Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service: their effect and implications

Brian Godman, Amanj Kurdi, Holly McCabe, Sean MacBride-Stewart, Axel Leporowski, Simon Hurding, Marion Bennie, Alec Morton

Research output: Contribution to journalArticle

Abstract

Introduction: There has been a considerable increase in the use of proton pump inhibitors (PPIs) in recent years due to their effectiveness versus H2 antagonists. This includes reducing GI bleeds in patients at risk. However, there are concerns with their long term use and potential costs. Costs can be reduced with increased prescribing of low cost generic PPIs. Aims: To analyse the influence of multiple demand-side measures in Scotland in recent years to increase the prescribing of low cost generic PPIs as well as encourage the prescribing of lower strength PPIs. Methods: Documenting utilization (mainly items dispensed) and expenditure in Scotland from 2001 to 2017 using health authority databases combined with documenting the multiple initiatives and measures both nationally and regionally. Results: The multiple measures in Scotland ensured high International non-proprietary name prescribing (up to 100% for some PPIs) as well as the prescribing of generic versus patented PPIs, with costs of generic PPIs as low as 8.5% of their pre-patent loss prices. Overall, total expenditure on PPIs in Scotland was 66.7% lower in 2017 at GB£18.83million compared to 2001 levels. This was despite a 3.06-fold increase in PPI utilization during this period. The savings were driven by the increasing use of generic omeprazole and lansoprazole versus patent protected PPIs. There was also a reduction in the prescribing of high strength PPIs during this period. Conclusion: Multiple initiatives in Scotland in recent years have reduced expenditure on PPIs despite appreciably increased utilisation. Multiple initiatives have also helped to reduce the prescribing of higher strength PPIs. This is an exemplar to other countries seeking to enhance their prescribing efficiency
LanguageEnglish
Pages142-151
Number of pages10
JournalGenerics and Biosimilars Initiative journal
Volume7
Issue number4
Publication statusPublished - 12 Nov 2018

Fingerprint

Proton Pump Inhibitors
National Health Programs
Health
Scotland
Costs and Cost Analysis
Health Expenditures
Costs
Lansoprazole
Omeprazole
Names

Keywords

  • PPIs
  • Scottish NHS
  • expenditure
  • reforms
  • drug utilisation
  • generics

Cite this

@article{8f6387e5b65d4f80a4f13515bdf2fc63,
title = "Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service: their effect and implications",
abstract = "Introduction: There has been a considerable increase in the use of proton pump inhibitors (PPIs) in recent years due to their effectiveness versus H2 antagonists. This includes reducing GI bleeds in patients at risk. However, there are concerns with their long term use and potential costs. Costs can be reduced with increased prescribing of low cost generic PPIs. Aims: To analyse the influence of multiple demand-side measures in Scotland in recent years to increase the prescribing of low cost generic PPIs as well as encourage the prescribing of lower strength PPIs. Methods: Documenting utilization (mainly items dispensed) and expenditure in Scotland from 2001 to 2017 using health authority databases combined with documenting the multiple initiatives and measures both nationally and regionally. Results: The multiple measures in Scotland ensured high International non-proprietary name prescribing (up to 100{\%} for some PPIs) as well as the prescribing of generic versus patented PPIs, with costs of generic PPIs as low as 8.5{\%} of their pre-patent loss prices. Overall, total expenditure on PPIs in Scotland was 66.7{\%} lower in 2017 at GB£18.83million compared to 2001 levels. This was despite a 3.06-fold increase in PPI utilization during this period. The savings were driven by the increasing use of generic omeprazole and lansoprazole versus patent protected PPIs. There was also a reduction in the prescribing of high strength PPIs during this period. Conclusion: Multiple initiatives in Scotland in recent years have reduced expenditure on PPIs despite appreciably increased utilisation. Multiple initiatives have also helped to reduce the prescribing of higher strength PPIs. This is an exemplar to other countries seeking to enhance their prescribing efficiency",
keywords = "PPIs, Scottish NHS, expenditure, reforms, drug utilisation, generics",
author = "Brian Godman and Amanj Kurdi and Holly McCabe and Sean MacBride-Stewart and Axel Leporowski and Simon Hurding and Marion Bennie and Alec Morton",
year = "2018",
month = "11",
day = "12",
language = "English",
volume = "7",
pages = "142--151",
journal = "Generics and Biosimilars Initiative journal",
issn = "2033-6403",
number = "4",

}

Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service : their effect and implications. / Godman, Brian; Kurdi, Amanj; McCabe, Holly; MacBride-Stewart, Sean; Leporowski, Axel; Hurding, Simon; Bennie, Marion; Morton, Alec.

