Increased drug spending is creating funding crisis, report says

BMJ 2003; 326 doi: (Published 29 March 2003) Cite this as: BMJ 2003;326:677
  1. Sarah Macdonald
  1. London

    Spending on prescribed drugs in primary care grew by 10% between 2001 and 2002, and many primary care trusts are facing a major gap in funding, a report from the Audit Commission says.

    The report says that drugs linked to national service frameworks and National Institute for Clinical Excellence (NICE) guidelines account for almost half of this rise in spending.

    In 2001–2 a total of £540m ($850m; a800m) more was spent on prescribed drugs than in 2000-1, says the report. The total cost of prescription drugs in primary care was £5.5bn last year. Overall spending rose by 7% but there was a 25% increase in drugs in four particular categories.

    Spending on lipid regulating drugs, including statins, increased by 33% The main reason for this, according to the Audit Commission, was the national service framework on coronary heart disease, which recommends that patients who have a diagnosis of coronary heart disease or who are at risk of getting the disease should receive a number of interventions. The 18% increase in antihypertensives was also a result of the framework, the report says.

    Spending on drugs to treat diabetes rose by 23% The report says this was due to the national service framework on diabetes, NICE guidance, and an increase in the number of diagnoses. Spending on antipsychotic drugs rose by 32

    —a result of the availability of the new class of anti-psychotic drugs and their reinforcement by NICE guidance.

    Most primary care trusts have increased their drug budgets for 2002–3 by about 10% but drug costs are forecast to rise by around 12% The Audit Commission says this will leave £110m—an average of £360000 per trust—to be funded from other budgets.

    “The rise in prescribing could bring a potentially serious finance and performance risk,” it says.

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