Activities to optimize quality and efficiency of medicines in Scotland

Brian Godman, Amanj Kurdi, Holly McCabe, Sean MacBride-Stewart, Chris F Johnson, Simon Hurding, Marion Bennie, Alec Morton

Research output: Contribution to conferenceAbstract

Abstract

Introduction: The growing prevalence of non-communicable diseases, combined with greater recognition of the effectiveness of lipid lowering agents (LLAs), has fueled their increasing use in recent years. Similarly, increasing recognition of mental health and, arguably, societal expectations and pressures has driven appreciable growth in antidepressant prescribing in recent years. Concurrent with this, growing resource pressures enhanced by the continual launch of new premium priced medicines necessitates reforms and initiatives within finite budgets. Scotland has introduced multiple measures in recent years to improve both the quality and efficiency of prescribing. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of the utilization (items dispensed) and expenditure of key LLAs (mainly statins) and SSRIs between 2001 and 2017 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99% for statins and up to 99.9% for SSRIs). They have also increased preferential prescribing of generic versus patented statins with low costs for generics, reduced inappropriate prescribing of ezetimibe due to effectiveness concerns, and increased the prescribing of higher dose statins (71% in 2015). These measures have resulted in a 50% reduction in LLA expenditure between 2001 and 2015 despite a 412% increase in utilization. Initiatives to reduce the prescribing of escitalopram as lack of evidence demonstrating cost-benefits over generic citalopram, along with high INN prescribing, achieved a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilisation. Concerns with paroxetine, and more recently citalopram and escitalopram following safety warnings, resulted in a considerable reduction in their use alongside a significant increase in sertraline. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin and SSRI prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing to provide future direction.
LanguageEnglish
Number of pages1
Publication statusAccepted/In press - 1 Feb 2019
EventHTAi Cologne, Germany - Cologne, Germany
Duration: 15 Jun 201919 Jun 2019
http://www.htai2019.org/

Conference

ConferenceHTAi Cologne, Germany
CountryGermany
CityCologne
Period15/06/1919/06/19
Internet address

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Scotland
Citalopram
Health Expenditures
Lipids
Names
Inappropriate Prescribing
Pressure
Sertraline
Paroxetine
Budgets
Antidepressive Agents
Cost-Benefit Analysis
Mental Health
Safety
Costs and Cost Analysis
Growth

Keywords

  • non-communicable diseases (NCDs)
  • mental health
  • prescribing
  • SSRIs

Cite this

Godman, B., Kurdi, A., McCabe, H., MacBride-Stewart, S., Johnson, C. F., Hurding, S., ... Morton, A. (Accepted/In press). Activities to optimize quality and efficiency of medicines in Scotland. Abstract from HTAi Cologne, Germany, Cologne, Germany.
Godman, Brian ; Kurdi, Amanj ; McCabe, Holly ; MacBride-Stewart, Sean ; Johnson, Chris F ; Hurding, Simon ; Bennie, Marion ; Morton, Alec. / Activities to optimize quality and efficiency of medicines in Scotland. Abstract from HTAi Cologne, Germany, Cologne, Germany.1 p.
@conference{d69586afdeb34f64812b5c073cf80935,
title = "Activities to optimize quality and efficiency of medicines in Scotland",
abstract = "Introduction: The growing prevalence of non-communicable diseases, combined with greater recognition of the effectiveness of lipid lowering agents (LLAs), has fueled their increasing use in recent years. Similarly, increasing recognition of mental health and, arguably, societal expectations and pressures has driven appreciable growth in antidepressant prescribing in recent years. Concurrent with this, growing resource pressures enhanced by the continual launch of new premium priced medicines necessitates reforms and initiatives within finite budgets. Scotland has introduced multiple measures in recent years to improve both the quality and efficiency of prescribing. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of the utilization (items dispensed) and expenditure of key LLAs (mainly statins) and SSRIs between 2001 and 2017 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99{\%} for statins and up to 99.9{\%} for SSRIs). They have also increased preferential prescribing of generic versus patented statins with low costs for generics, reduced inappropriate prescribing of ezetimibe due to effectiveness concerns, and increased the prescribing of higher dose statins (71{\%} in 2015). These measures have resulted in a 50{\%} reduction in LLA expenditure between 2001 and 2015 despite a 412{\%} increase in utilization. Initiatives to reduce the prescribing of escitalopram as lack of evidence demonstrating cost-benefits over generic citalopram, along with high INN prescribing, achieved a 73.7{\%} reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilisation. Concerns with paroxetine, and more recently citalopram and escitalopram following safety warnings, resulted in a considerable reduction in their use alongside a significant increase in sertraline. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin and SSRI prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing to provide future direction.",
keywords = "non-communicable diseases (NCDs), mental health, prescribing, SSRIs",
author = "Brian Godman and Amanj Kurdi and Holly McCabe and Sean MacBride-Stewart and Johnson, {Chris F} and Simon Hurding and Marion Bennie and Alec Morton",
year = "2019",
month = "2",
day = "1",
language = "English",
note = "HTAi Cologne, Germany ; Conference date: 15-06-2019 Through 19-06-2019",
url = "http://www.htai2019.org/",

