Prescribing incentive schemes : a useful approach?
BACKGROUND
From 2000 to 2004, primary care organisations (PCOs) in England were legally required to operate a prescribing incentive scheme for their general practices. A statutory framework specified the types of target, maximum rewards and use of 'good cause for failure' provisions that schemes should include. Our objective was to explore whether schemes might be a useful approach to encourage 'good quality' prescribing.


METHODS
We requested copies of the original schemes from all PCOs in England in 2001 and 2002. Data were extracted on the rewards offered, types of budgetary targets set and additional conditions specified.


RESULTS
Many schemes had not been finalised, some PCOs had no scheme, and one scheme operated without rewards. Although schemes covered similar therapeutic areas, they varied considerably in their length, complexity, reward levels and reward structure. Over half the schemes contained no 'good cause for failure' provision.


CONCLUSIONS
PCOs are offering diverse incentives to general practices and some have interpreted the statutory framework imaginatively. Better use of the 'good cause for failure' provision may help to overcome inflationary pressures on prescribing, but further research is needed to clarify the role of financial incentives in influencing prescribing.
Mason
Anne R
AR
Centre for Health Economics, University of York, Heslington, York, England. arm10@york.ac.uk
Drummond
Michael F
MF
Hunter
Jane A
JA
Towse
Adrian K
AK
Cooke
Jonathan
J
D011307:Drug Prescriptions; D004739:England; D006801:Humans; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care; D012052:Reimbursement, Incentive; D013222:State Medicine