4. COMMISSIONING
4.1.4 What was pharmaceutical expenditure
in each year from 1997-98, by sector (community and secondary
care)? Can the Department provide the number and net ingredient
cost of generic and branded prescription items dispensed in the
community, with the average net ingredient cost per item, for
each year from 1997-98? Could the same information be provided
for each type of dispensing contractor in the community (pharmacists,
appliance contractors and dispensing GPs)? (Q30)
Answer
1. Total NHS net expenditure on medicines
and listed appliances in England in 2007-08 was £10,925 million.
Some £7,651 million of this total relates to prescription
items dispensed in the community and £3,274 million relates
to medicines supplied in a secondary care setting.
2. In 2008-09, the provisional total spent
on medicines and listed appliances was £11,378 million. Of
this, expenditure on prescription items dispensed in the community
was £7,730 million and expenditure on medicines supplied
in a secondary care setting was £3,647 million.
3. Table 30a provides the NHS drugs
bill expenditure figures, broken down by sector, for the financial
years 1997-98 to 2008-09.
4. Table 30b provides a breakdown
of the number, net ingredient cost and average net ingredient
cost per item of prescription items dispensed in the community
for generic and branded prescription items, dressings and appliances
for the financial years 1997-98 to 2008-09.
5. Table 30c provides a breakdown
of the number and net ingredient cost of generic and branded prescription
items dispensed in the community by contractor type for the financial
years 2004-05 to 2008-09. Detailed information on this is only
held for the last 60 months. Figures for complete financial years
have therefore been provided.
Table 30a
PHARMACEUTICAL EXPENDITURE BY SECTOR (1)
|
| |
| | £ million
|
|
| Year (2) | Net expenditure relating to prescriptions
dispensed in the community (3)
| Net expenditure relating to medicines
supplied in a secondary care setting
| Total |
|
| Cash terms |
| |
|
| 1997-98 | 4,085
| 1,088 | 5,173
|
| 1998-99 | 4,339
| 1,211 | 5,550
|
| 1999-2000 | 4,833
| 1,369 | 6,202
|
| Resource terms (from 2000-01)
| |
|
| 2000-01 | 5,158
| 1,530 | 6,688
|
| 2001-02 | 5,707
| 1,740 | 7,447
|
| 2002-03 | 6,342
| 2,013 | 8,355
|
| 2003-04 | 6,960
| 2,311 | 9,271
|
| 2004-05 | 7,370
| 2,595 | 9,965
|
| 2005-06 | 7,215
| 2,764 | 9,979
|
| 2006-07 | 7,577
| 2,969 | 10,545
|
| 2007-08 | 7,651
| 3,274 | 10,925
|
| 2008-09(4) | 7,730
| 3,647 | 11,378
|
|
| Source: |
| NHS Prescription Services (part of the NHS Business Services Authority) and Department of Health Finance Division
|
| Footnotes: |
| 1. Figures are net which include Pharmaceutical Price Regulation Scheme (PPRS) receipt savings.
|
| 2. From 2000-01, figures are in resource terms. Prior to this, figures are in cash terms. Cash expenditure represents the amounts paid between April to March for medicines, and appliances and relate to prescriptions dispensed between March and February. This is due to the delay in prescription processing and payment calculations. Resource expenditure represents the actual cost of the prescriptions for medicines and appliances dispensed in the period April to March.
|
| 3. Prescriptions dispensed in the community do not cover costs for drugs prescribed in hospital but dispensed in the community. These are reflected in the secondary care setting figures.
|
| 4. Figures for 2008-09 are provisional.