In: Generics and Biosimilars Initiative journal, Vol. 7, No. 4, 12.11.2018, p. 142-151.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service

T2 - Generics and Biosimilars Initiative journal

AU - Godman, Brian

AU - Kurdi, Amanj

AU - McCabe, Holly

AU - MacBride-Stewart, Sean

AU - Leporowski, Axel

AU - Hurding, Simon

AU - Bennie, Marion

AU - Morton, Alec

PY - 2018/11/12

Y1 - 2018/11/12

N2 - Introduction: There has been a considerable increase in the use of proton pump inhibitors (PPIs) in recent years due to their effectiveness versus H2 antagonists. This includes reducing GI bleeds in patients at risk. However, there are concerns with their long term use and potential costs. Costs can be reduced with increased prescribing of low cost generic PPIs. Aims: To analyse the influence of multiple demand-side measures in Scotland in recent years to increase the prescribing of low cost generic PPIs as well as encourage the prescribing of lower strength PPIs. Methods: Documenting utilization (mainly items dispensed) and expenditure in Scotland from 2001 to 2017 using health authority databases combined with documenting the multiple initiatives and measures both nationally and regionally. Results: The multiple measures in Scotland ensured high International non-proprietary name prescribing (up to 100% for some PPIs) as well as the prescribing of generic versus patented PPIs, with costs of generic PPIs as low as 8.5% of their pre-patent loss prices. Overall, total expenditure on PPIs in Scotland was 66.7% lower in 2017 at GB£18.83million compared to 2001 levels. This was despite a 3.06-fold increase in PPI utilization during this period. The savings were driven by the increasing use of generic omeprazole and lansoprazole versus patent protected PPIs. There was also a reduction in the prescribing of high strength PPIs during this period. Conclusion: Multiple initiatives in Scotland in recent years have reduced expenditure on PPIs despite appreciably increased utilisation. Multiple initiatives have also helped to reduce the prescribing of higher strength PPIs. This is an exemplar to other countries seeking to enhance their prescribing efficiency

AB - Introduction: There has been a considerable increase in the use of proton pump inhibitors (PPIs) in recent years due to their effectiveness versus H2 antagonists. This includes reducing GI bleeds in patients at risk. However, there are concerns with their long term use and potential costs. Costs can be reduced with increased prescribing of low cost generic PPIs. Aims: To analyse the influence of multiple demand-side measures in Scotland in recent years to increase the prescribing of low cost generic PPIs as well as encourage the prescribing of lower strength PPIs. Methods: Documenting utilization (mainly items dispensed) and expenditure in Scotland from 2001 to 2017 using health authority databases combined with documenting the multiple initiatives and measures both nationally and regionally. Results: The multiple measures in Scotland ensured high International non-proprietary name prescribing (up to 100% for some PPIs) as well as the prescribing of generic versus patented PPIs, with costs of generic PPIs as low as 8.5% of their pre-patent loss prices. Overall, total expenditure on PPIs in Scotland was 66.7% lower in 2017 at GB£18.83million compared to 2001 levels. This was despite a 3.06-fold increase in PPI utilization during this period. The savings were driven by the increasing use of generic omeprazole and lansoprazole versus patent protected PPIs. There was also a reduction in the prescribing of high strength PPIs during this period. Conclusion: Multiple initiatives in Scotland in recent years have reduced expenditure on PPIs despite appreciably increased utilisation. Multiple initiatives have also helped to reduce the prescribing of higher strength PPIs. This is an exemplar to other countries seeking to enhance their prescribing efficiency

KW - PPIs

KW - Scottish NHS

KW - expenditure

KW - reforms

KW - drug utilisation

KW - generics

UR - http://gabi-journal.net/

UR - http://gabi-journal.net/ongoing-activities-to-influence-the-prescribing-of-proton-pump-inhibitors-within-the-scottish-national-health-service-their-effect-and-implications.html

M3 - Article

VL - 7

SP - 142

EP - 151

JO - Generics and Biosimilars Initiative journal

JF - Generics and Biosimilars Initiative journal

SN - 2033-6403

IS - 4

ER -