Statin prescribing in Northern Ireland and England pre and post introduction of the quality and outcomes framework
- 144 Downloads
Objective The objective of this research was to examine differences in patterns of statin prescribing between Northern Ireland and England both before and after the introduction of the Quality and Outcomes Framework (QOF). Setting: Primary care practices in Northern Ireland and England. Method Northern Ireland practices were matched with practices in England, statin prescribing data and QOF achievement scores (for the first year post-QOF) were obtained. Crude prescribing data from matched practices were manipulated to provide a data set of Defined Daily Doses (DDDs)/1,000 patients and cost/DDD/1,000 patients for each statin drug entity covering 1 year before and after the introduction of QOF. QOF achievements were converted into percentage scores for matched practices. Main outcome measure Cost per defined daily dose (DDD) per 1,000 patients. Results Significantly less statins (DDD/1,000 patients) were dispensed in Northern Ireland compared with the matched region in England both before and after the introduction of QOF (P < 0.001). However, significantly more statins were dispensed in both regions after the introduction of QOF. As a result of the introduction of QOF, the cost/DDD/1,000 patients rose by £13.17 in NI, but fell by £3.76 in the matched region in England. Conclusion Strategies should be considered to educate prescribers on cost-effectiveness by increasing their awareness of the negative budgetary impact resulting from early adoption of new and expensive statins and by encouraging generic prescribing.
KeywordsCost containment Northern Ireland Prescribing Quality and outcomes framework (QOF) Statins United Kingdom
The authors would like to thank Dr Gordon Cran, Department of Epidemiology, Queen’s University Belfast for his statistical support.
Conflict of interest
- 3.Jacoby A, Smith M, Eccles M. A qualitative study to explore influences on general practitioners’ decisions to prescribe new drugs. BJGP. 2003;53(487):120–5.Google Scholar
- 8.National Health Services. Quality and outcomes framework information. 2006. Government document available from http://www.gpcontract.co.uk/FAQ.php.
- 12.Hadley-Brown M. The QOF: quality outcomes or just framework? Diabetes Prim Care. 2005;7:52–60.Google Scholar
- 13.Appleby J. Independent review of health and social care services in Northern Ireland. 2005. http://www.dhsspsni.gov.uk/appleby-section3-4.pdf.
- 14.Scoggins A, Tiessen J, Pabinovich L. Prescribing in primary care: understanding what shapes GP’s prescribing choices and how might these be changed. Technical report prepared for the National Audit Office. Cambridge, UK: RAND Corporation; 2006.Google Scholar
- 15.Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease. The Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–9.Google Scholar
- 18.Peck P. Statins are underused and under dosed, even in clinical trial population: Medscape. 2004. http://www.medscape.com/viewarticle/471276.