Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland?

Marion Bennie, Iain Bishop, Brian Godman, Stephen Campbell, Jamilette Miranda, Alexander E Finlayson, Lars L Gustafsson

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

There are on-going initiatives in Scotland to improve the quality and efficiency of prescribing in primary care. Activities to enhance prescribing of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) include prescribing guidance, guidelines, benchmarking, prescribing targets and financial incentives. These measures stabilised reimbursed expenditure for renin-angiotensin inhibitor drugs between 2001 and 2007 despite a 159% increase in volumes. Generic losartan was included in the Drug Tariff from July 2010. As there is no appreciable difference between ARBs, and the prices of generic losartan are falling, health boards should be actively encouraging its prescribing.
To primarily assess changes in utilisation patterns of losartan versus other ARBs after July 2010. Second, to assess the utilisation of generic versus originator losartan.
 We used an interrupted time series analysis of ARB utilisation, measured in defined daily doses (DDDs) before and after July 2010. Utilisation data were obtained from the NHS National Services Scotland Corporate Warehouse.
There was no significant change in the utilisation pattern of losartan or other ARBs combined before or after the introduction of generic losartan. Losartan accounted for 32% of total ARBs 12 months after listing. Between 98 and 99% of losartan was prescribed generically. In March 2012, the price of losartan was 88% below prepatent prices with potential savings of ?8m per year.
Specific measures are needed to change prescribing habits especially with complex messages. The cost of deriving savings must be weighed against other quality initiatives and other ARBs losing or shortly losing their patents.

LanguageEnglish
Pages7-15
Number of pages9
JournalQuality in Primary Care
Volume21
Issue number1
Publication statusPublished - 1 Apr 2013

Fingerprint

Losartan
Scotland
Angiotensin Receptor Antagonists
Benchmarking
Patents
Cost Savings
Angiotensins
Health Expenditures
Angiotensin-Converting Enzyme Inhibitors
Renin
Pharmaceutical Preparations
Habits
Motivation
Primary Health Care
Guidelines
Health

Keywords

  • antihypertensive agents
  • drug utilization review
  • drugs, generic
  • humans
  • hypertension
  • losartan
  • physician's practice patterns
  • primary health care
  • scotland

Cite this

Bennie, M., Bishop, I., Godman, B., Campbell, S., Miranda, J., Finlayson, A. E., & Gustafsson, L. L. (2013). Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland? Quality in Primary Care , 21(1), 7-15.
Bennie, Marion ; Bishop, Iain ; Godman, Brian ; Campbell, Stephen ; Miranda, Jamilette ; Finlayson, Alexander E ; Gustafsson, Lars L. / Are prescribing initiatives readily transferable across classes : the case of generic losartan in Scotland?. In: Quality in Primary Care . 2013 ; Vol. 21, No. 1. pp. 7-15.
@article{2164fd22972e41fd8661a9b3b6346937,
title = "Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland?",
abstract = "There are on-going initiatives in Scotland to improve the quality and efficiency of prescribing in primary care. Activities to enhance prescribing of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) include prescribing guidance, guidelines, benchmarking, prescribing targets and financial incentives. These measures stabilised reimbursed expenditure for renin-angiotensin inhibitor drugs between 2001 and 2007 despite a 159{\%} increase in volumes. Generic losartan was included in the Drug Tariff from July 2010. As there is no appreciable difference between ARBs, and the prices of generic losartan are falling, health boards should be actively encouraging its prescribing. To primarily assess changes in utilisation patterns of losartan versus other ARBs after July 2010. Second, to assess the utilisation of generic versus originator losartan.  We used an interrupted time series analysis of ARB utilisation, measured in defined daily doses (DDDs) before and after July 2010. Utilisation data were obtained from the NHS National Services Scotland Corporate Warehouse. There was no significant change in the utilisation pattern of losartan or other ARBs combined before or after the introduction of generic losartan. Losartan accounted for 32{\%} of total ARBs 12 months after listing. Between 98 and 99{\%} of losartan was prescribed generically. In March 2012, the price of losartan was 88{\%} below prepatent prices with potential savings of ?8m per year. Specific measures are needed to change prescribing habits especially with complex messages. The cost of deriving savings must be weighed against other quality initiatives and other ARBs losing or shortly losing their patents.",
keywords = "antihypertensive agents, drug utilization review, drugs, generic, humans, hypertension, losartan, physician's practice patterns, primary health care, scotland",
author = "Marion Bennie and Iain Bishop and Brian Godman and Stephen Campbell and Jamilette Miranda and Finlayson, {Alexander E} and Gustafsson, {Lars L}",
year = "2013",
month = "4",
day = "1",
language = "English",
volume = "21",
pages = "7--15",
journal = "Quality in Primary Care",
issn = "1479-1072",
number = "1",

}

Bennie, M, Bishop, I, Godman, B, Campbell, S, Miranda, J, Finlayson, AE & Gustafsson, LL 2013, 'Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland?' Quality in Primary Care , vol. 21, no. 1, pp. 7-15.

