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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
1998–991999–20002000–012001–022002–032003–042004–05(56)
England total637,600662,000649,700660,200660,700662,000641,900
SHA
Avon, Gloucestershire and Wiltshire23,90031,30030,10027,30026,10026,30023,200
Bedfordshire and Hertfordshire11,70012,00013,70014,80015,00019,00016,800
Birmingham and the Black Country35,00032,40029,70030,90028,30026,50024,400
Cheshire and Merseyside27,10029,80032,70034,80034,40035,30034,900
County Durham and Tees Valley15,10017,50015,10017,00017,20017,40018,700
Cumbria and Lancashire25,30022,70022,60025,30026,30025,00025,300
Dorset and Somerset17,10015,10018,20019,00017,50018,50017,100
Essex14,00036,60015,50017,40020,40023,30026,700
Greater Manchester38,30042,90040,00042,40037,80037,30036,300
Hampshire and Isle of Wight17,20017,30015,20023,80019,60023,80023,900
Kent and Medway19,00015,10015,50016,80020,70022,50018,600
Leicestershire, Northamptonshire and Rutland16,00017,40016,10018,00018,70019,10020,600
N and E Yorkshire and N Lincolnshire21,00013,30020,90023,10025,70024,70024,600
Norfolk, Suffolk and Cambridgeshire20,70022,00020,70023,90024,80026,80029,100
North Central London12,50013,30012,50014,90014,20013,40011,900
North East London26,10022,00016,40017,60018,00018,00019,000
North West London22,90020,40019,40018,10018,90020,40019,400
Northumberland, Tyne and Wear25,20030,30030,10027,50029,10028,20025,700
Shropshire and Staffordshire22,00028,60030,00020,80021,00021,00026,700
South East London21,80023,50021,40020,70020,60019,20018,600
South West London17,10017,10017,60017,30017,10016,30014,000
South West Peninsula19,10021,10022,50024,50026,70023,20022,000
South Yorkshire16,30023,90023,00019,30019,30017,10018,100
Surrey and Sussex26,70028,40034,20033,40030,00027,70021,700
Thames Valley22,10017,30018,50019,90017,70019,00017,500
Trent50,70043,60048,50042,80039,40037,40034,800
West Midlands South15,50013,30016,10015,60019,90020,20019,300
West Yorkshire37,90033,60033,50033,20036,30035,30033,000


(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:

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-JuneJuly-SeptemberOctober-DecemberJanuary-MarchApril-JuneJuly-SeptemberOctober-December
Number of prescription items (thousand)
Amlodipine1,695.71,728.91,790.31,747.01,830.41,872.91,943.4
Lisinopril1,558.51,578.31,612.91,550.81,606.61,634.21,669.3
Simvastatin1,712.91,859.62,005.62,043.22,239.82,435.72,652.7
Net ingredient cost (£ thousand)
Amlodipine34,758.035,400.436,683.935,655.537,214.340,500.643,337.6
Lisinopril21,925.422,288.122,871.321,039.920,866.620,209.518,254.5
Simvastatin61,003.766,808.572,698.874,423.181,742.081,890.871,024.2


2004
2005
January-MarchApril-JuneJuly-SeptemberOctober-DecemberJanuary-MarchApril-JuneJuly-September
Number of prescription items (thousand)
Amlodipine1,934.52,010.82,073.12,173.52,138.52,287.92,354.5
Lisinopril1,639.61,684.31,717.91,763.61,694.61,788.01,808.4
Simvastatin2,756.33,018.43,297.93,608.43,623.13,966.34,272.2
Net ingredient cost (£ thousand)
Amlodipine42,947.842,188.340,534.537,345.335,521.536,328.236,671.9
Lisinopril15,698.416,077.214,703.711,705.811,192.35,965.05,365.3
Simvastatin63,548.269,749.366,109.151,471.951,814.620,572.115,940.2


Table 2: Reimbursement prices (pence)

