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  1. Posted
    Categories
    • OpenPrescribing

    Ghost Branded Generics - How to fix it

    Ghost Branded Generics are a relatively new category of cost-saving opportunities, caused by prescribers specifying a manufacturer for a generic product, often resulting in a higher reimbursement price compared to the true generic. We estimate the problem costs the NHS £11.6m a year. We have written about this extensively since our first blog on discovering the issue and developed a Ghost Branded Generics dashboard and measure for every practice and CCG in England.

  2. Posted
    Categories
    • OpenPrescribing

    NHS Price Concession Alerts — A new feature on OpenPrescribing

    Today we launched a new feature on OpenPrescribing: an NHS Price Concession email alerts service. This is in addition to our existing calculator that shows cost impact of price concessions, which can already be viewed on every practice, CCG and All England dashboard. You can read more about price concessions (aka NCSO) in our previous blogs.

    Many users of OpenPrescribing receive our monthly newsletter and our innovative email alert service for practice and CCG prescribing measures. Today we are adding a new NHS Price Concession email alerts service. Once signed up, this alert will pop into your inbox a few hours after a new price concession is announced, which will be approximately once per week, to update you on the impact these costs are predicted to have on your practice/CCG.

  3. Posted
    Categories
    • Policy Insights

    Retracted RCTs and clinical guidelines

    As you know, here at the Bennett Institute we are working on the RetractoBot project to reduce the number of cited retracted papers.

    Citations of retracted RCTs are particularly dangerous because such trials provide strong and unbiased evidence of treatment’s safety and efficacy (hierarchy of evidence). Moreover, results of RCTs are often pooled in systematic reviews and meta-analyses, which are used to synthesise the available evidence on a given subject or to justify clinical guidelines.

  4. Posted
    Categories
    • OpenPrescribing

    QIPP Planning: How To…

    …Identify CCG Cost Savings Opportunities using OpenPrescribing.net

    Every year in the NHS local teams around the country put together “QIPP Plans”. QIPP stands for Quality, Innovation, Productivity and Prevention and is a large scale programme introduced across the NHS to ensure the NHS delivers more for the same funding. We make no comment on the programme itself but we think OpenPrescribing is a useful tool in helping develop “QIPP Plans” and to identify new areas for savings related to medicines spend.

  5. Posted
    Categories
    • Research Integrity

    Trial Reporting at NHS Trusts in England

    Nearly all trials of medicinal products conducted in Europe since 2004 are required to post their results directly onto the EU trials register within one year of completion. Since September, our EU TrialsTracker has monitored all clinical trials in the EU to check whether they are compliant. Recently we produced a specific report on data on trial reporting at UK Universities: the House of Commons Science and Technology Committee is currently using this data to alert Universities and monitor their current reporting performance.

  6. Posted
    Categories
    • OpenPrescribing

    Two new measures on OpenPrescribing — Herbal medicines and Freestyle Libre

    We have recently released two new measures on OpenPrescribing — the prescribing costs of herbal medicines, and the quantity of Freestyle Libre.

    Herbal medicines

    For techie reasons, we’re quite excited about the herbal medicines measure. We don’t like to write measures that require a manually managed list of preparations, as these require a lot of curation, and can quickly become inaccurate if a new drug is released. Therefore for most (if not all) of our measures we use the hierarchical BNF codes provided by the NHS Business Services Authority (you can read more on these here).

  7. Posted
    Categories
    • TrialsTracker

    New Year Updates to the EU TrialsTracker

    Our EU TrialsTracker has been live for 4 months providing data on who is and isn’t meeting EU trial reporting guidelines. The tracker reached a major milestone last week when our data was used by the House of Commons Science and Technology Committee to inform UK Universities of their current reporting performance and remind them of their ethical and legal obligations to report their sponsored trials.

    As some of our regular users may have spotted, we’ve recently make some changes to the EU TrialsTracker. We wanted to take some time to describe these updates and let you know why we made them.

  8. Posted
    Categories
    • OpenPrescribing

    Adventures in time travel with the Drug Tariff

    While investigating the data behind Ghost Branded Generics, we came across something that we didn’t expect. As part of our work in creating the Drug Tariff viewer (once we’d managed to obtain the data), we’ve got an archive of Drug Tariff (DT) prices going back to 2010. We used our DT archive to compare listed reimbursement prices with what was actually being paid for generics, we sometimes found that the price paid wasn’t the one listed in the tariff. Instead, sometimes the price was based on the drug tariff price…from the future. or to be more precise, one month into the future.

  9. Posted
    Categories
    • OpenPrescribing

    Ghost Branded Generics - Positive News!

    Before Christmas we wrote about Ghost Branded Generics, a very nerdy story about a problem we uncovered that costs the NHS………£11.6million a year. Since then we have launched a freely accessible Ghost Branded Generics dashboard on Openprescribing.net for every practice and CCG in the country; and a Ghost Branded Generics measure so practices and CCGs can track their prescribing of Ghost Branded Generics over time.

    We have also had lots of people get in touch about this whole new category of NHS savings. In particular we were contacted by TPP who produce SystmOne, the “electronic health record” (EHR) system used by approximately 40% of GPs in England.

  10. Posted
    Categories
    • Research Integrity

    Science and Technology Select Committee Chair Uses EU TrialsTracker Data in Letters to UK Universities

    Yesterday, we shared an overview of trial reporting performance for all UK Universities on our EU TrialsTracker and FDAAA TrialsTracker. Today, we are pleased to see this data being put to good use.

