Select Committee on Health Written Evidence


SUPPLEMENTARY MEMORANDUM FROM THE DEPARTMENT OF HEALTH (continued)

Table 3

NUMBER OF EXEMPT PRESCRIPTION ITEMS AND PERCENTAGE OF TOTAL ITEMS DISPENSED IN THE COMMUNITY BY CATEGORY OF EXEMPTION, 2003 AND 2004

ENGLAND


2003
2004
Number
%
Number %

Number of prescription items (millions)
535.7
82.5
570.983.2
Children under 16
37.0
5.7
35.7 5.2
Young people 16, 17 or 18 in full time education
5.4
0.8
5.40.8
Elderly people
363.5
55.9
391.4 57.0
Maternity exemption
5.0
0.8
5.0 0.7
Medical exemption
40.8
6.3
45.1 6.6
Income support
54.5
8.4
54.8 8.0
Working Families' Tax Credit/Working Tax Credit
10.8
1.7
14.72.1
Minimum Income Guarantee/Pension Credit
0.1
0.0
0.50.1
Disabled Person's Tax Credit/Disability working allowance
1.3
0.2
0.00.0
Holders of an HC2 certificate
3.9
0.6
3.9 0.6
Income based Jobseekers allowance
6.7
1.0
7.3 1.1
War pension
0.6
0.1
0.6 0.1
No declaration/declaration not specific
6.1
0.9
6.40.9
Net ingredient cost (£millions)
5,975.4
79.6
6,503.780.5
Children under 16
281.5
3.7
293.8 3.6
Young people 16,17 or 18 in full time education
57.2
0.8
59.90.7
Elderly people
3,988.5
53.1
4,334.0 53.6
Maternity exemption
40.8
0.5
41.1 0.5
Medical exemption
656.0
8.7
734.7 9.1
Income support
631.3
8.4
660.2 8.2
Working Families' Tax Credit/Working Tax Credit
106.3
1.4
158.72.0
Minimum Income Guarantee/Pension Credit
1.3
0.0
5.50.1
Disabled Person's Tax Credit/Disability working allowance
19.6
0.3
0.50.0
Holders of an HC2 certificate
48.0
0.6
50.3 0.6
Income based Jobseekers allowance
64.7
0.9
76.0 0.9
War pension
9.5
0.1
10.1 0.1
No declaration/declaration not specific
70.5
0.9
78.81.0
Average net ingredient cost per prescription item
11.15
11.4
Children under 16
7.61
8.22
Young people 16, 17 or 18 in full time education
10.56
11.19
Elderly people
10.97
11.07
Maternity exemption
8.11
8.19
Medical exemption
16.06
16.28
Income support
11.59
12.05
Working Families' Tax Credit/Working Tax Credit/Family Credit
9.88
10.76
Minimum Income Guarantee/Pension Credit
11.62
12.11
Disabled Person's Tax Credit/Disability working allowance
14.61
15.86
Holders of an HC2 certificate
12.32
12.80
Income based Jobseekers allowance
9.72
10.40
War pension
15.45
15.69
No declaration/declaration not specific
11.50
12.38

  NOTES:

  1.  The analysis of 2003 and 2004 data for non-charged categories is based on a 1 in 20 sample of all exempt prescriptions submitted to the PPA by dispensing doctors as well as chemists and appliance contractors. Contraceptives and items personally administered by prescribing and dispensing doctors are free and are not shown in the table but are included in the totals used to calculate percentages.

  2.  See paragraph 51 for definition of exemption categories.

  3.  Information for Medical and Maternity exemption categories is shown separately. A very small number of items was recorded on "old" forms under the HA exemption category which included both medical and maternity exemption.These have been pro-rated to the Medical and Maternity categories.

Table 4

NUMBER OF PRESCRIPTION ITEMS(1) AND PERCENTAGE OF TOTAL ITEMS DISPENSED BY COMMUNITY PHARMACISTS AND APPLIANCE CONTRACTORS AND DISPENSING DOCTORS, BY CHARGED AND NON-CHARGED CATEGORIES, 2004

