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13 Feb 2006 : Column 1758W—continued

Disabled People (Independent Living)

Mr. Hunt: To ask the Secretary of State for Health what the outcome was of the consultation referred to in Improving the Life Chances of Disabled People on
 
13 Feb 2006 : Column 1759W
 
whether people should have a right to request not to live in residential or nursing care; and if she will make a statement. [49830]

Mr. Byrne [holding answer 7 February 2006]: Consultation on whether people should have the right to request not to live in residential or nursing care was included in the adult social care Green Paper Independence Well-being and Choice: our vision for the future of social care for adults in England" which ran between 21 March and 28 July 2005.

An analysis of this consultation was published on 19 October 2005 and is available in the Library.
 
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Domiciliary Care

Mr. Burstow: To ask the Secretary of State for Health how many people over the age of 65 years were supported to live at home in (a) England and (b) each strategic health authority in each year since 1997. [47935]

Mr. Byrne: Information on the number of older people aged 65 or over helped to live at home in England and each strategic health authority as at 31 March, for the years 1998–99 to 2004–05 is shown in the table.

Following the last spending review, the Department was expected to ensure that, by March 2006, the number of older people supported intensively to live at home increased to 30 per cent. of the total being supported by social services at home or in residential care. This target was met two years early, in 2003–04, when the national average reached 30.1 per cent.
Number of older people aged 65 or over helped to live at home⁽⁵⁴⁾ by strategic health authority (SHA), 1998–99 to 2004–05⁽⁵⁵⁾—England

Rounded numbers
	1998–99	1999–2000	2000–01	2001–02	2002–03	2003–04	2004–05(56)
England total	637,600	662,000	649,700	660,200	660,700	662,000	641,900
SHA
Avon, Gloucestershire and Wiltshire	23,900	31,300	30,100	27,300	26,100	26,300	23,200
Bedfordshire and Hertfordshire	11,700	12,000	13,700	14,800	15,000	19,000	16,800
Birmingham and the Black Country	35,000	32,400	29,700	30,900	28,300	26,500	24,400
Cheshire and Merseyside	27,100	29,800	32,700	34,800	34,400	35,300	34,900
County Durham and Tees Valley	15,100	17,500	15,100	17,000	17,200	17,400	18,700
Cumbria and Lancashire	25,300	22,700	22,600	25,300	26,300	25,000	25,300
Dorset and Somerset	17,100	15,100	18,200	19,000	17,500	18,500	17,100
Essex	14,000	36,600	15,500	17,400	20,400	23,300	26,700
Greater Manchester	38,300	42,900	40,000	42,400	37,800	37,300	36,300
Hampshire and Isle of Wight	17,200	17,300	15,200	23,800	19,600	23,800	23,900
Kent and Medway	19,000	15,100	15,500	16,800	20,700	22,500	18,600
Leicestershire, Northamptonshire and Rutland	16,000	17,400	16,100	18,000	18,700	19,100	20,600
N and E Yorkshire and N Lincolnshire	21,000	13,300	20,900	23,100	25,700	24,700	24,600
Norfolk, Suffolk and Cambridgeshire	20,700	22,000	20,700	23,900	24,800	26,800	29,100
North Central London	12,500	13,300	12,500	14,900	14,200	13,400	11,900
North East London	26,100	22,000	16,400	17,600	18,000	18,000	19,000
North West London	22,900	20,400	19,400	18,100	18,900	20,400	19,400
Northumberland, Tyne and Wear	25,200	30,300	30,100	27,500	29,100	28,200	25,700
Shropshire and Staffordshire	22,000	28,600	30,000	20,800	21,000	21,000	26,700
South East London	21,800	23,500	21,400	20,700	20,600	19,200	18,600
South West London	17,100	17,100	17,600	17,300	17,100	16,300	14,000
South West Peninsula	19,100	21,100	22,500	24,500	26,700	23,200	22,000
South Yorkshire	16,300	23,900	23,000	19,300	19,300	17,100	18,100
Surrey and Sussex	26,700	28,400	34,200	33,400	30,000	27,700	21,700
Thames Valley	22,100	17,300	18,500	19,900	17,700	19,000	17,500
Trent	50,700	43,600	48,500	42,800	39,400	37,400	34,800
West Midlands South	15,500	13,300	16,100	15,600	19,900	20,200	19,300
West Yorkshire	37,900	33,600	33,500	33,200	36,300	35,300	33,000

⁽⁵⁴⁾ Helped to live at home by means of any service recorded on Referrals, Assessments and Packages of Care (RAP) return P2s. This includes planned short term breaks, direct payments, professional support, transport and equipment and adaptations as well as home care, day care and meals services. Data for 1998–99 on this basis are estimated as are data for 1999–2000 for around a quarter of the 150 local authorities.
⁽⁵⁵⁾ Data as at March each year. Data for 1997–98 has been excluded as it is not comparable with later years.
⁽⁵⁶⁾ Data on the number of people helped to live at home in 2004–05 is not comparable to data for previous years. In 2004–05 restated guidance was issued to exclude people receiving services from grant-funded organisations who had not had a community care assessment.
Source:
KS1 and RAP proforma P2s

