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  1. Posted
    Categories
    • OpenPrescribing

    Omega-3 isn't very effective: using prescribing data to explore the impact of trials, reviews, and guidelines

    We’ve been thinking in the Bennett Institute about doing stories, using our prescribing data, to go with landmark clinical trials and systematic reviews. Here’s an example.

    A new systematic review published this week in JAMA shows that Omega-3 “fish oil” pills don’t really help improve cardiovascular health. As a systematic review, it’s a very useful overview of previous existing research. Perhaps reassuringly, as that evidence accumulated over time, clinicians were already changing their prescribing behaviour. Here’s the long-term NHS prescribing data from our database: NHS doctors gradually began to reduce prescribing of omega-3 a long time ago. Peak omega-3 was 2011!

  2. Posted
    Categories
    • OpenPrescribing

    OpenPrescribing January 2018 Newsletter

    New Year - same Price Concessions issues…

    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 announced the latest list of price concessions for December 2017, slightly smaller than November’s, with 86 lines. However, we still estimated a monthly impact for the NHS in December of £27 million, bringing the total excess cost for the nine months to December to £285 million:

  3. Posted
    Categories
    • OpenPrescribing

    New Year - same Price Concessions issues…

    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:

  4. Posted
    Categories
    • OpenPrescribing

    Trends and variation in gluten-free food prescribing

    Many people I’ve spoken to aren’t aware that gluten-free foods can be prescribed, but it happens quite extensively in an effort to help patients with coeliac disease adhere to a gluten-free diet.

    Below is a chart showing the rate of gluten-free product prescribing since 1998, where there is a gradual increase until 2011, when guidance changed to recommend only prescribing of staple foods such as bread and flour. Recently there has been a sharper decline.

  5. Posted
    Categories
    • Open Working

    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.

  6. Posted
    Categories
    • OpenPrescribing

    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:

    1. 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. The same applies for gabapentin and amlodipine 10mg tablets.
    2. Some items, such as pramiprexole 88mcg tablets have been removed as a price concession, although once again the tariff price has increased significantly.
    3. Although there are eight new chemicals listed in price concessions, these haven’t a huge impact: topiramate being the largest new cost pressure at around half a million pounds estimated in November.

    As always, you can find our Drug Tariff viewer at www.openprescribing.net/tariff. We’d love to know what you think about the work we’re doing, or anything to do with the OpenPrescribing tool. Please let us know on Twitter, our Facebook page, or via email at feedback@openprescribing.net.

  7. Posted
    Categories
    • OpenPrescribing

    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:

    1. The PSNC spreadsheet had a typo, listing the Zolmitriptan 2.5mg tablets as “$.69”. Therefore until this is corrected we’ve used the October 2017 price concession which is £18.00 for 6 tablets. (edit) - this has now been corrected, and the data below refreshed.
    2. We added in an estimated “Actual Cost” calculation - which is close to what CCGs actually pay, rather than the Net Ingredient Cost. This estimate is used by taking the National average discount percentage from here for October 2017 (7.43%)

    The total for England (actual cost) for November is £38.5m. We’ll do some further calculations when we get the chance. It’s less of an impact than we were expecting - possibly as some of the “big excess” items have been removed. We’ll take another look tomorrow!(edit) - we’ve taken a quick look - and here are some of the reasons why the total cost of price concessions is lower.

  8. Posted
    Categories
    • OpenPrescribing

    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. We calculate the difference in the unit cost, i.e. (price concession cost per pack - DT cost per pack)/pack size and then multiply by the prescription quantity for each affected presentation. Please note that these calculations are based on Net Ingredient Cost (NIC) not Actual Cost, and so the impact to CCGs will be slightly lower (about 7%).

  9. Posted
    Categories
    • Open Working

    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.

  10. Posted
    Categories
    • OpenPrescribing

    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.

  11. Posted
    Categories
    • OpenPrescribing

    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:

  12. Posted
    Categories
    • OpenPrescribing

    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.

  13. Posted
    Categories
    • OpenPrescribing

    OpenPrescribing November 2017 Newsletter

    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. We have “normalised” the data (by hand!) to take account of all this, so we can show each drug according to its current position in the latest BNF dictionary. We have also taken account of changes in national population, and even corrected all prescribing costs to 2016 pounds sterling!

  14. Posted
    Categories
    • OpenPrescribing

    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.

  15. Posted
    Categories
    • OpenPrescribing

    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.

  16. Posted
    Categories
    • TrialsTracker

    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. And, of course, the results should be published in a paper (the icing on top); the outcome pre-specified (the colour of the case), and the same outcome reported (same colour flag). A plus or minus on top indicated a positive or negative result. However, only a small number of our cakes looked this good!

  17. Posted
    Categories
    • OpenPrescribing

    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.

  18. Posted
    Categories
    • OpenPrescribing

    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. For these measures, if a practice is doing badly, we wanted it to be easy for everyone to see exactly which drugs are contributing to that score.