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Awareness of the cost of psychotropic medication among doctors: a service evaluation

  • Dhananjay Kumar Singh (a1), Shakil Khawaja (a2), Ishaq Pala (a1), Jaleel Khaja (a3), Ray Krishnanu (a1), Heather Walker (a2) and Julian Bustin (a1)...
Abstract
Aims and method

Cost-effective prescribing is an increasingly important aspect of our practice. A service evaluation was carried out to assess the level of awareness and knowledge of different aspects of cost-effective prescribing among doctors working in the North East London Foundation Trust. A semi-structured questionnaire was used to benchmark knowledge against six standards.

Results

The survey was completed by 71% of doctors working in adult or old age psychiatry. A total of 2% of doctors stated that they should always take into consideration the price of the drug when prescribing and only 5% of doctors claimed to know the price of medications they prescribe most frequently.

Clinical implications

Strategies to improve the poor level of knowledge and awareness in this area of clinical practice would be of benefit in making the best use of limited financial resources without any detriment to patient care.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Julian Bustin (julianbustin@gmail.com)
Footnotes
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See commentaries, pp. 367-368 and pp. 369-370, this issue.

Declaration of interest

None.

Footnotes
References
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Awareness of the cost of psychotropic medication among doctors: a service evaluation

  • Dhananjay Kumar Singh (a1), Shakil Khawaja (a2), Ishaq Pala (a1), Jaleel Khaja (a3), Ray Krishnanu (a1), Heather Walker (a2) and Julian Bustin (a1)...
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eLetters

Cost-effective Prescribing

Sara Smith, Consultant Psychiatrist
17 September 2010

Sir,D K Singh et al’s(1) discussion of cost effective prescribing is timely. Very small changes in prescription writing habits can produce significant savings without noticeable change in clinical practice. A clear example isthat of venlafaxine modified release which is produced in both capsule andtablet form. These are bioequivalent but vary widely in cost. It has been calculated that switching from capsule to tablet would save our local healthcare economy approximately £148,000. The only change required of doctors would be to specify tablets on the prescription, so ensuring the more cost-effective preparation is dispensed. The twice daily formulation is cheaper still but would require a greater degree of change and perhaps affect compliance.Fluoxetine provides another example. Fluoxetine 10mg, a dose often used inCAMHS, is not available in tablet form in the UK. Importing a supply can result in a single prescription cost of several hundred pounds. Specifyingfluoxetine syrup ensures the cost remains under £10(2).

Clearly, significant savings are to be had without compromising patient care or clinical autonomy. With regular support from a vigilant chief pharmacist and medicines management committee, the vagaries of the drug tariff could be navigated and the drug budget be spent more cost effectively.

(1)Singh DK, Khawaja S et al Awareness of the cost of psychotropic medication among doctors: a service evaluation. The Psychiatrist 2010; 34:364-6(2)British National Formulary March 2010
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Conflict of interest: None Declared

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