Drug Costs

John Hemming: To ask the Secretary of State for Health (1) how many fees have been paid to pharmacists for each price category of (a) amlodipine, (b) simvastatin and (c) lisinopril (i) in each month of the last three financial years and (ii) to date in 2005–06; what the value was of each fee; and what the total payment was for each month for each price category of each drug; [48781]

(2) when (a) amlodipine, (b) simvastatin and (c) lisinopril went out of patent; [48782]

(3) what assessment she has made of the generic rates payable for (a) amlodipine, (b) simvastatin and (c) lisinopril since each drug went out of patent; [48783]

(4) what steps she plans to take to ensure that when drugs are out of patent fees are paid at a generic rate rather than a branded rate; and if she will make a statement. [48784]

 
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Jane Kennedy: Data on the number of prescriptions and costs is recorded on a quarterly rather than monthly basis and is only currently available for the period up to September 2005. Table one, provides the number of items prescribed and their net ingredient cost for each of the medicines in each quarter. The drug tariff prices for each of these medicines during the period in question are provided in table two.

Data held by the Department records the following expiry dates for amlodipine, simvastatin and lisinopril:

Amlodipine—March 2004

Simvastatin—May 2003

Lisinopril—October 2002

The reimbursement prices for generic simvastatin and lisinopril followed the usual procedure and timeframe, moving from category C, reimbursement price based on a brand, to category A, reimbursement price based on a basket of generic suppliers, when the generic became available. However, it became apparent that there were significant differences between these generic reimbursement prices and the prices at which they could be purchased by community pharmacy contractors and dispensing doctors. These differences would normally be recovered by a discount inquiry, but these medicines entered the market
 
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after the last inquiry. Therefore, following a consultation, the Government reduced the prices of these medicines on two occasions; the first with effect from 1 December 2003 and the second with effect from September 2004.

Following patent expiry of amlodipine, the Department followed the usual procedure for setting a generic reimbursement price moving from category C to category A. However, the entry of amlodipine into category M was delayed 1 October 2005 by supply side instability.

The Department has already taken considerable action to ensure that off patent medicines are reimbursed appropriately. Following an unexpected increase in prices in 1999, the Department introduced a short term maximum price scheme whilst undertaking a wider consultation on the arrangements for the future supply and reimbursement of national health service generic medicines. Taking account of responses to this consultation, as part introduced a new category M into the drug tariff in April 2005 based on a new mechanism for setting reimbursement prices of commonly prescribed generics. The prices of category M medicines now reflect the average manufacturers' market prices after discount, but leave a margin of unrecovered discount as part of pharmacy funding. The prices for category M are recalculated quarterly.
Table 1: Number of prescription items and net ingredient cost of Amlodipine, Lisinopril and Simvastatin dispensed in the community in England. Quarterly data

	2002			2003
	April-June	July-September	October-December	January-March	April-June	July-September	October-December
Number of prescription items (thousand)
Amlodipine	1,695.7	1,728.9	1,790.3	1,747.0	1,830.4	1,872.9	1,943.4
Lisinopril	1,558.5	1,578.3	1,612.9	1,550.8	1,606.6	1,634.2	1,669.3
Simvastatin	1,712.9	1,859.6	2,005.6	2,043.2	2,239.8	2,435.7	2,652.7
Net ingredient cost (£ thousand)
Amlodipine	34,758.0	35,400.4	36,683.9	35,655.5	37,214.3	40,500.6	43,337.6
Lisinopril	21,925.4	22,288.1	22,871.3	21,039.9	20,866.6	20,209.5	18,254.5
Simvastatin	61,003.7	66,808.5	72,698.8	74,423.1	81,742.0	81,890.8	71,024.2

	2004				2005
	January-March	April-June	July-September	October-December	January-March	April-June	July-September
Number of prescription items (thousand)
Amlodipine	1,934.5	2,010.8	2,073.1	2,173.5	2,138.5	2,287.9	2,354.5
Lisinopril	1,639.6	1,684.3	1,717.9	1,763.6	1,694.6	1,788.0	1,808.4
Simvastatin	2,756.3	3,018.4	3,297.9	3,608.4	3,623.1	3,966.3	4,272.2
Net ingredient cost (£ thousand)
Amlodipine	42,947.8	42,188.3	40,534.5	37,345.3	35,521.5	36,328.2	36,671.9
Lisinopril	15,698.4	16,077.2	14,703.7	11,705.8	11,192.3	5,965.0	5,365.3
Simvastatin	63,548.2	69,749.3	66,109.1	51,471.9	51,814.6	20,572.1	15,940.2

Table 2: Reimbursement prices (pence)

