Work previously undertaken by the prescription pricing division of the National Health Service Business Service Authority has shown that quantities prescribed already match that of an available pack size in the majority of cases. For example, sample statistics show that drugs available in a pack size of 28 are prescribed in multiples of 28 nearly 78 per cent of the time. Further, it is unlikely that standard packs sizes would always represent the best or most clinically appropriate quantity for every patient. We are therefore not convinced that further encouragement for prescribers to prescribe in line with patient pack sizes will significantly increase the dispensing of patient packs.
However, we are fully supportive of increasing the use of patient packs and new services provided as part of the new community pharmacy contractual framework—such as repeat dispensing and medicines use review—are giving community pharmacists and general practitioners new opportunities to work together. These two services may give rise to the opportunity to consider the optimum quantities in which medicines should be prescribed for an individual patient, taking into account, amongst other things, the ability to dispense using a patient pack.
Further, at the end of 2005, we consulted on proposals to simplify the reimbursement arrangements for NHS dispensing contractors. These included measures designed to further promote patient pack dispensing, such as allowing pharmacists a limited dispensing discretion with regard to the quantity prescribed to be able to dispense a full patient pack on more occasions. We are currently considering how we take this forward in light of responses.