Page last updated: 30-SEP-2008

Prescribing

Statistical Publication Notice

30 September 2008

Prescribing Statistics and Minor Ailment Service

INTRODUCTION

ISD maintains a detailed database of all NHS prescriptions dispensed in the community in Scotland. The information is supplied to ISD by Practitioner Services Division (PSD) who are responsible for the processing and pricing of all prescriptions dispensed in Scotland.
 
These data are augmented with information on prescriptions written in Scotland that were dispensed elsewhere in the United Kingdom. All these prescriptions are dispensed by community pharmacies, dispensing doctors and a small number of specialist appliance suppliers.
 
GPs write the vast majority of these prescriptions, with the remainder written predominantly by nurses, dentists and community pharmacists (mainly for MAS). They also include prescriptions written in hospitals that are dispensed in the community, but exclude drugs supplied directly to patients within hospitals and clinics.
 
The prescribing statistics include details on prescribing trends data, the top ten drugs, generic drugs, nurse prescribing, prescription cost analysis, dispenser information, prescription costs, minor ailment service and dispenser fees.   All data are presented at Scotland level, with some being presented at NHS Board level.  Data is shown for the financial year 2007/08, with the exception of dispensing doctors and community pharmacies, which are at October 2007.

KEY POINTS

  • There was a 3.1% increase over the last year in the number of prescription items dispensed, however there was an increase of 0.4% in the gross ingredient cost.
  • The most commonly prescribed drug in Scotland is aspirin.
  • The number of prescription items written using the generic drug name was 82.1% in 2007/08 (0.5% increase from last year).
  • There was a 31.3% increase in the number of items issued by nurse prescribers compared to 2006/07.
  • The exchequer cost of NHS prescription drugs and remuneration to dispensing contractors increased by 1.9% compared to 2006/07.  The average cost to NHS Scotland of a prescription decreased from £12.55 to £12.41. 
  • The overall cost of prescribing to NHS Scotland was £1017.5 million.
  • The number of patients registered for MAS (minor aliment service) at March 08 was 586,336.

INTERPRETATION

This data relates to prescriptions dispensed within the community, but does not take into account medicines dispensed by hospitals or hospital based clinics.

DETAILED FINDINGS

Prescribing trends:
  • The number of prescription items dispensed year on year continued to increase.
  • In 2007/08 there were 82 million items, an increase of 3.1 % from previous financial year.
  • The gross ingredient cost (GIC) was £966M in 2007/08.
  • There was an increase in the GIC of 0.4% compared to 2006/07.   This increase was less than the volume increase due to a reduction in cost of several commonly prescribed drugs.
Top ten drugs:
  • In terms of volume, aspirin was the most commonly prescribed drug in 2007/08, which is primarily prescribed to help prevent cardiovascular disease.  This was consistent with previous years.
  • In terms of cost, Atorvastatin (used for controlling cholesterol) was the most expensive (by gross ingredient cost) prescribed drug in 2007/08.
Generic drugs
  • Doctors are encouraged to prescribe generic (i.e unbranded) versions of drugs where available, in order to help reduce drug costs.
  • In 2007/08 the proportion of all prescriptions written using the generic name was 82.1% (0.5% increase from last year).

Nurse prescribing

  • In 2007/08, nurse prescribing accounted for 715,466 items, which is around 1% of total number of prescribed items.
  • In 2007/08, the number of prescriptions written by nurses increased by 31.3%, with an increase of 35.0% in gross ingredient cost on the previous year.
  • The most common items prescribed by nurses in 2007/08 were for dressings, similar to 2006/07.
  • The second most common items prescribed by nurses in 2007/08 were for prescriptions for infections, replacing items for skin conditions in 2006/07.
Prescription cost analysis
  • The file for 2007/08 is available for download, which gives a detailed breakdown of items dispensed by BNF chapters, BNF sections, BNF subsections, chemical names and individual items.
Dispensers
  • The number of community pharmacies increased by 18 on the previous year, to total 1,193 in October 2007.
  • The number of Essential Small Pharmacies increased by 6 on the previous year from 48 to 54 at 31 March 2008.
  • At October 2007 there were 275 dispensing doctors in Scotland, a decrease of 3 compared to the previous year. 
Prescription costs and dispensing fees
  • In 2007/08 the net ingredient cost to NHS Scotland for prescription drugs dispensed by community pharmacies, appliance suppliers and dispensing doctors was £883 million, down 0.3% on last year.
  • The overall exchequer cost (also known as net cost) of parmaceutical services to NHS Scotland in 2007/08 was £1,017.5 million.  This equates to £187 per person registered with a GP in Scotland.
  • The total number of prescriptions dispensed has risen by 3.1% to 82.0 million.  The average exchequer cost a prescription to NHS Scotland has fallen from £12.55 to £12.41 per item on last year.
Minor ailment service (MAS)
  • Almost all Scottish community pharmacies provided the service in March 2008.
  • 586,336 people were registered for MAS in March 2008.  This represents a 19% drop from March 2007 due to lapsed registrations from July 2007 onwards.
  • MAS represents just over 1% of all items dispensed by community pharmacies in 2007/08, with paracetamol being the most frequently prescribed MAS item.
  • The overall MAS gross ingredient cost (GIC) to NHS Scotland in 2007/08 was £1.9 million.  The average GIC per MAS item was £1.99.


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MAIN CONTACTS:

Jane Chisholm
Principal Information Analyst
0131 275 6197
Healthcare Information Group (Prescribing)
Jane.Chisholm@isd.csa.scot.nhs.uk

Victoria Hepworth
Information Analyst/Statistician
0131 275 6225
Healthcare Information Group (Prescribing)
Victoria.Hepworth@isd.csa.scot.nhs.uk

Sharon Kennedy
Information Analyst
0141 282 2318
Healthcare Information Group (Prescribing)
Sharon.Kennedy@isd.csa.scot.nhs.uk

Iain Bishop
Principal Pharmacist (Prescribing)
0131 275 6509
Healthcare Information Group
Iain.Bishop@isd.csa.scot.nhs.uk

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GLOSSARY:

An item is an individual product prescribed by a doctor, nurse or pharmacist e.g., Aspirin 300mg tablets.  A prescription can contain up to three items.
Gross ingredient cost (GIC) is the cost of drugs, dressings or appliances before the deduction of any discount.
Net ingredient cost (NIC) is the cost of drugs and appliances after deduction of any discount, plus special payments made to dispensing doctors.
Gross cost is NIC, transitional payments, dispensing fees plus other fees and allowances centrally paid.
Exchequer cost is gross cost minus charges paid by patients
 
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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

The Scottish Government
Chief Executives of each NHS Board
Chief Prescribing Advisers of each NHS Board
Members of epharmacy information steering group (MAS Only)
 
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HISTORY OF THIS PUBLICATION:

Last Published: 25 September 2007
Next Due: 29 September 2009
Data Avaliable Since: 
March 1980 for prescription charges
March 1987 for prescribing volume and cost
March 1992 for generic prescribing
March 1999 for summary statistics (Scotland)
March 2000 for prescription cost analysis and nurse prescribing
March 2002 for summary statistics (NHS Board)
October 1991 community pharmacies
October 1990 dispensing doctors
July 2006 minor ailment service (MAS)
Current year only for Top 10 drugs and essential small pharmacies

 


Main contact: Email Jane Chisholm