The impact of a general practice group intervention on prescribing costs and patterns

Background- The formation of Primary care groups (PCGs) and trusts (PCTs) has shifted the emphasis from individual practice initiatives to group-based efforts to control rising prescribing costs. However, there is a paucity of literature describing such group initiatives We report the results of a multilevel group initiative, involving input from a pharmaceutical adviser, practice comparison feedback, and peer review meetings. Aim, To determine the impact of a prescribing initiative on the prescribing patterns of a group of general practices, Design of study: A comparative study with non-matched controls. Setting, Nine semi-rural/rural practices forming a commissioning group pilot, later a PCG, in Southern Derbyshire with nine practices as controls. Method: Practice data were collated for overall prescribing and for therapeutic categories, between the years 199711998 and 199811999 and analysed statistically, Prescribing expenditure trends were also collated. Results. Although both groups came well within their prescribing budgets in the study group this was for the-first time in five years. Their rate of increase in expenditure slowed significantly following the initiative compared with that of the comparison group, which continued to rise (median practice net ingredient cost/patient unit (nic/PU) increase. pound0.69 and pound3.80 respectively; P = 0. 03). The study group's nic/PU dropped below, and stayed below, that of the comparison group one month after the start of the initiative. For most therapeutic categories the study group had lower increases in costs and higher increases in percentage of generic items than the camparison group. Quality markers were unaffected. Conclusion: We suggest that practices with diverse prescribing patterns can work together effectively within a PCT locality to control prescribing costs.