND WEST BIRMINGHAM CCG £275,828 £2,818,831
NHS KERNOW CCG £269,317 £2,811,283
NHS SHEFFIELD CCG £255,214 £2,768,527
NHS SOMERSET CCG £263,130 £2,730,529
NHS SOUTHERN DERBYSHIRE CCG £249,142 £2,726,230
NHS COASTAL WEST SUSSEX CCG £236,007 £2,695,366
NHS WEST HAMPSHIRE CCG £247,540 £2,631,875
NHS HERTS VALLEYS CCG £245,536 £2,602,319
NHS COVENTRY AND RUGBY CCG £246,358 £2,531,763
NHS EAST AND NORTH HERTFORDSHIRE CCG £245,393 £2,517,020
NHS WILTSHIRE CCG £229,325 £2,415,986
NHS BEDFORDSHIRE CCG £215,292 £2,315,988
NHS WEST KENT CCG £249,499 £2,216,915
NHS EAST LANCASHIRE CCG £200,430 £2,157,719
NHS BRISTOL CCG £202,718 £2,103,663
NHS WIGAN BOROUGH CCG £197,537 £2,094,874
NHS NORTH EAST ESSEX CCG £213,887 £2,083,016
NHS IPSWICH AND EAST SUFFOLK CCG £204,829 £2,021,703
NHS MID ESSEX CCG £200,963 £1,945,692
NHS SOUTH TEES CCG £192,518 £1,927,763
NHS WAKEFIELD CCG £192,412 £1,907,832
NHS MORECAMBE BAY CCG £170,768 £1,879,717
NHS BRIGHTON AND HOVE CCG £165,139 £1,839,329
NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG £188,179 £1,830,319
NHS NORTHUMBERLAND CCG £178,686 £1,818,313
NHS WIRRAL CCG £157,610 £1,812,729
NHS WEST LEICESTERSHIRE CCG £185,922 £1,793,807
NHS LEICESTER CITY CCG £167,637 £1,727,681
NHS EALING CCG £164,464 £1,726,090
NHS SUNDERLAND CCG £187,599 £1,699,172
NHS NORTH CUMBRIA CCG £153,734 £1,690,779
NHS STOKE ON TRENT CCG £158,517 £1,661,649
NHS HULL CCG £170,471 £1,658,494
NHS BRADFORD DISTRICTS CCG £163,905 £1,645,656
NHS BARNET CCG £158,591 £1,640,274
NHS NOTTINGHAM CITY CCG £157,521 £1,632,762
NHS BIRMINGHAM SOUTH AND CENTRAL CCG £157,296 £1,629,261
NHS HARTLEPOOL AND STOCKTON-ON-TEES CCG £162,965 £1,606,409
NHS STOCKPORT CCG £164,477 £1,602,903
NHS CROYDON CCG £147,752 £1,601,148
NHS SHROPSHIRE CCG £157,176 £1,587,210
NHS NORTH DERBYSHIRE CCG £141,347 £1,575,990
NHS SOUTH WORCESTERSHIRE CCG £162,480 £1,574,283
NHS SOUTH DEVON AND TORBAY CCG £141,374 £1,555,186
NHS TAMESIDE AND GLOSSOP CCG £154,958 £1,530,438
NHS HASTINGS AND ROTHER CCG £161,995 £1,528,912
NHS SOUTHAMPTON CCG £131,432 £1,525,087
NHS DUDLEY CCG £162,796 £1,522,784
NHS LEEDS WEST CCG £154,518 £1,516,973
NHS LINCOLNSHIRE EAST CCG £154,670 £1,516,249
NHS DONCASTER CCG £155,652 £1,503,075
NHS OLDHAM CCG £148,627 £1,499,042
NHS SALFORD CCG £143,146 £1,489,412
NHS WALSALL CCG £141,349 £1,488,421
NHS HEYWOOD, MIDDLETON AND ROCHDALE CCG £154,485 £1,486,995
NHS BOLTON CCG £146,159 £1,485,941
NHS GREAT YARMOUTH AND WAVENEY CCG £131,225 £1,483,079
NHS BROMLEY CCG £147,530 £1,478,018
NHS NORTH WEST SURREY CCG £153,843 £1,458,646
NHS ENFIELD CCG £130,188 £1,448,981
NHS EAST RIDING OF YORKSHIRE CCG £162,505 £1,446,543
NHS TOWER HAMLETS CCG £116,243 £1,441,414
NHS MEDWAY CCG £147,946 £1,430,095
NHS LAMBETH CCG £128,935 £1,422,846
NHS NEWHAM CCG £129,040 £1,418,383
NHS BRENT CCG £140,103 £1,410,461
NHS VALE OF YORK CCG £129,629 £1,404,740
NHS WEST CHESHIRE CCG £126,497 £1,395,226
NHS WANDSWORTH CCG £124,535 £1,370,992
NHS BARNSLEY CCG £134,510 £1,369,512
NHS ST HELENS CCG £138,316 £1,358,408
NHS EAST LEICESTERSHIRE AND RUTLAND CCG £136,160 £1,356,749
NHS SOUTH WARWICKSHIRE CCG £133,315 £1,327,119
NHS GREENWICH CCG £116,702 £1,319,211
NHS BASILDON AND BRENTWOOD CCG £135,879 £1,316,968
NHS NORTH DURHAM CCG £127,156 £1,310,982
NHS LEEDS SOUTH AND EAST CCG £133,427 £1,310,328
NHS LINCOLNSHIRE WEST CCG £132,131 £1,309,594
NHS ROTHERHAM CCG £129,780 £1,302,114
NHS CHILTERN CCG £128,742 £1,301,037
NHS GREATER PRESTON CCG £131,236 £1,298,486
NHS WOLVERHAMPTON CCG £130,441 £1,297,451
NHS HARINGEY CCG £110,379 £1,294,155
NHS EASTBOURNE, HAILSHAM AND SEAFORD CCG £120,879 £1,280,963
NHS LEWISHAM CCG £113,148 £1,272,602
NHS KNOWSLEY CCG £132,382 £1,251,424
NHS WEST ESSEX CCG £125,285 £1,246,580
NHS BLACKPOOL CCG £126,501 £1,245,648
NHS WEST SUFFOLK CCG £128,024 £1,229,135
NHS SOUTH SEFTON CCG £130,092 £1,222,798
NHS SURREY DOWNS CCG £118,052 £1,222,220
NHS SOUTH KENT COAST CCG £130,795 £1,216,881
NHS WALTHAM FOREST CCG £104,925 £1,207,076
NHS TRAFFORD CCG £116,688 £1,198,645
NHS NORWICH CCG £126,124 £1,189,380
NHS CANTERBURY AND COASTAL CCG £121,233 £1,188,665
NHS CITY AND HACKNEY CCG £103,560 £1,182,366
NHS NORTH TYNESIDE CCG £127,545 £1,179,151
NHS HILLINGDON CCG £112,255 £1,172,547
