Important things you need to know.
- Almost half of all adults take prescription medication. The most commonly prescribed items are for cholesterol, blood pressure and pain management.
- Just ten medications make up 24% of all prescribed items but it’s a very long tail – there are over 125k prescription items available on the NHS. We estimate that 85% of these are dispensed for managing chronic disease, defined as any disease lasting three months or more (e.g. asthma).
- There are over 1.25bn items prescribed in the UK each year. Adults over 60 account for 60% by volume, almost 50 items each. Adults between the ages of 20 to 59 are prescribed 12 items each and children & teenagers just four.
Doctors typically write prescriptions that cover two to three months of treatment; this enables them to monitor the patient’s condition and reduce waste (estimated to cost the NHS £300m pa). Repeat prescript requests are typically initiated by the patient, carer or pharmacy.
- Prescription items cost the patient £8.60 each. This is money paid by the patient to the pharmacy and passed back to the NHS. The £8.60 charge bears no relation to the actual cost of the medication.
- In reality, 90% of prescriptions are issued free of charge. Patients aged 60 or over are exempt from payment, as are a number of different cohorts including pregnant women and the unemployed. That said, prescription fraud costs the NHS an estimated £237m each year.
- Pharmacies purchase medication from wholesalers and are reimbursed by the NHS; the amount reimbursed is set by an NHS document called the Drug Tariff and varies widely. Pharmacies generate part of their profit by purchasing items at a lower price than the Drug Tariff rate.
- Electronic prescribing enables GPs to send prescriptions electronically to a patient’s ‘nominated’ pharmacy, eliminating paperwork and ideally reducing admin for the patient, doctor and pharmacist. 76% of GP practices are technically capable of issue electronic prescriptions but less than half of these sites use the functionality. By volume, only 35% of prescriptions are processed electronically.
- Most repeat prescriptions are still managed manually – typically the patient faxes or emails their GP who issues a paper prescription for collection. The patient then takes this to their pharmacy and picks up their medication in-person. This is an admin-heavy, opaque process full of break-points, including:
- The patient waits until the last minute to request a repeat prescription, placing stress across the entire system
- The GP asks to see the patient before prescribing but this request is not relayed back to the patient
- Important paperwork is mislaid
- Manual workflows are disrupted due to high staff turnover
- The GP surgery / pharmacy is not open at convenient times
- Overworked GPs and surgery staff lose track of requests
- The pharmacy does not have enough medication in stock
- The patient does not have the time to visit the GP surgery / pharmacy in-person
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