ENGLAND


Total 2004
Community
pharmacists
and appliance
contractors
Dispensing
doctors

Number
%
Number
%
Number
%
Number of prescription items (millions):
Charged at point of dispensing
57.8
8.6
53.8
8.6
4.0
8.6
Pre-payment certificates
32.2
4.6
28.5
4.6
3.7
8.0
No charge contraceptives
8.2
1.2
7.6
1.2
0.6
1.2
Exempt prescription items
570.9
85.6
532.6
85.6
38.3
82.1
Of Which:
  Children under 16
35.7
5.3
34.0
5.5
1.7
3.7
  Young people 16, 17 or 18 in full time education
5.4
0.8
5.0
0.8
0.3
0.7
  Elderly people
391.4
58.5
361.5
58.1
29.9
64.1
  Maternity exemption
5.0
0.7
4.7
0.8
0.3
0.6
  Medical exemption
45.1
6.7
42.0
6.7
3.1
6.7
  Income support
54.8
8.2
53.6
8.6
1.2
2.7
  Working Families' Tax Credit/Working Tax Credit
14.7
2.2
14.1
2.3
0.6
1.3
  Minimum Income Guarantee/Pension Credit
0.5
0.1
0.4
0.1
0.0
0.0
  Disabled Person's Tax Credit
0.0
0.0
0.0
0.0
0.0
0.0
  Holders of an HC2 certificate
3.9
0.6
3.8
0.6
0.1
0.3
  Income based Jobseekers allowance
7.3
1.1
7.2
1.2
0.2
0.3
  War pension
0.6
0.1
0.6
0.1
0.0
0.1
  No declaration/declaration not specific
6.4
1.0
5.6
0.9
0.7
1.6
Net ingredient cost (£millions):
Charged at point of dispensing
808.9
10.3
761.9
10.3
47.0
10.3
Pre-payment certificates
479.9
6.1
434.7
5.9
45.3
9.9
No charge contraceptives
62.1
0.8
58.5
0.8
3.6
0.8
Exempt prescription items
6,503.7
82.8
6,144.3
83.0
359.4
79.0
Of Which:
  Children under 16
293.8
3.7
281.1
3.8
12.7
2.8
  Young people 16, 17 or 18 in full time education
59.9
0.8
56.7
0.8
3.2
0.7
  Elderly people
4,334.0
55.2
4,060.0
54.9
274.0
60.2
  Maternity exemption
41.1
0.5
39.1
0.5
2.0
0.4
  Medical exemption
734.7
9.4
699.7
9.5
35.0
7.7
  Income support
660.2
8.4
645.6
8.7
14.7
3.2
  Working Families' Tax Credit/Working Tax Credit
158.7
2.0
152.2
2.1
6.5
1.4
  Minimum Income Guarantee/Pension Credit
5.5
0.1
5.3
0.1
0.2
0.0
  Disabled Person's Tax Credit
0.5
0.0
0.5
0.0
0.0
0.0
  Holders of an HC2 certificate
50.3
0.6
48.6
0.7
1.7
0.4
  Income based Jobseekers allowance
76.0
1.0
74.4
1.0
1.6
0.4
  War pension
10.1
0.1
9.6
0.1
0.5
0.1
  No declaration/declaration not specific
78.8
1.0
71.6
1.0
7.2
1.6
Average net ingredient cost per prescription item (£):
Charged at point of dispensing
14.0
14.2
11.67
Pre-payment certificates
14.9
15.3
12.07
No charge contraceptives
7.6
7.7
6.19
Exempt prescription items
11.4
11.5
9.39
Of Which:
  Children under 16
8.22
8.26
7.38
  Young people 16, 17 or 18 in full time education
11.19
11.26
10.07
  Elderly people
11.07
11.23
9.17
  Maternity exemption
8.19
8.24
7.40
  Medical exemption
16.28
16.66
11.23
  Income support
12.05
12.05
11.76
  Working Families' Tax Credit/Working Tax Credit
10.76
10.77
10.58
  Minimum Income Guarantee/Pension Credit
12.11
12.17
10.59
  Disabled Person's Tax Credit
15.86
15.97
9.19
  Holders of an HC2 certificate
12.80
12.84
11.89
  Income based Jobseekers allowance
10.40
10.39
10.79
  War pension
15.69
15.91
12.52
  No declaration/declaration not specific
12.38
12.71
9.89

  NOTES:

  1.  Personally administered items are excluded from this analysis.

  2.  The analysis of 2004 data for non-charged categories is based on a 1 in 20 sample of all exempt prescriptions submitted to the PPA by community pharmacists and appliance contractors and dispensing doctors.

  3.  See paragraph 51 for definition of exemption categories.

  4.  Information for Medical and Maternity exemption categories is shown separately. A very small number of items was recorded on "old" forms under the HA exemption category which included both medical and maternity exemption. These have been pro-rated to the Medical and Maternity categories.

