ArticleBMJ (Clinical research ed.)1996
Fundholders' prescribing costs: the first five years.
Article in BMJ (Clinical research ed.), 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmaceutical policies: effects of financial incentives for prescribers.The Cochrane database of systematic reviews · 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
- Trial
- The impact of physician-level drug budgets on prescribing behavior.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Article
- Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.PharmacoEconomics · 2015Review
- Do existing mechanisms contribute to improvements in care coordination across levels of care in health services networks? Opinions of the health personnel in Colombia and Brazil.BMC health services research · 2015Article
- A review of the differences and similarities between generic drugs and their originator counterparts, including economic benefits associated with usage of generic medicines, using Ireland as a case study.BMC pharmacology & toxicology · 2013Review
- Influence of mandatory generic substitution on pharmaceutical sales patterns: a national study over five years.BMC health services research · 2008Article
- Impacts of cost containment strategies on pharmaceutical expenditures of the National Health Insurance in Taiwan, 1996-2003.PharmacoEconomics · 2006Article
- European healthcare policies for controlling drug expenditure.PharmacoEconomics · 2003Article
- 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
- [Comparison of primary care teams in Barcelona according to management formulas].Atencion primaria · 2000Article
- A prescription for improvement? An observational study to identify how general practices vary in their growth in prescribing costs.BMJ (Clinical research ed.) · 2000Article
- Do GPs working in practice with high or low prescribing costs have different views on prescribing cost issues?The British journal of general practice : the journal of the Royal College of General Practitioners · 2000Article
- New Zealand's independent practitioner associations: a working model of clinical governance in primary care?BMJ (Clinical research ed.) · 1999Review
- 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
- Primary care groups and the right to prescribe.BMJ (Clinical research ed.) · 1998Article
- 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
- Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan.Journal of epidemiology and community health · 1998Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether the first five waves of English fundholding practices have reduced their prescribing costs relative to non-fundholding practices, and the duration of any reduction achieved.
designAnalysis of item and cost data for all general practices in England in the six years from April 1990 to March 1996. The practices of each of the first five waves were identified at the Prescription Pricing Authority.
settingAll general practices in England.
main outcome measuresChanges and rates of change in net ingredient cost per prescribing unit, and changes in number of items per prescribing unit in fundholding practices, before and after fundholding, relative to continuing non-fundholders.
resultsAbsolute prescribing costs increased over the six years, by 66% in the continuing non-fundholders and by 56-59% for fundholders. Successive waves of fundholders showed a similar pattern of change: a small relative reduction in the pre-fundholding year, maximum relative reduction in the first year, and a declining relative reduction in the second and third years. After this, their increases in costs were largely similar to those of non-fundholders. The number of items dispensed remained stable over the six years in all groups.
conclusionsThe real budgets operated by fundholders were associated with a reduction in costs of about 6% relative to continuing non-fundholders, and this saving seemed to be retained during the study. The relative reduction was small compared with the absolute increase seen in all groups and disappeared after the third year of fundholding. It was brought about by lowering the average cost per item rather than by giving fewer items.
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