2017 Round-Up

In our second full year of existence we produced even more exciting outputs and continued to grow. You can see the team on our website: Emma-Jane has been our project manager since the Spring; we have two new part-time coders working for us; and researchers Alex, Nick, Daniel and Karolina all started this year. We’ve delivered a range of great new features on OpenPrescribing, got great progress on numerous pre-launch projects, and have a nice portfolio of papers submitted.

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Price Concessions - why are the excess costs lower in November than October 2017?

We’ve taken a quick look at the data to see why, despite the number of price concession lines have increased to 91 in November, the estimated total excess cost has reduced. (Reminder - we’ve used September prescribing data to estimate the effects, as that’s the latest data available). The full table is below, but here are some highlights: Some of the price concessions have reduced since October. For example, olanzapine 10mg tabs have dropped considerably, from £62/box to under £27/box - although the tariff price has increased from just over £1/box at the beginning of the year.

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Price Concessions Estimate for November 2017 - CCG data

The PSNC has published the list today of Price Concessions for November 2017. The list is the biggest yet, at 91 lines. We’ve taken a first stab at calculating the estimated effect for CCGs, using September 2017 prescribing data. The Google Sheet can be found here. (edit) - the Google Sheet now also contains national calculations per presentation and all CCG presentation data. A couple of calculation changes: The PSNC spreadsheet had a typo, listing the Zolmitriptan 2.

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Price concessions data for CCGs, including October 2017 estimate

We have been writing a lot recently about the effect of price concessions on the NHS primary care drugs bill, and on the problems community pharmacy are facing. We’ve been asked for some CCG-level data, and so here it is; both for the confirmed data for April-September 2017, and for an estimate for October, which is based on October price concession data with September’s prescribing data. (edit) We’ve also been asked how the costs were calculated.

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Getting the data for the Drug Tariff tool (*sigh*)

Today we’ve released our new Drug Tariff viewer. It was a dataset that we previously didn’t hold, but thought that it would be useful to turn into a graphical viewer for people to use to see how the reimbursement price on drugs changes over time, and also to use as the basis of the effect that price concessions are having on the NHS. However, obtaining and normalising the data proved to be a bit of a challenge.

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New interactive OpenPrescribing tool: Explore Changes in the Drug Tariff (and out of stock medicines) back to 2010!

The Drug Tariff, published on behalf of the Department of Health and updated monthly, is a strange and mysterious document, written largely in legalese, and understood by pharmacists and almost no-one else. Ask a GP where they find out the cost of the drug, and they’ll say either their computer system or the BNF. For pharmacists, it’s usually the Drug Tariff (or the Tariff). And that’s usually where the most accurate price will be found.

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Drug shortages and "Price Concessions" - how much is it costing the NHS?

There has been an interesting and concerning story in The Times today regarding shortages on a number of commonly-used medicines and a corresponding increase in the costs. Here at OpenPrescribing we have been taking a look at these data as well, and trying to estimate to the cost to the NHS this year. As the Times article suggested, the excess costs are now hitting £50m per month, with £175m extra spent in primary care by September:

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OpenPrescribing December 2017 Newsletter

New: Analyse page no longer needs a denominator One of the most common requests we receive is to be able to use the analyse page without needing to select a denominator, so that you can simply see how much of a drug is being prescribed in each CCG or practice. We’ve now made this feature available. When creating an analysis, simply select “nothing” in the versus dropdown, and you can then see raw monthly data for each practice or CCG.

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OpenPrescribing November 2017 Newsletter

Long Term Trends Tool! All prescribing, 1998-2016 We have created a new interactive tool for exploring the national Prescribing Cost Analysis (PCA) data, allowing you to investigate prescribing trends over 19 years from 1998 to 2016. We’ve done a huge amount of hard work to make this tool simple and easy. For example, lots of drug names have changed over time, treatments have moved between Chapters of the BNF, or been assigned new codes.

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New OpenPrescribing tool: long-term prescribing trends, back to 1998!

