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Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates

David Cohen, M. Fasihul Alam, Frank D.J. Dunstan, Susan Myles, Dyfrig A. Hughes, Philip A. Routledge, Fasihul Alam

Value in Health, Volume: 13, Issue: 5, Pages: 675 - 680

Swansea University Author: Fasihul Alam

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DOI (Published version): 10.1111/j.1524-4733.2010.00717.x

Abstract

OBJECTIVE: To assess effects of abolition of prescription copayments in Wales on rates of dispensing.METHODS: General practice-level monthly dispensing data were compared before/after abolition between Wales and North East (NE) England where the charge was retained. Data for 14 medicines that had mo...

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Published in: Value in Health
Published: 2010
URI: https://cronfa.swan.ac.uk/Record/cronfa20833
first_indexed 2015-04-22T02:08:23Z
last_indexed 2018-02-09T04:57:47Z
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spelling 2015-04-21T17:37:17.5795777 v2 20833 2015-04-21 Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates 642c9290a11352cb60741fc2b1004f6d Fasihul Alam Fasihul Alam true false 2015-04-21 OBJECTIVE: To assess effects of abolition of prescription copayments in Wales on rates of dispensing.METHODS: General practice-level monthly dispensing data were compared before/after abolition between Wales and North East (NE) England where the charge was retained. Data for 14 medicines that had most items dispensed subject to charge before abolition were similarly compared with NE England. For those with over-the-counter substitutes, wholesale sales to pharmacies were examined. A survey examined local initiatives, which might differentially affect dispensing between the two areas.RESULTS: Total dispensing rates (items/1000 patients) increased significantly in both areas but significantly less so in Wales (difference = -19.7, P = 0.024, 95% confidence interval [CI] = -36.7 to -2.6). For the 14 selected medicines, combined dispensing rates increased significantly in both areas but significantly more in Wales (difference = 27.51, P &#60; 0.0001, 95% CI = 23.66-31.35). There was much variation for individual drugs, but categories tended to show this same trend except for antibiotics, where rates increased in Wales but decreased in NE England. The survey revealed few local initiatives that could explain these differences. Sales of over-the-counter substitutes did not explain the changes in dispensing.CONCLUSIONS: The Welsh policy was associated with a modest increase in dispensing rates relative to NE England for the 14 medicines with the highest number of items dispensed subject to charge before abolition. Although factors besides the copayment may have influenced these observations, the smaller relative increase in total dispensing rates in Wales suggests that the overall impact of abolition was minimal. Journal Article Value in Health 13 5 675 680 31 8 2010 2010-08-31 10.1111/j.1524-4733.2010.00717.x COLLEGE NANME COLLEGE CODE Swansea University 2015-04-21T17:37:17.5795777 2015-04-21T17:33:31.5881725 Faculty of Medicine, Health and Life Sciences School of Health and Social Care David Cohen 1 M. Fasihul Alam 2 Frank D.J. Dunstan 3 Susan Myles 4 Dyfrig A. Hughes 5 Philip A. Routledge 6 Fasihul Alam 7
title Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
spellingShingle Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
Fasihul Alam
title_short Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
title_full Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
title_fullStr Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
title_full_unstemmed Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
title_sort Abolition of Prescription Copayments in Wales: An Observational Study on Dispensing Rates
author_id_str_mv 642c9290a11352cb60741fc2b1004f6d
author_id_fullname_str_mv 642c9290a11352cb60741fc2b1004f6d_***_Fasihul Alam
author Fasihul Alam
author2 David Cohen
M. Fasihul Alam
Frank D.J. Dunstan
Susan Myles
Dyfrig A. Hughes
Philip A. Routledge
Fasihul Alam
format Journal article
container_title Value in Health
container_volume 13
container_issue 5
container_start_page 675
publishDate 2010
institution Swansea University
doi_str_mv 10.1111/j.1524-4733.2010.00717.x
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
document_store_str 0
active_str 0
description OBJECTIVE: To assess effects of abolition of prescription copayments in Wales on rates of dispensing.METHODS: General practice-level monthly dispensing data were compared before/after abolition between Wales and North East (NE) England where the charge was retained. Data for 14 medicines that had most items dispensed subject to charge before abolition were similarly compared with NE England. For those with over-the-counter substitutes, wholesale sales to pharmacies were examined. A survey examined local initiatives, which might differentially affect dispensing between the two areas.RESULTS: Total dispensing rates (items/1000 patients) increased significantly in both areas but significantly less so in Wales (difference = -19.7, P = 0.024, 95% confidence interval [CI] = -36.7 to -2.6). For the 14 selected medicines, combined dispensing rates increased significantly in both areas but significantly more in Wales (difference = 27.51, P &#60; 0.0001, 95% CI = 23.66-31.35). There was much variation for individual drugs, but categories tended to show this same trend except for antibiotics, where rates increased in Wales but decreased in NE England. The survey revealed few local initiatives that could explain these differences. Sales of over-the-counter substitutes did not explain the changes in dispensing.CONCLUSIONS: The Welsh policy was associated with a modest increase in dispensing rates relative to NE England for the 14 medicines with the highest number of items dispensed subject to charge before abolition. Although factors besides the copayment may have influenced these observations, the smaller relative increase in total dispensing rates in Wales suggests that the overall impact of abolition was minimal.
published_date 2010-08-31T04:55:19Z
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score 11.096913

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