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GPs dispensing drugs from their own practice could cost NHS £7MILLION

GPs who dispense drugs from their own practices could be costing the NHS £7MILLION per year by ‘choosing expensive medications’

  • Researchers analysed 7,836 practices with a mean patient list of 7,258 people
  • Experts blame reimbursement system for creating a financial conflict of interest 
  • Many GPs negotiate cut prices on drug acquisitions, yet are refunded at full rate

GPs who dispense drugs from their own practice could be costing the NHS more than £7million per year by choosing more expensive medications. 

Experts say the NHS’s reimbursement system has created a ‘financial conflict of interest in treatment decisions’. 

Specifically, it allows doctors to choose medicines which are costlier but are no more effective than their cheaper counterparts.

This, the researchers claim, allows some GPs to negotiate and buy drugs at lower prices but still be reimbursed the full cost by the NHS, increasing their profits.

Cost: Experts blame the NHS’ reimbursement system for dispensing practices for creating a ‘financial conflict of interest in treatment decisions’

Billed as the largest-ever study on dispensing practices, the data was reviewed by researchers at the University of Oxford, Imperial College London, the Institute for Global Health and the London School of Hygiene & Tropical Medicine.

Now, after publishing their findings in BMJ Open, they’re calling for a ‘robust routine audit of practices’ which ‘may help reduce costs’. 

One in eight practices in primary care in England are dispensing practices, which allow patients to collect their medications on site. 

Many of them are located in rural areas, where separate pharmacies are not always nearby, GP magazine Pulse reported.

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The researchers analysed 7,836 practices with a mean patient list of 7,258 people.

Comparing non-dispensing and dispensing practices, they looked at several expensive medicines, such as statins, ACE inhibitors and angiotensin receptor blockers.

The mean cost per dose was calculated separately for dispensing and non-dispensing practices. 

Expense: One in eight practices in primary care in England are dispensing practices, which allow patients to collect their medications on site

‘For [most] classes of drug… dispensing practices appear to be over-represented among the highest prescribers of high-cost drugs,’ it continued.

The authors said: ‘We found that doctors in England rarely prescribe high-cost drugs where there are equally effective low-cost alternatives, but that doctors with a potential financial conflict of interest through working in a dispensing practice are significantly more likely to prescribe high-cost options, for four commonly prescribed classes of drug. 

‘Total cost savings available, if doctors in dispensing practices were to prescribe drugs at the same price as doctors in non-dispensing practices, are £7,546,502 per year.’

‘We strongly suggest that existing processes to identify and address problematic prescribing behaviour should be reviewed, with their costs and evidence base assessed,’ they added. 

Doctors are told to ‘resist’ patients trying to stock up on medication in fear of running out after Brexit 

Doctors are being told to resist patients who try to stock up on prescription medicines in fear of running out after Brexit.

The Department of Health and Social Care (DHSC) has warned GPs that they should not over-prescribe in the lead up to March 29.

Medics have reported feeling pressured by worried patients who believe they will be left short of vital medication if there is no Brexit deal.

Experts suspect Brexit has ‘exacerbated’ usual medicine shortages and the Government has this week admitted there could be six months of disruption if transport routes are disrupted next month.

The DHSC has insisted there will be a big enough supply of drugs thanks to contingency plans – but warned that GPs need to play by the rules.

A spokesperson told the BMJ: ‘We are confident that, if everyone does what they should do, the supply of medicines should be uninterrupted in the event of a no-deal EU exit.

‘Patients should not stockpile medicines, and GPs do not need to write longer NHS prescriptions.

‘We are working closely with pharmaceutical companies to ensure patients can continue to access the medicines they need, including asking many of them to ensure a minimum of six weeks’ additional supply of medicine over and above usual buffer stocks by 29 March.’

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