Prescribing costs in dispensing practices.

Abstract

OBJECTIVE: To examine differences in prescribing between dispensing and non-dispensing practices. SETTING: The 108 practices covered by Lincolnshire Family Health Services Authority. DESIGN: Analysis of prescribing data for 1990-1 from PD2 reports from the Prescription Pricing Authority in relation to data on practice characteristics obtained from Lincolnshire Family Health Services Authority; and aggregated level 3 prescribing and cost information (PACT data) for 10 selected drugs from the Prescription Pricing Authority to examine amounts prescribed. MAIN OUTCOME MEASURES: Prescribing cost per patient, items per patient, and cost per item in dispensing and non-dispensing practices. RESULTS: Dispensing practices had higher prescribing costs per patient than non-dispensing practices. This difference held for non-dispensing patients within dispensing practices. Structural features failed to explain the differences in prescribing cost, except for the higher numbers of elderly patients in dispensing practices (which explained 13% of the difference) and the number of partners (5%). The main determinant of the difference was the lower use of generic drugs in dispensing practices (84%). Dispensing patients were prescribed lower quantities of drugs on average for each item. CONCLUSIONS: Dispensing practices could reduce their prescribing expenditure to that of non-dispensing practices by increasing their prescribing of generic drugs. The shorter prescribing intervals for dispensing patients may be due to dispensing fees being related to the number of prescribed items.