    Following-up on the October 2018 report on clinical trials transparency, the chair of the House of Commons Science and Technology Committee, Norman Lamb MP, has sent letters to 41 universities with trials registered on the EU Clinical Trials Register (EUCTR).

    The letter reminds each institution of their trial reporting responsibilities under EU and US law. It gives them their current reporting performance, taking current figures directly from our EU TrialsTracker (BMJ paper here). It asks each university to verify that systems are in place to ensure compliance with these requirements, and opens the possibility that continued poor performance could lead to being called in front of the committee in the near future.

  11. Posted
    Categories
    • Research Integrity

    Trial Reporting at UK Universities

    Our EU TrialsTracker has now been live for four months. As of 10 January 2019, we have identified 8,062 trials registered in Europe that are unambiguously due to report results under EU guidelines; a total of 4,323 (53.6%) trials have reported results to the registry. We have also seen some institutions — for example Kings College London — improve their trial reporting performance dramatically and rapidly.

    Our BMJ paper showed that non-commercial sponsors (mostly universities) were substantially worse at reporting results to the registry, when compared with drug companies. The House of Commons Science and Technology emphasised this worrying finding in their October 2018 report on clinical trials transparency:

  12. Posted
    Categories
    • OpenPrescribing

    Ghost Branded Generics: A new dashboard on OpenPrescribing

    Before Christmas we wrote a nerdy story about Ghost Branded Generics, a problem that costs the NHS £11.6m a year due to prescribers selecting specific manufacturer’s products rather than true generics. This is largely avoidable. Today we launch our Ghost Branded Generics dashboard for every practice and CCG in the country. This can be accessed through every dashboard page (example below) and we think it will be useful to help people change prescriptions from Ghost Branded Generics to true generic prescriptions.

  13. Posted
    Categories
    • OpenPrescribing

    Ghost branded generics: Why does the cost of generic atorvastatin vary?

    This a very nerdy story about a problem that costs the NHS £11.6m a year. It shows how one small design choice in the software GPs use can have huge ramifications for how we prescribe, and a huge cost impact on the NHS. More than that, it shows how problems like these can only be spotted, and addressed, by mixed teams like ours — doctors, pharmacists, researchers and software engineers — pooling our different skills to build tools and papers.

  14. Posted
    Categories
    • OpenPrescribing

    Dispensing data shows huge variation in Out of Pocket Expenses

    Each year, we estimate there are up to £5m of Out of Pocket Expenses (OOPE) expenses charged to the NHS, added by dispensing contractors to their invoices. Could some of these expenses be reduced? In 2014/15 NHS Islington CCG wrote to dispensing contractors highlighting such expenses, and from this single intervention achieved a 50% reduction; spread across the country this could amount to a saving of £2.5m.

    We’ve done some initial investigations, but don’t have resources to follow up in detail. This post is to note what we’ve found so far. If you are interested in finding out more, and have access to funding, let us know!

  15. Posted
    Categories
    • OpenPathology

    2018 Round-Up

    In our third full year of existence we produced even more exciting outputs and continued to grow. We welcomed Lydia Berry, back from maternity leave; Dave Evans, Consultant Programmer, who joined the OpenPrescribing technical team; and Brian MacKenna, an Honorary Research Fellow Pharmacist and member of the NHS England Medicines and Diagnostics Policy Unit. We also welcomed Darren Smyth, a UK and European Patent Attorney - our work so far includes our pregabalin papers (here and here), and he has also contributed to our EUCTR work.

  16. Posted
    Categories
    • Research Integrity

    New Lawsuit Against US Government Cites FDAAA Tracker

    Earlier this week, the Media, Freedom & Information Access Clinic at Yale Law School filed a lawsuit against the heads of the Department of Health and Human Services, the NIH, and the FDA over their interpretation and implementation of trial reporting provisions in the FDA Amendments Act of 2007 (FDAAA 2007). The lawsuit was filed on behalf of Charles Seife, a journalist and NYU professor, and Dr. Peter Lurie, President of the Center for Science in the Public Interest.

  17. Posted
    Categories
    • OpenPrescribing

    OpenPrescribing December 2018 Newsletter

    New “do not prescribe” measures on OpenPrescribing.net

    At OpenPrescribing we pride ourselves on developing our tools in response to the needs of our users. Last week NHS England announced a new “Do Not Prescribe” list for consultation. Within an hour we made graphs showing every GP practice’s prescribing of these items. You can drill down to CCG level, and then practice level.

    We hope that this data will be useful for clinicians and CCG pharmacists to identify where there is most room for improvement, or change. Or, to drive discussion about agreement on the guidance.

  18. Posted
    Categories
    • OpenPrescribing

    Price Concessions Calculator — A New Feature on OpenPrescribing

    This week we launched a new feature on OpenPrescribing, an NHS Price Concession calculator. We show the cost impact of price concessions for the whole of England here and the calculator appears on every single practice and CCG dashboard so you can work out the impact locally.

    What are price concessions and what are the broader issues?

    Price concessions are a short term agreement by the NHS to pay more than the already agreed price for a generic medicine because pharmacists are unable to obtain the generic at its usual price. Regular readers of our blog will remember a series of blogs last year (see archive) where we detailed the issues and this led to the development of our magnificent Drug Tariff and Concession Viewer, which shows the prices over time for each individual drug, automatically updated on a daily basis.