Are prescribing initiatives readily transferable across classes : the case of generic losartan in Scotland? / Bennie, Marion; Bishop, Iain; Godman, Brian; Campbell, Stephen; Miranda, Jamilette; Finlayson, Alexander E; Gustafsson, Lars L.

In: Quality in Primary Care , Vol. 21, No. 1, 01.04.2013, p. 7-15.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Are prescribing initiatives readily transferable across classes

T2 - Quality in Primary Care

AU - Bennie, Marion

AU - Bishop, Iain

AU - Godman, Brian

AU - Campbell, Stephen

AU - Miranda, Jamilette

AU - Finlayson, Alexander E

AU - Gustafsson, Lars L

PY - 2013/4/1

Y1 - 2013/4/1

N2 - There are on-going initiatives in Scotland to improve the quality and efficiency of prescribing in primary care. Activities to enhance prescribing of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) include prescribing guidance, guidelines, benchmarking, prescribing targets and financial incentives. These measures stabilised reimbursed expenditure for renin-angiotensin inhibitor drugs between 2001 and 2007 despite a 159% increase in volumes. Generic losartan was included in the Drug Tariff from July 2010. As there is no appreciable difference between ARBs, and the prices of generic losartan are falling, health boards should be actively encouraging its prescribing. To primarily assess changes in utilisation patterns of losartan versus other ARBs after July 2010. Second, to assess the utilisation of generic versus originator losartan.  We used an interrupted time series analysis of ARB utilisation, measured in defined daily doses (DDDs) before and after July 2010. Utilisation data were obtained from the NHS National Services Scotland Corporate Warehouse. There was no significant change in the utilisation pattern of losartan or other ARBs combined before or after the introduction of generic losartan. Losartan accounted for 32% of total ARBs 12 months after listing. Between 98 and 99% of losartan was prescribed generically. In March 2012, the price of losartan was 88% below prepatent prices with potential savings of ?8m per year. Specific measures are needed to change prescribing habits especially with complex messages. The cost of deriving savings must be weighed against other quality initiatives and other ARBs losing or shortly losing their patents.

AB - There are on-going initiatives in Scotland to improve the quality and efficiency of prescribing in primary care. Activities to enhance prescribing of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) include prescribing guidance, guidelines, benchmarking, prescribing targets and financial incentives. These measures stabilised reimbursed expenditure for renin-angiotensin inhibitor drugs between 2001 and 2007 despite a 159% increase in volumes. Generic losartan was included in the Drug Tariff from July 2010. As there is no appreciable difference between ARBs, and the prices of generic losartan are falling, health boards should be actively encouraging its prescribing. To primarily assess changes in utilisation patterns of losartan versus other ARBs after July 2010. Second, to assess the utilisation of generic versus originator losartan.  We used an interrupted time series analysis of ARB utilisation, measured in defined daily doses (DDDs) before and after July 2010. Utilisation data were obtained from the NHS National Services Scotland Corporate Warehouse. There was no significant change in the utilisation pattern of losartan or other ARBs combined before or after the introduction of generic losartan. Losartan accounted for 32% of total ARBs 12 months after listing. Between 98 and 99% of losartan was prescribed generically. In March 2012, the price of losartan was 88% below prepatent prices with potential savings of ?8m per year. Specific measures are needed to change prescribing habits especially with complex messages. The cost of deriving savings must be weighed against other quality initiatives and other ARBs losing or shortly losing their patents.

KW - antihypertensive agents

KW - drug utilization review

KW - drugs, generic

KW - humans

KW - hypertension

KW - losartan

KW - physician's practice patterns

KW - primary health care

KW - scotland

UR - http://www.ingentaconnect.com/content/rmp/qpc/2013/00000021/00000001/art00003?crawler=true#expand/collapse

M3 - Article

VL - 21

SP - 7

EP - 15

JO - Quality in Primary Care

JF - Quality in Primary Care

SN - 1479-1072

IS - 1

ER -