Table 5

AVERAGE NUMBER OF PRESCRIPTION ITEMS DISPENSED IN THE COMMUNITY PER HEAD OF POPULATION BY BROAD AGE GROUP, 1994-2004




ENGLAND
Year
Children aged 0-15 years
Others aged 16-59/64 years
Elderly people
All ages

Community pharmacists and appliance contractors only(1)
1994
5.0
6.3
20.8
9.5
1995
5.4
6.4
21.8
9.8
1996
5.3
6.1
21.2
10.0
1997
5.3
6.2
22.3
10.3
1998
5.0
6.4
23.2
10.5
1999
4.6
6.3
24.8
10.8
2000
4.4
6.4
26.5
11.2
2001
4.5
6.5
29.6
11.9
  
All dispensed items
2001(a)
4.8
6.9
32.0
11.9
2002(a)
4.6
7.2
34.1
12.4
2003(a)
4.6
7.4
36.2
13.0
2004(a)
4.5
7.8
37.2
13.7

  NOTES :

  1.  The analysis of 1993 to 2001 data for non-charged categories is based on a 1 in 20 sample of all exempt prescriptions submitted to the PPA by community pharmacists and appliance contractors only. Items dispensed by dispensing doctors and personal administration prescriptions are excluded. Data for 2001(a) to 2004(a) also includes prescription items dispensed by dispensing doctors. Items personally administered by prescribing and dispensing doctors are not included in the broad age groups, but are included in the "All ages" group.

  2.  The calculation of the average number of prescriptions per head for children includes prescriptions of persons under 19 in full time education, although the population figure used is for children and young people aged 15 years and under only.

  3.  All no charge contraceptives items have been included under "others aged 16-59/64 years".

  4.  Prior to 20 October 1995 "Elderly people" includes men aged 65 years and over and women aged 60 and over. After this date "Elderly people" includes men and women aged 60 and over. The population figures used from 1993 to 1995 are for men aged 65 years and over and women aged 60 and over.

  5.  Revised ONS mid-year resident population estimates for 1994 to 2003 and mid-year resident projections for 2004, based on the 2001 Census, have been used.

  6.  Prescription items per head for all dispensers from 1994 to 2004 is shown on Table 1.

Table 6

NUMBER, NET INGREDIENT COST (NIC) AND AVERAGE NIC PER PRESCRIPTION ITEM BY CLASS OF PREPARATION, 1994-2004

ENGLAND


Class of preparation

Year
Prescribed and
dispensed
generically(2)
(class 1)
Prescribed
generically,
dispensed and
reimbursed as
proprietary
(3)
(class 2)
Prescribed and
dispensed as
proprietary
(class 3)
Dressings and
appliances
(class 4)
All classes
Number of prescription items (million)
1994
180.3
47.4
214.1
14.3
456.1
1995
198.4
55.7
204.8
14.5
473.3
1996
210.2
60.4
199.6
14.7
484.9
1997
226.6
65.8
192.9
14.9
500.2
1998
237.9
75.7
184.7
14.9
513.2
1999
248.4
90.9
175.4
15.1
529.8
2000
277.6
103.2
155.4
15.5
551.8
2001
297.5
125.1
147.8
16.6
587.0
2002
317.9
138.1
144.0
17.0
617.0
2003
350.1
141.5
140.1
17.9
649.7
2004
385.6
142.3
139.6
18.5
686.1
  
Net ingredient cost (£million)
1994
381.2
804.2
2,016.6
201.7
3,405.2
1995
445.6
996.3
2,025.4
213.3
3,680.6
1996
500.2
1,161.0
2,119.5
226.3
4,007.0
1997
624.1
1,319.9
2,186.7
236.8
4,367.5
1998
685.1
1,547.5
2,221.3
247.5
4,701.5
1999
917.1
1,937.3
2,171.9
264.9
5,291.2
2000
1,143.0
2,167.0
1,990.1
284.5
5,584.6
2001
1,035.4
2,747.6
2,021.4
312.3
6,116.6
2002
1,297.0
3,132.5
2,079.9
337.2
6,846.7
2003
1,694.6
3,325.2
2,119.6
370.6
7,510.1
2004
2,021.8
3,435.2
2,220.6
402.0
8,079.6
  
