ArticleBMJ (Clinical research ed.)1993
Effect of fundholding and indicative prescribing schemes on general practitioners' prescribing costs.
Article in BMJ (Clinical research ed.), 1993. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pharmaceutical policies: effects of financial incentives for prescribers.The Cochrane database of systematic reviews · 2015Pooled it
- International experience in controlling pharmaceutical expenditure: influencing patients and providers and regulating industry - a systematic review.Journal of health services research & policy · 2015Pooled it
- An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes.The Cochrane database of systematic reviews · 2011Pooled it
- Perceptions of Generic Drugs in the Pharmacists of Public Hospitals: A Cross-sectional Survey in Hubei Province of China.Current medical science · 2021Article
- Non- medical prescribing in Australasia and the UK: the case of podiatry.Journal of foot and ankle research · 2010Article
- Ethics of evidence based medicine in the primary care setting.Journal of medical ethics · 2004Review
- A qualitative comparative investigation of variation in general practitioners' prescribing patterns.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Article
- A healthy disposition? The use and limitations of the characteristics approach to general practice research.The British journal of general practice : the journal of the Royal College of General Practitioners · 2001Article
- A prescription for improvement? An observational study to identify how general practices vary in their growth in prescribing costs.BMJ (Clinical research ed.) · 2000Article
- Therapeutic substitution and therapeutic conservatism as cost-containment strategies in primary care: a study of fundholders and non-fundholders.The British journal of general practice : the journal of the Royal College of General Practitioners · 1999Article
- A comparison of three methods of setting prescribing budgets, using data derived from defined daily dose analyses of historic patterns of use.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Article
- General practice fundholding: progress to date.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Review
- Controversies in primary care. Setting prescribing budgets in general practice. Effective prescribing at practice level should be identified and rewarded.BMJ (Clinical research ed.) · 1998Article
- Implementing guidelines and innovations in general practice: which interventions are effective?The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Review
- Constraints on antidepressant prescribing and principles of cost-effective antidepressant use. Part 1: Depression and its treatment.PharmacoEconomics · 1997Review
- Prescribing behaviour in general practice: the impact of promoting therapeutically equivalent cheaper medicines.The British journal of general practice : the journal of the Royal College of General Practitioners · 1997Article
- Fundholders' prescribing costs: the first five years.BMJ (Clinical research ed.) · 1996Article
- Research into purchasing health care: time to face the challenge.Journal of epidemiology and community health · 1996Article
- The modernisation of general practice in the UK: 1980 to 1995 and beyond. Part II.Postgraduate medical journal · 1996Review
- Lessons from international experience in controlling pharmaceutical expenditure. II: Influencing doctors.BMJ (Clinical research ed.) · 1996Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare general practitioners' prescribing costs in fundholding and non-fundholding practices before and after implementation of the NHS reforms in April 1991.
designAnalysis of prescribing and cost information (PACT data; levels 2 and 3) over two six month periods in 1991 and 1992.
settingOxford region.
participantsThree dispensing fundholding practices; five non-dispensing fundholding practices; and seven non-dispensing, non-fundholding practices.
main outcome measuresPercentage change in net cost of ingredients, number of items prescribed, average cost per item, and proportion of generic drugs prescribed after NHS reforms.
resultsPrescribing costs increased in all practices in the six months after the reforms. The net costs of ingredients increased among dispensing fundholders by 10.2%, among non-dispensing fundholders by 13.2%, and among non-fundholders by 18.7%. The number of items prescribed also increased in all three groups (by 5.2%, 7.5%, and 6.1% respectively). The increase in average cost per item was 4.8% for dispensing fundholders, 5.3% for non-dispensing fundholders, and 11.9% for non-fundholders. Dispensing fundholders increased the proportion of generic drugs prescribed from 26.9% to 34.5% and non-dispensing fundholders from 44.5% to 48.7%; non-fundholders showed no change (47%). Five of the eight fundholding practices made savings in their drugs budgets at the end of the first year of fundholding (range 2.9-10.7%; the three other practices overspent by up to 3.6%). All non-fundholding practices exceeded their indicative prescribing amounts (range 3.2-20.0%).
conclusionsFundholding has helped to curb increases in prescribing costs, even among dispensing general practitioners, for whom the incentives are different. Indicative prescribing amounts for non-fundholding practices do not seem to have had the same effect.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.