Use of NICE-appraised Medicines in the NHS in England - 2012, Experimental statistics
Please note: on 7 February 2014 updated versions of the pdf report and the Excel spreadsheet were uploaded to correct under-reporting of the use of medicines in certain medicine groups. National figures have been revised as follows:
- Alzheimer’s Disease by five per cent, - ADHD by six per cent, - Alitretinoin by four per cent, - Riluzole by one per cent, - Exenatide and Liraglutide by less than one per cent.
Within these medicine groups, some sub national data is affected more than others. All other elements of the report are unaffected. This was as a result of complications arising from the extraction of data relating to prescriptions issued in hospital and dispensed in the community.
The National Institute for Health and Care Excellence (NICE) technology appraisal process assesses the clinical and cost effectiveness of new and existing drugs and treatments, and provides guidance on their use by the NHS. As part of the Pharmaceutical Price Regulation Scheme (PPRS) agreement which came into operation on 1 January 2009, the Department of Health (DH) and the Association of the British Pharmaceutical Industry agreed that the DH would review the variation in uptake of selected medicines in the NHS in England.
The Health and Social Care Information Centre was commissioned to work with NICE, DH and the Pharmaceutical Industry to produce and publish a report looking at variation in the use of these medicines in relation to the number of eligible patients as estimated by NICE. Data on the number of patients being treated is not available and so estimated predicted use (using the estimated number of patients and the amount of medicine they would be expected to receive) was compared with observed use where possible. Data on observed use was taken from the primary care prescribing data provided by NHS Prescribing Services and secondary care data was provided by IMS Health. Several pharmaceutical companies also provided their own data.
This report contains a new approach to measure variation in usage of medicines. The variation approach is used to compare changes over time and between organisations and has been adopted to enable a wider range of medicines to be included in the report. It enables those medicines where significant uncertainty remains in establishing an estimate of eligible patient population and/or estimate of usage to be included.
Both methods report use of medicines under the new NHS structure. The report is factual and does not seek to find reasons for variation in prescribing.
NHS medicine use for 54 medicines in 28 therapy groups, relating to 47 technology appraisals are included. For 10 groups the estimate approach is used and the variation approach is used for 18 groups.
Have your say: This is an experimental publication and is the fourth of a planned annual series. We invite feedback to help inform how best to estimate uptake to allow meaningful interpretation of any variation across NHS organisations in future. Please give feedback using the form below.
- The report covers 54 medicines and 47 Technology Appraisals grouped into 28 therapy groups.
- For 10 groups an estimate approach was used which compares expected and observed use.
- For 2 groups use was higher than expected, for 4 groups use was lower than expected and use was close to expected for 3 groups.
- For one drug group it was not possible to calculate a ratio of expected and observed use.
- For all 10 groups, use of these medicines in the NHS has increased over the last few years.
- For 18 groups a new variation approach is used to compare changes over time and between organisations.
- The report asks for feedback on ways of improving the methodology used in this experimental statistic.