How has fundholding in Northern Ireland affected prescribing patterns? A longitudinal study

Area of Science:

• Health Services Research
• Pharmaceutical Policy
• General Practice Management

Background:

• The introduction of fundholding in the UK aimed to give general practices more control over prescribing budgets.
• Understanding the impact of fundholding on prescribing behavior is crucial for healthcare policy.

Purpose of the Study:

• To evaluate changes in general practice prescribing patterns following the implementation of fundholding.
• To determine if fundholding influenced prescribing costs and generic drug utilization.

Main Methods:

• Analysis of prescribing data from Northern Ireland (1989-1996).
• Comparison of fundholding practices (various waves) against non-fundholding practices.
• Key metrics included prescribing costs, items per patient, cost per item, and generic prescribing rates.

Main Results:

• Prescribing costs and frequency increased across all practice groups.
• Fundholding practices exhibited a significantly lower rate of cost increase compared to non-fundholders.
• A notable rise in generic prescribing rates coincided with a decrease in the average cost per prescription item.

Conclusions:

• General practice fundholding was associated with a reduced rate of prescribing cost increase and a significant rise in generic prescribing.
• The impact of fundholding varied, with earlier adopting practices showing different characteristics than later adopters.