	2002
Drug	Pack	April	May	June	July	August	September	October	November	December
Amlodipine 5mg Tablets	28	1,185	1,185	1,185	1,185	1,185	1,185	1,185	1,185	1,185
Amlodipine l0mg Tablets	28	1,770	1,770	1,770	1,770	1,770	1,770	1,770	1,770	1,770
Lisinopril 2.5mg Tablets	28	626	626	626	626	626	626	626	626	626
Lisinopril 5mg Tablets	28	786	786	786	786	786	786	786	786	786
Lisinopril l0mg Tablets	28	970	970	970	970	970	970	970	970	970
Lisinopril 20mg Tablets	28	1,097	1,097	1,097	1,097	1,097	1,097	1,097	1,097	1,097
Simvastatin l0mg Tablets	28	1,803	1803	1,803	1,803	1,803	1,803	1,803	1,803	1,803
Simvastatin 20mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2969
Simvastatin 40mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969
Simvastatin 80mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969

	2003
Drug	Pack	January	February	March	April	May	June	July	August	September	October	November	December
Amlodipine 5mg Tablets	28	1,185	1,185	1,185	1,185	1,185	1,185	1,185	1,304	1,304	1,304	1,304	1,304
Amlodipine l0mg Tablets	28	1,770	1,770	1,770	1,770	1,770	1,770	1,770	1,947	1,947	1,947	1,947	1,947
Lisinopril 2.5mg Tablets	28	616	608	595	582	571	571	560	550	539	526	514	375
Lisinopril 5mg Tablets	28	773	764	752	736	720	720	708	696	670	666	649	495
Lisinopril l0mg Tablets	28	954	942	930	914	898	898	884	860	846	840	823	677
Lisinopril 20mg Tablets	28	1,079	1,066	1,054	1,035	1,012	1,012	998	978	957	951	936	750
Simvastatin l0mg Tablets	28	1,803	1,803	1,803	1,803	1,803	1,803	1,803	1,659	1,630	1,518	1,456	1,199
Simvastatin 20mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,692	2,614	2,421	2,307	1,600
Simvastatin 40mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,809	2,774	2,681	2,620	2,100
Simvastatin 80mg Tablets	28	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,969	2,908	2,908	2,877	2,877

 
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	2004
Drug	Pack	January	February	March	April	May	June	July	August	September	October	November	December
Amlodipine 5mg Tablets	28	1,304	1,304	1,304	1,304	1,304	1,304	1,211	1,167	1,092	1,056	1,004	1,284
Amlodipine l0mg Tablets	28	1,947	1,947	1,947	1,947	1,947	1,947	1,792	1,727	1,583	1,534	1,445	926
Lisinopril 2.5mg Tablets	28	375	375	375	375	375	375	375	375	289	289	289	289
Lisinopril 5mg Tablets	28	495	495	495	495	495	495	495	495	347	347	347	347
Lisinopril l0mg Tablets	28	677	677	677	677	677	677	677	677	404	404	404	404
Lisinopril 20mg Tablets	28	750	750	750	750	750	750	750	750	549	549	549	549
Simvastatin l0mg Tablets	28	1,199	1,199	1,199	1,199	1,199	1,199	1,199	1,199	578	578	578	578
Simvastatin 20mg Tablets	28	1,600	1,600	1,600	1,600	1,600	1,600	1,600	1,600	780	780	780	780
Simvastatin 40mg Tablets	28	2,100	2,100	2,100	2,100	2,100	2,100	2,100	2,100	1,560	1,560	1,560	1,560
Simvastatin 80mg Tablets	28	2,877	2,877	2,877	2,877	2,877	2,877	2,877	2,877	2,877	2,877	2,877	2,877

	2005
Drug	Pack	January	February	March	April	May	June	July	August	September	October	November	December
Amlodipine 5mg Tablets	28	870	962	889	889	889	889	889	889	889	548	548	548
Amlodipine l0mg Tablets	28	1,233	1,362	1,225	1,225	1,225	1,225	1,225	1,225	1,225	796	796	796
Lisinopril 2.5mg Tablets	28	289	289	289	176	176	176	117	117	117	130	130	130
Lisinopril 5mg Tablets	28	347	347	347	198	198	198	134	134	134	155	155	155
Lisinopril l0mg Tablets	28	404	404	404	178	178	178	170	170	170	198	198	198
Lisinopril 20mg Tablets	28	549	549	549	243	243	243	222	222	222	268	268	268
Simvastatin 10mg Tablets	28	578	578	578	212	212	212	165	165	165	175	175	175
Simvastatin 20mg Tablets	28	780	780	780	226	226	226	148	148	148	179	179	179
Simvastatin 40mg Tablets	28	1,560	1,560	1,560	487	487	487	357	357	357	414	414	414
Simvastatin 80mg Tablets	28	2,877	2,877	2,877	2,679	2,679	2,679	2,029	2,029	2,029	2,572	2,572	2,572

		2006
Drug	Pack	January	February
Amlodipine 5mg Tablets	28	540	540
Amlodipine l0mg Tablets	28	782	782
Lisinopril 2.5mg Tablets	28	130	130
Lisinopril 5mg Tablets	28	154	154
Lisinopril l0mg Tablets	28	198	198
Lisinopril 20mg Tablets	28	268	268
Simvastatin 10mg Tablets	28	175	175
Simvastatin 20mg Tablets	28	171	171
Simvastatin 40mg Tablets	28	389	389
Simvastatin 80mg Tablets	28	2,529	2,529

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