NHS NORTH STAFFORDSHIRE CCG £109,379 £1,157,658
NHS SWINDON CCG £115,206 £1,149,565
NHS SOLIHULL CCG £116,446 £1,148,182
NHS SOUTH NORFOLK CCG £133,564 £1,147,716
NHS NORTH HAMPSHIRE CCG £106,387 £1,146,785
NHS SOUTHWARK CCG £104,079 £1,145,847
NHS GREATER HUDDERSFIELD CCG £108,110 £1,143,372
NHS SOUTH GLOUCESTERSHIRE CCG £123,904 £1,134,392
NHS BURY CCG £115,607 £1,133,060
NHS HOUNSLOW CCG £108,323 £1,132,939
NHS NORTH SOMERSET CCG £107,710 £1,123,779
NHS MANSFIELD AND ASHFIELD CCG £108,254 £1,119,508
NHS FAREHAM AND GOSPORT CCG £106,985 £1,112,981
NHS SOUTH EASTERN HAMPSHIRE CCG £104,974 £1,109,672
NHS ISLINGTON CCG £94,529 £1,099,655
NHS MILTON KEYNES CCG £99,198 £1,093,069
NHS PORTSMOUTH CCG £103,470 £1,091,529
NHS DARTFORD, GRAVESHAM AND SWANLEY CCG £107,461 £1,084,112
NHS HAVERING CCG £107,189 £1,079,302
NHS HORSHAM AND MID SUSSEX CCG £101,586 £1,077,671
NHS CALDERDALE CCG £104,918 £1,071,093
NHS WARWICKSHIRE NORTH CCG £111,641 £1,061,931
NHS REDBRIDGE CCG £98,139 £1,061,187
NHS NORTH NORFOLK CCG £125,905 £1,053,630
NHS SOUTH EAST STAFFORDSHIRE AND SEISDON PENINSULA CCG £107,155 £1,052,999
NHS SOUTHEND CCG £120,361 £1,045,743
NHS EASTERN CHESHIRE CCG £98,839 £1,041,629
NHS WARRINGTON CCG £106,006 £1,036,318
NHS TELFORD AND WREKIN CCG £90,360 £1,016,211
NHS CHORLEY AND SOUTH RIBBLE CCG £103,429 £1,015,410
NHS THANET CCG £104,885 £1,008,883
NHS CAMDEN CCG £89,260 £997,741
NHS HIGH WEALD LEWES HAVENS CCG £106,485 £996,490
NHS BEXLEY CCG £98,027 £995,350
NHS WEST NORFOLK CCG £106,086 £989,401
NHS FYLDE AND WYRE CCG £102,357 £989,272
NHS NORTH EAST HAMPSHIRE AND FARNHAM CCG £106,115 £975,781
NHS WEST LONDON CCG £86,524 £967,151
NHS HARROW CCG £95,154 £966,064
NHS BLACKBURN WITH DARWEN CCG £88,335 £965,052
NHS LUTON CCG £92,087 £950,659
NHS SOUTH CHESHIRE CCG £93,422 £947,441
NHS GUILDFORD AND WAVERLEY CCG £104,320 £926,106
NHS NORTH KIRKLEES CCG £93,551 £925,242
NHS CASTLE POINT AND ROCHFORD CCG £112,656 £909,561
NHS ISLE OF WIGHT CCG £83,868 £886,266
NHS NORTH EAST LINCOLNSHIRE CCG £86,533 £873,841
NHS BATH AND NORTH EAST SOMERSET CCG £83,554 £872,294
NHS BARKING AND DAGENHAM CCG £81,876 £871,653
NHS HEREFORDSHIRE CCG £82,417 £866,268
NHS LEEDS NORTH CCG £87,232 £860,688
NHS SOUTH TYNESIDE CCG £83,147 £857,977
NHS AYLESBURY VALE CCG £76,103 £847,936
NHS SUTTON CCG £73,507 £835,958
NHS CENTRAL LONDON (WESTMINSTER) CCG £71,519 £822,524
NHS NORTH LINCOLNSHIRE CCG £88,399 £818,888
NHS SOUTHPORT AND FORMBY CCG £93,052 £812,455
NHS REDDITCH AND BROMSGROVE CCG £80,665 £805,980
NHS EAST SURREY CCG £77,086 £802,300
NHS HAMMERSMITH AND FULHAM CCG £72,724 £785,000
NHS AIREDALE, WHARFEDALE AND CRAVEN CCG £73,911 £779,370
NHS RICHMOND CCG £70,702 £769,822
NHS MERTON CCG £68,800 £764,507
NHS STAFFORD AND SURROUNDS CCG £73,619 £753,196
NHS NOTTINGHAM NORTH AND EAST CCG £75,885 £748,521
NHS THURROCK CCG £77,704 £735,295
NHS KINGSTON CCG £68,179 £733,055
NHS SOUTH LINCOLNSHIRE CCG £69,670 £724,098
NHS HARROGATE AND RURAL DISTRICT CCG £71,375 £713,025
NHS HAMBLETON, RICHMONDSHIRE AND WHITBY CCG £74,080 £699,403
NHS NEWARK AND SHERWOOD CCG £67,564 £686,915
NHS SLOUGH CCG £69,985 £676,698
NHS CANNOCK CHASE CCG £68,080 £664,243
NHS WOKINGHAM CCG £64,442 £661,640
NHS ASHFORD CCG £65,143 £637,069
NHS WYRE FOREST CCG £61,381 £635,955
NHS HALTON CCG £66,439 £628,109
NHS SOUTH WEST LINCOLNSHIRE CCG £62,339 £624,878
NHS HARDWICK CCG £56,032 £619,418
NHS SWALE CCG £63,688 £609,206
NHS DARLINGTON CCG £59,772 £609,008
NHS WINDSOR, ASCOT AND MAIDENHEAD CCG £69,233 £605,583
NHS EAST STAFFORDSHIRE CCG £59,399 £604,297
NHS SCARBOROUGH AND RYEDALE CCG £55,584 £601,984
NHS BASSETLAW CCG £54,476 £593,035
NHS WEST LANCASHIRE CCG £60,159 £583,099
NHS SOUTH READING CCG £57,797 £580,245
NHS VALE ROYAL CCG £56,913 £572,213
NHS BRACKNELL AND ASCOT CCG £57,798 £550,686
NHS BRADFORD CITY CCG £54,162 £541,962
NHS CRAWLEY CCG £49,406 £536,657
NHS NEWBURY AND DISTRICT CCG £49,178 £532,308
NHS EREWASH CCG £51,053 £529,105
NHS NORTH AND WEST READING CCG £49,915 £519,660
NHS RUSHCLIFFE CCG £52,013 £507,259
NHS NOTTINGHAM WEST CCG £47,225 £452,567
NHS CORBY CCG £44,627 £450,469
NHS SURREY HEATH CCG £50,175 £432,763
Non-CCG FP10 £25,321 £353,613
Grand Total £27,720,101 £284,082,452

