The impact of a general practice group intervention on prescribing costs and patterns.
BACKGROUND
The formation of primary care groups (PCGs) and trusts (PCTs) has shifted the emphasis from individual practice initiatives to group-based efforts to control rising prescribing costs. However, there is a paucity of literature describing such group initiatives. We report the results of a multilevel group initiative, involving input from a pharmaceutical adviser, practice comparison feedback, and peer review meetings.


OBJECTIVE
To determine the impact of a prescribing initiative on the prescribing patterns of a group of general practices.


METHODS
A comparative study with non-matched controls.


METHODS
Nine semi-rural/rural practices forming a commissioning group pilot, later a PCG, in Southern Derbyshire with nine practices as controls.


METHODS
Practice data were collated for overall prescribing and for therapeutic categories, between the years 1997/1998 and 1998/1999 and analysed statistically. Prescribing expenditure trends were also collated.


RESULTS
Although both groups came well within their prescribing budgets, in the study group this was for the first time in five years. Their rate of increase in expenditure slowed significantly following the initiative compared with that of the comparison group, which continued to rise (median practice net ingredient cost/patient unit (nic/PU) increase: Pound Sterling0.69 and Pound Sterling3.80 respectively; P = 0.03). The study group's nic/PU dropped below, and stayed below, that of the comparison group one month after the start of the initiative. For most therapeutic categories the study group had lower increases in costs and higher increases in percentage of generic items than the comparison group. Quality markers were unaffected.


CONCLUSIONS
We suggest that practices with diverse prescribing patterns can work together effectively within a PCT locality to control prescribing costs.
Walker
Jane
J
University of Sheffield, Institute of General Practice and Primary Care, Community Sciences Centre, Northern General Hospital.
Mathers
Nigel
N
D002017:Budgets; D016527:Drug Costs / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000191:economics* / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D016568:Drugs, Generic / Q000191:economics; D004739:England; D005194:Family Practice / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012423:Rural Health
D016568:Drugs, Generic