We have created a new interactive tool for exploring the national Prescribing Cost Analysis (PCA) data, allowing you to investigate prescribing trends going back to 1998. The PCA data contains annual data on all drugs dispensed in the community in England. Note this makes it slightly different to the monthly dataset used elsewhere on OpenPrescribing which shows how items were prescribed in England. This means that, for example, in PCA data generic products will not appear until the generic is available to be dispensed, and prescriptions written in Wales will be included provided they were dispensed in England.

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OpenPrescribing October 2017 Newsletter

We send out monthly newsletters for OpenPrescribing, detailing new features and updates, which you can sign up for here. Our latest issue is below: Low Priority Treatments NHS England recently launched a consultation on new prescribing guidelines, which lists treatments that should generally no longer be prescribed. We have launched a new tool that allows you to explore the prescribing of these ’low value’ items in any GP Practice or CCG in England.

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Publication Bias: in cake form - Bennett Institute at the Curiosity Carnival

We were at Oxford University’s Curiosity Carnival, an event featuring researchers from all disciplines enthusiastically explaining their work to members of the public in an enormous variety of forms, all around the city. We entered the Great Research Bake-Off and took on the challenge of representing some of the key issues around research integrity through the medium of cake. We displayed an array of fairy cakes, each representing clinical trials. To produce a good cake, or trial, a good methodology is fundamental.

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Which GPs are prescribing the treatments advised against by NHS England?

Today we launch another exciting new feature on OpenPrescribing. NHS England recently shared a list of 19 classes of treatment which they think should not be prescribed by GPs. These treatments were advised against on the grounds that they are ineffective, and therefore wasteful, or at least “low priority”. We think it’s good for everyone to be able to see what GP practices are prescribing: the GPs themselves, but also patients, journalists, commissioners of health services, the public, medicines optimisation teams, and indeed anyone who is interested in exploring and improving healthcare.

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See Data on the Individual Drugs in our Prescribing Measures

Today we launch another new feature on OpenPrescribing. As you will probably know, we have various standard prescribing measures which show how a practice or CCG is prescribing in comparison with their peers. These are presented as percentages or rates, and often the maths is very simple: what is the proportion of “undesirable drug” divided by “all drugs in that class”. But sometimes there are lots of drugs in the “numerator”, the top half of the equation.

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What is a Dormant GP practice, and why are they prescribing?

At OpenPrescribing, we provide tools for analysing prescribing behaviour in primary care in the NHS in England. If you work with prescribing data, you may have noticed that practices which are “dormant” apparently continue to prescribe. This short article explains why, for the curious. What is a Dormant practice? Our prescribing data comes from the NHS Business Services Authority (NHSBSA), who are responsible for processing dispensing information supplied by pharmacies. Each line of the data includes a practice code which uniquely identifies the GP Practice that issued the prescription.

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Our New Tool Finds Over £100m in New Cost Savings for the NHS

Today we are launching something very exciting: a new tool that identifies over £100m in new prescribing cost savings for the NHS. The average practice can save £50,166 a year by using our tool. These are vastly bigger savings than any other current advice such as “always prescribe generically”. You can use the tool right now, online, for free, at our OpenPrescribing.net service: just look for the “experimental measures” link on any CCG or GP practice page.

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Prescribing Data: Using the Dictionary of medicines and devices

Recently, we’ve been experimenting with integrating the Dictionary of medicines and devices (dm+d) into our prescribing data. dm+d is the standard dictionary for the medicines and devices used across the NHS, and it contains codes and descriptions for these medicines. There are several benefits to using dm+d; the most useful side-effect is to allow us to show user-friendly names for drugs. The canonical names for drugs in the NHS prescribing data are sometimes very hard to read.

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Downloading data from OpenPrescribing

We’ve recently added the option to download your results from the Analyse searches you complete on OpenPrescribing. There are now three ways to download data from the site. We do also offer free custom extracts, so if there is anything you are struggling to get from the website yourself send us an e-mail.Update: Due to resource limitations we are no longer able to offer free custom extracts. If you download and use any data from OpenPrescribing please link back to us or cite us.

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