Do doctors in dispensing practices with a financial conflict of interest prescribe more expensive drugs? A cross-sectional analysis of English primary care prescribing data

BMJ Open
Ben GoldacreLiam Smeeth

Abstract

Approximately one in eight practices in primary care in England are 'dispensing practices' with an in-house dispensary providing medication directly to patients. These practices can generate additional income by negotiating lower prices on higher cost drugs, while being reimbursed at a standard rate. They, therefore, have a potential financial conflict of interest around prescribing choices. We aimed to determine whether dispensing practices are more likely to prescribe high-cost options for four commonly prescribed classes of drug where there is no evidence of superiority for high-cost options. A list was generated of drugs with high acquisition costs that were no more clinically effective than those with the lowest acquisition costs, for all four classes of drug examined. Data were obtained prescribing of statins, proton pump inhibitors (PPIs), angiotensin receptor blockers (ARBs) and ACE inhibitors (ACEis). Logistic regression was used to calculate ORs for prescribing high-cost options in dispensing practices, adjusting for Index of Multiple Deprivation score, practice list size and the number of doctors at each practice. English primary care. All general practices in England. Mean cost per dose was calculated separately for...Continue Reading

References

May 8, 1993·BMJ : British Medical Journal·T J Morton-Jones, M A Pringle
Oct 1, 1996·Journal of Clinical Pharmacy and Therapeutics·D L BainesD K Whynes
Apr 1, 1997·Alimentary Pharmacology & Therapeutics·C J HawkeyR F Logan
Dec 1, 1998·Journal of Clinical Pharmacy and Therapeutics·D Baines, D Whynes
Jul 24, 2002·Health Policy and Planning·Birna TrapHans V Hogerzeil
Jul 8, 2005·Health Policy and Planning·Sylvia ParkDennis Ross-Degnan
Oct 10, 2008·The Cochrane Database of Systematic Reviews·Balraj S HeranJames M Wright
Aug 19, 2010·British Journal of Clinical Pharmacology·Martin G Duerden, Dyfrig A Hughes
Dec 21, 2010·BMJ : British Medical Journal·James C MoonAnthony S Wierzbicki
Aug 17, 2011·The Medical Journal of Australia·David LimV Bruce Sunderland
Mar 21, 2012·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Terry McCormackNorma O'Flynn
Jul 5, 2012·Journal of Paediatrics and Child Health·David Isaacs

❮ Previous
Next ❯

Citations

Jun 23, 2020·Family Medicine and Community Health·John Scott Frazer, Glenn Ross Frazer
Apr 5, 2020·BMC Health Services Research·Katherine H HoGillian Leng
Dec 2, 2020·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Mayam Gomez-CanoChristopher E Clark
Nov 19, 2021·Journal of the Royal Society of Medicine·Matias Ortiz De ZarateCarmine Ornaghi
Dec 17, 2021·British Journal of Clinical Pharmacology·Daniel Hill-McManus, Dyfrig A Hughes

❮ Previous
Next ❯

Software Mentioned

NHSBSA
Stata

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

BMJ : British Medical Journal
T J Morton-Jones, M A Pringle
British Medical Journal
M A Wilson
Revue de l'infirmière
A Montloin
© 2022 Meta ULC. All rights reserved