As part of the Pharmaceutical Price Regulation Scheme, which came into operation on 1 January 2009, it was agreed between the DH and the Association of the British Pharmaceutical Industry that the DH would review the variation in the uptake of selected medicines in the NHS in England.
The NHS Health and Social Care Information Centre (HSCIC) was accordingly asked to produce a bulletin examining variation in the use of certain medicines in relation to the number of eligible patients as estimated by NICE. In the absence of data on the number of patients being treated, predicted use (utilising the average dose and length of treatment) was compared with observed use taken from prescribing data from NHS Prescribing Services and IMS Health. Some pharmaceutical companies also provided their own data.
The report covers 52 medicines and 35 Technology Appraisals, grouped into 25 therapy groups. Of these, it was possible to compare observed or actual use with expected use for 13 treatment groups. Of these, use appeared higher than expected for six and lower than expected for another six. For the drug ranibizumab (Lucentis), the results varied according to the method of calculation.
Although HSCIC’s Chief Executive cautions against reading too much into the experimental data, when there may be gaps in it, differences in demography and disease prevalence, small cohorts and local prescribing preferences, it is interesting to note that the drugs whose use was higher than expected included statins and drugs for osteoporosis, smoking cessation and type 1 diabetes, whereas drugs whose use was lower than expected included trastuzumab (Herceptin).
The data in the report is classed as “experimental” and HSCIC welcomes feedback on its future development.