Alterations in prescribing by general practitioner fundholders: an observational study

Area of Science:

• Health economics
• Pharmaceutical policy
• General practice management

Background:

• General practice fundholding was introduced to give primary care practices more control over their prescribing budgets.
• Understanding the impact of fundholding on prescribing behavior is crucial for healthcare policy and resource allocation.

Purpose of the Study:

• To evaluate the effect of general practice fundholding on prescribing patterns.
• To compare prescribing costs, volume, and generic prescribing rates before and after practices became fundholders.

Main Methods:

• Analysis of prescribing data (PACT) for fundholding and non-fundholding general practices.
• Data collected one year before and one year after practices became fundholders (first, second, or third wave).
• Comparison of prescribing costs (net ingredient cost per unit), volume (items per 1000 units), cost per item, and generic prescribing percentage.

Main Results:

• Prescribing costs and volume increased across all practice groups.
• Fundholding practices demonstrated a significantly lower rate of increase in prescribing costs compared to non-fundholders.
• Cost per item and prescribing volume tended to decrease in fundholding practices, likely due to increased generic prescribing.

Conclusions:

• General practice fundholding demonstrably altered prescribing patterns.
• Fundholding led to increased generic prescribing and a reduced rate of prescribing cost escalation.
• These findings highlight the financial and prescribing efficiency impacts of fundholding in primary care.