Davey, Nicola Jane; (1996) Generic prescribing in general practice. Masters thesis (M.Phil), UCL (University College London).

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Abstract

The study highlights the need to design new prescribing initiatives to realise remaining savings from generics. This presents a particular challenge: In the absence of demonstrable economic benefits e.g. money released to pay for other treatments, or clinical benefits (for which the evidence is sparse) the advantages of generic prescribing are less easy to promote to GPs already overloaded with information and demands on their time. The generic prescribing rate in General Practice in the UK increased from 41% in 1991 to 47% in 1993. Despite this large variation remains in the generic rate at Regional, Family Health Service Authority (FHSA) and practice levels. In marked contrast to the detailed information on generic prescribing rate, information on actual and potential savings are not routinely available. In this thesis a new measure of generic prescribing performance was developed to identify practices where substantial generic savings could be achieved. In addition the relationship between practice characteristics and generic savings potential was examined in order to identify practice characteristics associated with both high and low generic savings profiles. The generic rate was found to be significantly but only weakly correlated with generic savings potential and six practice characteristics were found to explain 65 % of the variation in generic savings at practice level. Practices with a larger number of partners, a lower generic rate, a higher patient per doctor ratio, a higher proportion of patients over 65, higher prescribing costs and no computer were associated with higher generic savings potential. Total quarterly generic savings potential for 21 products in the FHSA studied were £146,000, suggesting annual savings of £584,000. The ability to measure and monitor generic savings for individual practices on a regular basis and compare with information on practice profiles could enable prescribing advisers to design and target generic prescribing initiatives more accurately, and to reject initiatives that are not cost effective.

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