What drugs caused the greatest impact in December?

Here are the formulations sorted by the greatest estimated impact:

Drug Name Excess Actual Cost (Dec 2017)
Levetiracetam 500mg tablets £2,006,083
Amlodipine 5mg tablets £1,912,458
Duloxetine 60mg gastro-resistant capsules £1,432,726
Amlodipine 10mg tablets £1,289,454
Perindopril erbumine 8mg tablets £1,076,290
Eplerenone 25mg tablets £1,061,732
Citalopram 20mg tablets £1,051,558
Mefenamic acid 500mg tablets £1,011,318
Gabapentin 300mg capsules £947,366
Terbinafine 250mg tablets £832,962
Levetiracetam 1g tablets £798,662
Quetiapine 25mg tablets £797,530
Quetiapine 100mg tablets £785,571
Vitamin B compound strong tablets £735,430
Perindopril erbumine 2mg tablets £716,713
Perindopril erbumine 4mg tablets £707,991
Levetiracetam 750mg tablets £557,412
Quetiapine 300mg tablets £521,587
Chlorpromazine 25mg tablets £521,236
Duloxetine 30mg gastro-resistant capsules £513,097

Don’t forget that our Drug Tariff and Price Concessions viewer is freely available here, and is updated on a daily basis!

As always, let us know your thoughts via email at feedback@openprescribing.net, on Twitter or on our Facebook page.