Average net ingredient cost per prescription item (£)
1994
2.11
16.96
9.42
14.15
7.47
1995
2.25
17.90
9.89
14.72
7.78
1996
2.38
19.21
10.62
15.39
8.26
1997
2.75
20.07
11.34
15.94
8.73
1998
2.88
20.45
12.02
16.58
9.16
1999
3.69
21.32
12.38
17.52
9.99
2000
4.12
20.99
12.80
18.31
10.12
2001
3.48
21.96
13.67
18.83
10.42
2002
4.08
22.69
14.44
19.83
11.10
2003
4.84
23.50
15.13
20.67
11.56
2004
5.24
24.13
15.91
21.67
11.78

  NOTES:

  1.  The data are from the PCA system and cover prescription items dispensed by community pharmacists, appliance contractors, dispensing doctors and items personally administered.

  2.  Prescriptions which were written generically, are available generically and reimbursed at the Drug Tariff or generic price.

  3.  Drug is not available generically.

  4.  Preparation classes are defined in paragraph 46.

  5.  Some drugs were incorrectly allocated to OWC2 in the years 2000 and 2001. As a result figures for 2000 are unreliable for classes 2 and 3; figures for 2001 have been corrected.

Table 7

GENERIC PRESCRIBING AND DISPENSING, 1994-2004: ALL ITEMS EXCLUDING DRESSINGS AND APPLIANCES



ENGLAND
All items excluding dressings and appliances
Year
Prescribed
generically
(class 1 and 2)
Prescribed and
dispensed
generically
(2)
(class 1)
Prescribed
generically,
dispensed and
reimbursed as
proprietary
(3)
(class 2)
Total

Prescription items
Millions
1994
51.5%
40.8%
10.7% 441.8
1995
55.4%
43.2%
12.1% 458.9
1996
57.5%
44.7%
12.9% 470.2
1997
60.3%
46.7%
13.6% 485.3
1998
62.9%
47.7%
15.2% 498.3
1999
65.9%
48.3%
17.7% 514.7
2000
71.0%
51.8%
19.2% 536.3
2001
74.1%
52.2%
21.9% 570.5
2002
76.0%
53.0%
23.0% 600.0
2003
77.8%
55.4%
22.4% 631.8
2004
79.1%
57.8%
21.3% 667.6
  
Net ingredient cost
£ millions
1994
37.0%
11.9%
25.1% 3,203.4
1995
41.6%
12.9%
28.7% 3,467.4
1996
43.9%
13.2%
30.7% 3,780.6
1997
47.1%
15.1%
32.0% 4,130.7
1998
50.1%
15.4%
34.7% 4,454.0
1999
56.8%
18.2%
38.5% 5,026.4
2000
62.5%
21.6%
40.9% 5,300.1
2001
65.2%
17.8%
47.3% 5,804.3
2002
68.0%
19.9%
48.1% 6,509.4
2003
70.3%
23.7%
46.6% 7,139.5
2004
71.1%
26.3%
44.7% 7,677.6

  Notes:

  1.  The data are from the PCA system and cover prescription items dispensed by community pharmacists, appliance contractors, dispensing doctors and items personally administered.

  2.  Prescriptions which were written generically, are available generically and reimbursed at the Drug Tariff or generic price.

  3.  Drug is not available generically.

  4.  Some drugs were incorrectly allocated to "Of Which Class 2" in the years 2000 and 2001. As a result "prescribed generically" figures for 2000 are unreliable; figures for 2001 have been corrected.

Table 8

GENERIC PRESCRIBING AND DISPENSING, BASED ON ITEMS, BY BRITISH NATIONAL FORMULARY CHAPTERS, 2003 AND 2004




ENGLAND
Prescribed generically
Dispensed generically(5)
BNF chapter
2003
2004
20032004

1:Gastro-intestinal system
74.5%
76.3%
42.7%42.7%
2:Cardiovascular system
90.9%
91.8%
61.4%68.4%
3:Respiratory system
71.1%
71.7%
46.0% 46.0%
4:Central nervous system
89.7%
90.1%
71.9%72.5%
5:Infections
95.2%
95.9%
87.3% 88.1%
6:Endocrine system
69.9%
73.4%
57.2% 58.3%
7:Obstetrics, gynaecology, and urinary-tract disorders
37.6%
40.4%
  6.3%6.2%
8:Malignant disease and immunosuppression
83.5%
84.0%
61.8%60.5%
9:Nutrition and blood
54.6%
53.3%
45.5%46.5%
10:Musculoskeletal and joint diseases
78.5%
80.8%
49.3%49.2%
11:Eye
63.0%
64.7%
36.0% 35.2%
12:Ear, nose and oropharynx
51.6%
52.1%
23.8%22.4%
13:Skin
41.5%
43.4%
21.4% 21.9%
14:Immunological products and vaccines
21.9%
19.5%
21.4%18.9%
15:Anaesthesia
50.3%
50.5%
47.5% 47.2%
Other
26.8%
26.2%
26.5%
26.0%
Total (excluding dressings and appliances)
77.8%
79.0%
55.4%
57.7%