|
Table 30b
NUMBER AND NET INGREDIENT COST OF GENERIC (1) AND BRANDED
PRESCRIPTION ITEMS DISPENSED IN THE COMMUNITY
|
| | Prescription items (millions)(2)
| |
| Net ingredient cost (£ million) (3)
| |
| Year | Generic
| Branded | Dressings and
appliances
| Total | Generic
| Branded | Dressings and
appliances
| Total | Average net
ingredient
cost per item
(£)
|
|
| 1997-98 | 230
| 260 | 15
| 505 | 651
| 3,574 | 240 | 4,465
| 8.85 |
| 1998-99 | 240
| 261 | 15
| 516 | 703
| 3,845 | 251 | 4,799
| 9.30 |
| 1999-2000 | 254
| 265 | 15
| 534 | 1,049
| 4,116 | 270 | 5,435
| 10.18 |
| 2000-01 | 284
| 261 | 16
| 561 | 1,077
| 4,283 | 291 | 5,651
| 10.07 |
| 2001-02 | 300
| 275 | 17
| 592 | 1,079
| 4,886 | 316 | 6,281
| 10.61 |
| 2002-03 | 325
| 282 | 17
| 624 | 1,397
| 5,275 | 346 | 7,019
| 11.24 |
| 2003-04 | 359
| 282 | 18
| 659 | 1,799
| 5,488 | 378 | 7,665
| 11.62 |
| 2004-05 | 392
| 281 | 19
| 692 | 2,054
| 5,633 | 407 | 8,094
| 11.70 |
| 2005-06 | 427
| 286 | 20
| 733 | 2,042
| 5,523 | 449 | 8,013
| 10.93 |
| 2006-07 | 465
| 276 | 22
| 763 | 2,296
| 5,470 | 483 | 8,250
| 10.82 |
| 2007-08 | 502
| 278 | 23
| 803 | 2,193
| 5,602 | 508 | 8,304
| 10.34 |
| 2008-09 | 540
| 288 | 24
| 852 | 2,076
| 5,758 | 542 | 8,376
| 9.83 |
|
| Source: |
| Prescription Cost Analysis (PCA) system (4) (5)
|
| Footnotes: |
| 1. Generic dispensing covers drugs that are prescribed and available generically and the dispenser is reimbursed at the drug tariff or generic price. It is possible in some circumstances for a branded drug or parallel import to be dispensed against a generic prescription.
|
| 2. Prescriptions are written on a prescription form. Each single item written on the form is counted as a prescription item.
|
| 3. Net ingredient cost is the basic cost of a medicine. It does not take account of discounts, dispensing costs, fees or prescription charges income.
|
| 4. Prescription information is taken from the PCA system, supplied by NHS Prescription Services (part of the NHS Business Services Authority), and is based on a full analysis of all prescriptions dispensed in the community, ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospitals, including mental health trusts, or private prescriptions. Prescribers are GPs, hospital doctors, dentists and non medical prescribers such as nurses and pharmacists.
|
| 5. Data are extracted from the PCA system on the basis of the preparation class. Generic is class 1 (prescribed by generic name and a generic is available so reimbursed at generic price), branded is class 2 (prescribed by generic name but no generic is available) or 3 (prescribed by branded name) and dressings and appliances are class 4.
|
| 6. Figures may not sum due to rounding.