}

Godman, B, Kurdi, A, McCabe, H, MacBride-Stewart, S, Johnson, CF, Hurding, S, Bennie, M & Morton, A 2019, 'Activities to optimize quality and efficiency of medicines in Scotland' HTAi Cologne, Germany, Cologne, Germany, 15/06/19 - 19/06/19, .

Activities to optimize quality and efficiency of medicines in Scotland. / Godman, Brian; Kurdi, Amanj; McCabe, Holly; MacBride-Stewart, Sean; Johnson, Chris F; Hurding, Simon; Bennie, Marion; Morton, Alec.

2019. Abstract from HTAi Cologne, Germany, Cologne, Germany.

Research output: Contribution to conferenceAbstract

TY - CONF

T1 - Activities to optimize quality and efficiency of medicines in Scotland

AU - Godman, Brian

AU - Kurdi, Amanj

AU - McCabe, Holly

AU - MacBride-Stewart, Sean

AU - Johnson, Chris F

AU - Hurding, Simon

AU - Bennie, Marion

AU - Morton, Alec

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Introduction: The growing prevalence of non-communicable diseases, combined with greater recognition of the effectiveness of lipid lowering agents (LLAs), has fueled their increasing use in recent years. Similarly, increasing recognition of mental health and, arguably, societal expectations and pressures has driven appreciable growth in antidepressant prescribing in recent years. Concurrent with this, growing resource pressures enhanced by the continual launch of new premium priced medicines necessitates reforms and initiatives within finite budgets. Scotland has introduced multiple measures in recent years to improve both the quality and efficiency of prescribing. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of the utilization (items dispensed) and expenditure of key LLAs (mainly statins) and SSRIs between 2001 and 2017 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99% for statins and up to 99.9% for SSRIs). They have also increased preferential prescribing of generic versus patented statins with low costs for generics, reduced inappropriate prescribing of ezetimibe due to effectiveness concerns, and increased the prescribing of higher dose statins (71% in 2015). These measures have resulted in a 50% reduction in LLA expenditure between 2001 and 2015 despite a 412% increase in utilization. Initiatives to reduce the prescribing of escitalopram as lack of evidence demonstrating cost-benefits over generic citalopram, along with high INN prescribing, achieved a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilisation. Concerns with paroxetine, and more recently citalopram and escitalopram following safety warnings, resulted in a considerable reduction in their use alongside a significant increase in sertraline. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin and SSRI prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing to provide future direction.

AB - Introduction: The growing prevalence of non-communicable diseases, combined with greater recognition of the effectiveness of lipid lowering agents (LLAs), has fueled their increasing use in recent years. Similarly, increasing recognition of mental health and, arguably, societal expectations and pressures has driven appreciable growth in antidepressant prescribing in recent years. Concurrent with this, growing resource pressures enhanced by the continual launch of new premium priced medicines necessitates reforms and initiatives within finite budgets. Scotland has introduced multiple measures in recent years to improve both the quality and efficiency of prescribing. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of the utilization (items dispensed) and expenditure of key LLAs (mainly statins) and SSRIs between 2001 and 2017 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99% for statins and up to 99.9% for SSRIs). They have also increased preferential prescribing of generic versus patented statins with low costs for generics, reduced inappropriate prescribing of ezetimibe due to effectiveness concerns, and increased the prescribing of higher dose statins (71% in 2015). These measures have resulted in a 50% reduction in LLA expenditure between 2001 and 2015 despite a 412% increase in utilization. Initiatives to reduce the prescribing of escitalopram as lack of evidence demonstrating cost-benefits over generic citalopram, along with high INN prescribing, achieved a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilisation. Concerns with paroxetine, and more recently citalopram and escitalopram following safety warnings, resulted in a considerable reduction in their use alongside a significant increase in sertraline. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin and SSRI prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing to provide future direction.

KW - non-communicable diseases (NCDs)

KW - mental health

KW - prescribing

KW - SSRIs

UR - http://htai2019.org/

M3 - Abstract

ER -

Godman B, Kurdi A, McCabe H, MacBride-Stewart S, Johnson CF, Hurding S et al. Activities to optimize quality and efficiency of medicines in Scotland. 2019. Abstract from HTAi Cologne, Germany, Cologne, Germany.