  NOTES:

  1.  BNF chapters are based on the British National Formulary (September 2003). See paragraph 41.

2.  The data are from the PCA system and cover all prescription items dispensed by community pharmacists and appliance contractors, dispensing doctors and personal administration.

3.  The table covers BNF chapters 1 to 15 and "others"—see note 4 below. Dressings and appliances are excluded.

4.  The "Other" category covers drugs contained in pseudo British National Formulary chapters used by the Prescription Pricing Authority, eg homeopathic preparations.

5.  Prescriptions which were written generically, are available generically and reimbursed at the Drug Tariff or generic price.

Table 9

NUMBER, NET INGREDIENT COST (NIC) AND AVERAGE NIC PER PRESCRIPTION ITEM BY BRITISH NATIONAL FORMULARY CHAPTERS, 2003 AND 2004



ENGLAND
Prescription items (millions)
Net ingredient cost (£millions)
Average net ingredient cost per prescription item (£)
BNF Chapter
2003
2004
% Change
2003
2004
% Change
Increase
2003
2004
% Change

1:Gastro-intestinal system
48.8
51.1
4.8
636.8
647.7
1.7
10.9
13.05
12.66-3.0
2:Cardiovascular system
179.9
200.6
11.5
2,010.7
2,151.1
7.0
139.8
11.18
10.72-4.1
3:Respiratory system
50.2
50.8
1.2
715.7
772.9
8.0
57.3
14.26
15.22 6.7
4:Central nervous system
117.8
121.9
3.5
1,310.3
1,431.6
9.3
121.3
11.13
11.745.5
5:Infections
42.4
41.5
-2.1
235.2
240.2
2.1
4.9
5.55
5.79 4.3
6:Endocrine system
50.5
54.2
7.4
705.0
772.2
9.6
67.8
13.96
14.25 2.1
7:Obstetrics, gynaecology and urinary-tract disorders
15.5
16.2
4.5
205.2
230.4
12.3
25.2
13.26
14.257.5
8:Malignant disease and immunosuppression
3.8
4.0
4.8
268.4
292.1
8.8
23.7
70.48
73.193.8
9:Nutrition and blood
19.0
21.2
11.5
265.4
294.4
10.9
28.9
13.96
13.89-0.5
10:Musculoskeletal and joint diseases
29.2
29.6
1.5
285.0
305.0
7.0
20.0
9.76
10.295.4
11:Eye
15.1
15.8
5.0
103.7
113.0
9.0
9.3
6.89
7.14 3.7
12:Ear, nose and oropharynx
9.6
9.5
-1.9
56.6
59.0
4.2
2.4
5.87
6.246.2
13:Skin
34.7
35.0
0.8
201.3
210.3
4.5
9.0
5.79
6.00 3.6
14:Immunological products and vaccines
13.1
13.8
5.3
115.4
126.0
9.1
10.6
8.83
9.153.7
15:Anaesthesia
0.8
0.8
1.5
3.2
3.6
12.0
0.4
3.94
4.35 10.3
Other
1.4
1.5
9.1
21.6
28.1
30.3
6.5
15.41
18.40
19.4
Dressings and appliances
17.9
18.5
3.5
370.6
402.0
8.5
31.4
20.67
21.67
4.8
Overall Total
649.7
686.1
5.6
7,510.1
8,079.6
7.6
569.4
11.56
11.78
1.9

  NOTES:

  1.  Therapeutic classes are based on the British National Formulary (September 2003). See paragraph 41.

2.  The data are from the PCA system and cover all prescription items dispensed by community pharmacists and appliance contractors, dispensing doctors, and personal administration.

3.  The "Other" category covers drugs contained in pseudo British National Formulary chapters used by the Prescription Pricing Authority, eg homeopathic preparations.



 
previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2006
Prepared 5 May 2006