2002
DrugPackAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Amlodipine 5mg Tablets281,1851,1851,1851,1851,1851,1851,1851,1851,185
Amlodipine l0mg Tablets281,7701,7701,7701,7701,7701,7701,7701,7701,770
Lisinopril 2.5mg Tablets28626626626626626626626626626
Lisinopril 5mg Tablets28786786786786786786786786786
Lisinopril l0mg Tablets28970970970970970970970970970
Lisinopril 20mg Tablets281,0971,0971,0971,0971,0971,0971,0971,0971,097
Simvastatin l0mg Tablets281,80318031,8031,8031,8031,8031,8031,8031,803
Simvastatin 20mg Tablets282,9692,9692,9692,9692,9692,9692,9692,9692969
Simvastatin 40mg Tablets282,9692,9692,9692,9692,9692,9692,9692,9692,969
Simvastatin 80mg Tablets282,9692,9692,9692,9692,9692,9692,9692,9692,969


2003
DrugPackJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Amlodipine 5mg Tablets281,1851,1851,1851,1851,1851,1851,1851,3041,3041,3041,3041,304
Amlodipine l0mg Tablets281,7701,7701,7701,7701,7701,7701,7701,9471,9471,9471,9471,947
Lisinopril 2.5mg Tablets28616608595582571571560550539526514375
Lisinopril 5mg Tablets28773764752736720720708696670666649495
Lisinopril l0mg Tablets28954942930914898898884860846840823677
Lisinopril 20mg Tablets281,0791,0661,0541,0351,0121,012998978957951936750
Simvastatin l0mg Tablets281,8031,8031,8031,8031,8031,8031,8031,6591,6301,5181,4561,199
Simvastatin 20mg Tablets282,9692,9692,9692,9692,9692,9692,9692,6922,6142,4212,3071,600
Simvastatin 40mg Tablets282,9692,9692,9692,9692,9692,9692,9692,8092,7742,6812,6202,100
Simvastatin 80mg Tablets282,9692,9692,9692,9692,9692,9692,9692,9692,9082,9082,8772,877

 
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2004
DrugPackJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Amlodipine 5mg Tablets281,3041,3041,3041,3041,3041,3041,2111,1671,0921,0561,0041,284
Amlodipine l0mg Tablets281,9471,9471,9471,9471,9471,9471,7921,7271,5831,5341,445926
Lisinopril 2.5mg Tablets28375375375375375375375375289289289289
Lisinopril 5mg Tablets28495495495495495495495495347347347347
Lisinopril l0mg Tablets28677677677677677677677677404404404404
Lisinopril 20mg Tablets28750750750750750750750750549549549549
Simvastatin l0mg Tablets281,1991,1991,1991,1991,1991,1991,1991,199578578578578
Simvastatin 20mg Tablets281,6001,6001,6001,6001,6001,6001,6001,600780780780780
Simvastatin 40mg Tablets282,1002,1002,1002,1002,1002,1002,1002,1001,5601,5601,5601,560
Simvastatin 80mg Tablets282,8772,8772,8772,8772,8772,8772,8772,8772,8772,8772,8772,877


2005
DrugPackJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Amlodipine 5mg Tablets28870962889889889889889889889548548548
Amlodipine l0mg Tablets281,2331,3621,2251,2251,2251,2251,2251,2251,225796796796
Lisinopril 2.5mg Tablets28289289289176176176117117117130130130
Lisinopril 5mg Tablets28347347347198198198134134134155155155
Lisinopril l0mg Tablets28404404404178178178170170170198198198
Lisinopril 20mg Tablets28549549549243243243222222222268268268
Simvastatin 10mg Tablets28578578578212212212165165165175175175
Simvastatin 20mg Tablets28780780780226226226148148148179179179
Simvastatin 40mg Tablets281,5601,5601,560487487487357357357414414414
Simvastatin 80mg Tablets282,8772,8772,8772,6792,6792,6792,0292,0292,0292,5722,5722,572


2006
DrugPackJanuaryFebruary
Amlodipine 5mg Tablets28540540
Amlodipine l0mg Tablets28782782
Lisinopril 2.5mg Tablets28130130
Lisinopril 5mg Tablets28154154
Lisinopril l0mg Tablets28198198
Lisinopril 20mg Tablets28268268
Simvastatin 10mg Tablets28175175
Simvastatin 20mg Tablets28171171
Simvastatin 40mg Tablets28389389
Simvastatin 80mg Tablets282,5292,529


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