title: Variations in primary care prescribing: lessons to be learnt for GP commissioners.
abstract: The quality and quantity of primary care prescribing represents a fundamental determinant of the clinical and cost-effectiveness of the UK NHS. The aim of this study was to determine the 'supply' factors that affect primary care prescribing, controlling for 'demand' factors and consider the implications for clinical commissioning groups (CCGs). A detailed regression analysis was undertaken of prescribing in six therapeutic areas to determine differences in prescribing across primary care trusts (PCTs) in England. Results indicate that there are large unexplained variations in primary care prescribing. With the disbanding of the PCTs, and budgets moving to general practitioners (GPs), the role of efficiently and effectively managing prescribing will fall to GP commissioners. Therefore, mechanisms need to be put in place now to ensure that GPs are able to monitor their prescribing and reduce unnecessary drug usage, and further research into the reasons for variations in prescribing needs to be conducted at the CCG level.
authors.affiliation: 1Research Assistant, Department of Economics, Finance and Accounting, University of Liverpool Management School, Chatham Street, Liverpool, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Houten
authors.affiliation: 2 Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, UK.
authors.forename: Allan
authors.initials: A
authors.lastname: Wailoo
authors.affiliation: 3Technical Advisor, Centre for Health Technology Evaluation, National Institute for Health and Clinical Excellence, Manchester, UK.
authors.forename: Pall
authors.initials: P
authors.lastname: Jonsson
authors.affiliation: 4Research Assistant, Department of Economics, Finance and Accounting, University of Liverpool Management School, Chatham Street, Liverpool, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: McLeod
mesh_terms: D003362:Cost-Benefit Analysis; D017723:Drug Utilization Review; D004739:England; D006301:Health Services Needs and Demand; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards / Q000639:trends*; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D012044:Regression Analysis; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*