|
Table 30c
NUMBER AND NET INGREDIENT COST (NIC) OF GENERIC AND BRANDED
PRESCRIPTION ITEMS DISPENSED IN THE COMMUNITY BY CONTRACTOR TYPE
|
| Community pharmacy |
| | Generic
| | Branded
| | Dressings and appliances
| |
| Total |
| |
| |
| |
| |
| |
|
| Year | Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions) |
Average NIC
per item (£) |
| 2004-05 | - |
- | -
| - | -
| - | -
| - | -
| 7,262 | 625
| 11.62 |
| 2005-06 | 1,905
| 393 | 4.85
| 4,979 | 251
| 19.84 | 259
| 16 | 16.58
| 7,143 | 660
| 10.83 |
| 2006-07 | 2,138
| 428 | 5.00
| 4,951 | 244
| 20.31 | 273
| 17 | 15.95
| 7,362 | 688
| 10.69 |
| 2007-08 | 2,040
| 461 | 4.43
| 5,086 | 248
| 20.53 | 281
| 18 | 15.97
| 7,407 | 726
| 10.20 |
| 2008-09 | 1,933
| 496 | 3.89
| 5,239 | 257
| 20.37 | 288
| 18 | 16.12
| 7,460 | 772
| 9.67 |
|
| Appliance contractors |
|
| |
| |
| |
| |
|
| | Generic
| | Branded
| | Dressings and appliances
| |
| Total |
| |
| |
| |
| |
| |
| Year | Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions) |
Average NIC
per item (£) |
|
| 2004-05 | - |
- | -
| - | -
| - | 148
| 2.6 | 56.06
| 148 | 2.6 |
56.06 |
| 2005-06 | - |
- | -
| - | -
| - | 174
| 3.2 | 54.81
| 174 | 3.2 |
54.81 |
| 2006-07 | - |
- | -
| - | -
| - | 194
| 3.6 | 53.59
| 194 | 3.6 |
53.59 |
| 2007-08 | - |
- | -
| - | -
| - | 211
| 4.0 | 52.71
| 211 | 4.0 |
52.71 |
| 2008-09 | - |
- | -
| - | -
| - | 238
| 4.6 | 51.76
| 238 | 4.6 |
51.76 |
|
| Dispensing practices (including by personal administration)
|
| | Generic
| | Branded
| | Dressings and appliances
| |
| Total |
| |
| |
| |
| |
| |
| Year | Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions)
| Average NIC
per item (£)
| Net ingredient
cost (£m)
| Prescription
items (millions) |
Average NIC
per item (£) |
|
| 2004-05 | - |
- | -
| - | -
| - | -
| - | -
| 519 | 51 |
10.26 |
| 2005-06 | 114
| 30 | 3.83
| 390 | 23
| 16.63 | 16
| 1.3 | 12.22
| 519 | 54 |
9.55 |
| 2006-07 | 134
| 33 | 4.03
| 381 | 22
| 17.24 | 16
| 1.4 | 11.55
| 531 | 57 |
9.35 |
| 2007-08 | 129
| 37 | 3.50
| 383 | 22
| 17.78 | 16
| 1.4 | 11.38
| 528 | 60 |
8.81 |
| 2008-09 | 121
| 40 | 3.04
| 385 | 21
| 17.94 | 16
| 1.4 | 11.11
| 522 | 63 |
8.34 |
|
| Source: |
| NHS Prescription Services Information System (part of the NHS Business Services Authority)
|
| Footnotes: |
| 1. Prescriptions are written on a prescription form. Each single item on the form is counted as a prescription item.
|
| 2. The Net Ingredient Cost (NIC) is the basic cost of a drug. This cost does not take account of discounts, dispensing costs, fees or prescription charge income.
|
| 3. Figures are for prescription items dispensed by community pharmacies, appliance contractors and dispensing practices (including items personally administered) in England, for financial years. This includes prescriptions written by GPs in England, and also those written by nurses, dentists, pharmacists and hospital doctors, provided they were dispensed in the community. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data does not cover drugs dispensed in hospital or private prescriptions.
|
| 4. Data showing breakdown by generic/brand is not captured in the systems for appliance contractors.
|
| 5. A practice is considered to be a dispensing practice if any GP in the practice is a dispensing doctor. Data for dispensing practices includes items personally administered to patients as set out in the GMS Statement of Fees and Allowances (SFE) 2005 Paragraph 17.4
|
| 6. Figures exclude prescribing only practices (personal administration only).
|
| 7. Figures exclude Out Of Pocket Expenses (OOPE) from all years to ensure consistency. Figures provided previously for 2004-05, 2005-06 and 2006-07 have included OOPE.
|
| 8. Figures include oxygen.
|
| 9. The categorisation used to distinguish between dispensing practices and prescribing only practices (personal administration only) has been updated. Figures for dispensing practices from 2005-06 onwards have been updated accordingly and thus will differ to previous years. 2004-05 data presented uses the old categorisation because data was no longer available when the table was updated.
|
| 10. Totals in this table differ to table 30b. The reasons for this are detailed in footnotes 6 and 7. Figures may not sum due to rounding.
|
|
