OpenPrescribing June 2018 Newsletter
Updates to OpenPrescribing
Thanks largely to our new software developer Dave, we are making some improvements to the site.
With the fresh-faced enthusiasm of a new starter, Dave has begun by tackling the various not-so-exciting but still important tasks which we’ve put off doing for ages. These changes are mostly behind the scenes, but you should hopefully notice that the site feels a bit snappier to browse. One of the changes which you can see is that we now clearly label on the site where a practice has closed or become dormant. Due to the way prescribing data is collected, practices can appear to continue prescribing for several months after they become dormant, and so we now flag this up and explain what is happening.
Papers Published on Pregabalin
Earlier this month we had a pair of papers published, which describe the impact of litigation surrounding pregabalin and its branded form, Lyrica.
The product patent protection for pregabalin, based on its activity as an anticonvulsant, expired in 2013. However, it was also increasingly prescribed for pain, and Pfizer later sought a “second medical use” patent for pregabalin in pain, which expired in July 2017.
In response to this patent extension, in 2015, NHS England took an unprecedented step, and wrote to all CCGs instructing them to ensure that doctors prescribe pregabalin as branded Lyrica when it was being used to treat pain. Our analysis paper in the BMJ describes the issues surrounding this decision.
In our accompanying paper in BMJ Open we present data showing that overall GPs did not comply with NHS England’s instructions. About 70% of pregabalin prescriptions are estimated to be for pain, but during the period of litigation only 11% of practices prescribed Lyrica at this level, and no CCGs did so.
The current guidelines are once again to prescribe pregabalin generically for all indications. You can explore Lyrica prescribing for your CCG/practice at openprescribing.net/measure/lyrica/. We also have measures to monitor the overall level of pregabalin prescribing, by number of items and by total mg.
Dave has joined the OpenPrescribing technical team to help us with all the exiting new features we have planned for the site.
Brian is a pharmacist in the NHS England Medicines and Diagnostics Policy Unit and is working with the Bennett Institute on the Open Prescribing project to facilitate improvements in patient care through the better use of medicines data.
Invitation to suggest new measures for OpenPrescribing!
Last month we invited you to help us out with a new project, and we’re still open to suggestions!
We want to gather a list of prescribing measures where changes can be made easily by clinicians, as soon as they become aware. From our current measures this would include things like: simple brand/generic switches (such as high-cost statins); simple formulation switches (such as methotrexate 2.5mg). The measures don’t need to be common problems. We’re happy with things that only arise occasionally, because that’s the joy of working with big datasets: we can spot problems that only arise in a few practices of CCGs, and target our alerts to the small number of people who might benefit from them.
So, please contact us at firstname.lastname@example.org with your ideas for “easy fix” measures!
Prescribing data update!
We’ve updated OpenPrescribing with April’s data. Head over to www.openprescribing.net to see more.
In other news…
Unreported Trial of the Week
Each week we profile a new unreported clinical trial that has not reported results in accordance with their legal requirements. The latest trial to feature on the BMJ blog is “A Multicenter Trial of the Efficacy and Safety of Diclegis® for Nausea and Vomiting of Pregnancy in Pregnant Adolescents” (NCT02045901). This Phase 4 trial of Doxylamine/pyridoxine combination product enrolled 128 pregnant adolescent girls aged 12-17 suffering from nausea and vomiting (NVP) across six states.
Doxylamine/pyridoxine combination product is not available in the UK yet but it is expected to be launched in Autumn this year.
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