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PubMed1989

Prescribing costs when computers are used to issue all prescriptions.

The aim of the study was to see whether the use of a computer to issue prescriptions in conjunction with a computerised, customized drug formulary affects prescribing costs. Data on prescribing costs were obtained from the Scottish Prescription Pricing Bureau for 1978-87. A microcomputer system was introduced into the practice in 1983 and used initially to issue repeat prescriptions, but from 1985 onwards a new system was added to issue all prescriptions; a personal computerised drug formulary was developed in 1983. Personal prescribing costs before and after computerisation were compared with those of the other partners and those of the Lothian Health Board and Scotland combined. The prescribing costs of the partners and Lothian Health Board and Scotland combined increased almost linearly in line with inflation from 1978 to 1987. Personal prescribing costs increased steadily until 1983, when repeat prescriptions were issued by computer, and remained static for a year. Thereafter they increased steadily until 1985, when all prescriptions were issued by computer, and then showed a steady and sustained fall. Personal prescribing costs were 21.5% lower than those of the partners in 1986 and 29.5% lower in 1987. Prescribing costs were reduced when a computer was used to issue all prescriptions in conjunction with a personal, computerised formulary.

Computer Systems↗
PubMed1993

British National Formulary: its birth, death, and rebirth.

The British National Formulary is a direct descendant of the National War Formulary, in which the titles of the preparations were in Latin and the doses in minims and grains. The British National Formulary was born in 1948, did a good job for about 20 years, but sickened and died in 1976. It was reborn in 1981. Parturition was painful with a very hostile reception from the media and the drug industry, but it survived and has grown in stature. The 25th edition was published in February. Wish it well for the next 25 issues!

Formularies as Topic↗
PubMed1995

Changing to generic formulary: how one fundholding practice reduced prescribing costs.

OBJECTIVES: To observe one general practice's attempt to reduce prescribing costs on becoming third wave fundholders through the introduction of a generic formulary applied to all new and repeat prescribing. To assess the impact on patients and prescribing patterns. DESIGN: An observational study using interviews with patients and practitioners; questionnaires for patients and prescribing data. SETTING: One urban general practice with five partners in Scotland. It became fundholding in April 1993. SUBJECTS: 71 searches of the register of repeat prescriptions identified 1274 potential changes in drugs. Questionnaires were sent to a stratified random sample of 280 patients four months after the changes were made; 33 interviews were conducted with 17 patients selected by local pharmacists to represent a wide range of opinion. MAIN OUTCOME MEASURES: Changes in prescribing and response and satisfaction of patients. RESULTS: Of intended changes, 129 (70%) were in place after four months. Thirty three (20%) of the 167 patients who returned questionnaires were "very unhappy," though interviews suggested that this was primarily with the communication they received rather than the change itself. Generic prescribing rose from one in three (37%) to over a half (58%). The volume of treatment dispensed (as treatment days) fell by 67,674 (10.7%), and the average cost per day's treatment fell by 3.1 p from 32.3 p per day in 1992 (9.4%), producing a total absolute saving of 24% (137,712 pounds) over the first year. CONCLUSION: This practice has achieved a large reduction in prescribing costs rapidly. These were tolerated by patients, none of whom is thought to have left the practice for this reason. Great care must be taken to inform patients appropriately.

Communication↗