Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish national health service: influence and implications

Abstract

Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.

Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service: their effect and implications

“…Similar to the findings with lipid lowering agents (62), the loss of a patent appears to appreciably influence subsequent prescribing patterns not only omeprazole following generic availability in 2002 Total Dispensed Items 20mg Total Dispensed Items 40mg Total DDDs (Table 1) but also for the other PPIs (Figure 1). The use of lansoprazole stabilised following the availability of generic omeprazole and then rose following the availability of generic lansoprazole (2006/ 2007 onwards - Figure 1).…”

“…These combined measures have resulted in considerable savings in the past in Scotland (49). This is similar to the multiple activities that have been instigated nationally and regionally in Scotland to enhance prescribing efficiency for lipid lowering medicines with similar results (62).…”

“…In addition, continuing to encourage high INN prescribing. High INN prescribing in Scotland is also seen in other disease areas including anti-coagulants, anti-depressants, statins for hypercholesterolaemia, anti-hypertensives and atypical antipsychotics for schizophrenia (48,62,(76)(77)(78). As a result, providing exemplars to other European countries where there are concerns with generics (58,59).…”

“…It is a robust dataset that is regularly audited and covers the whole of Scotland rather than a selection of community pharmacies. NHS Scotland is a universal healthcare system serving the entire Scottish population (49,62), with currently no co-payment for medicines in Scotland.…”

“…In the case of patients with chronic diseases such as GERD or dyspepsia, a prescription is usually for 28 or 56 days. However, there has been tendency in recent years for physicians to increase the length of a prescription to help with their growing workloads (62). However, cognizant of the need to regularly review the strength of PPIs prescribed for patients on long term use (19).…”