Impact on drug spend and income revenue

Introduction

In this area, network members discussed a wide range of benefits from improved reporting and data, including on stock, wastage, drug spend, over-charging and cost of drug alternatives. They also discussed links between these and other benefit areas, such as litigation and safety. Members agreed that cash releasing benefits for consumables (paper) are an easy benefit to identify and realise (if small!)

What peers in the network found

  • Information is king and it deserves adequate resource

    Consider a dedicated role for data reviews and reporting and ensure this in the business case from the start. Do not underestimate the amount of time this will take and the importance of doing it well

  • Record your baseline and review regularly

    Look at the benefits over a longer time period to constantly update and keep track of exported and unexpected benefits

  • Challenge: who is asking for information and why?

    Better in some cases to report by exception rather than produce reports that aren’t read. Make it easy for people to do the thing you would like them to do.

  • Use the functionality of the ePMA system to drive the right behaviours

    If you want to restrict prescribers from prescribing something, make it harder to access using workflows (i.e. steer prescribers towards more cost-effective medicines)

Top tips from the network

  • Reporting on high cost drugs which are commissioned and therefore recharged is likely to be easier using ePMA, however, it is important to be able to differentiate between drugs issued (ward level administration) or dispensed only (inpatient / outpatient)
  • Litigation can have very long lead times. ePMA may be implement now, but litigation may not come for five years and could be resolved in 20 years, depending on complexity
  • Some Trusts don’t have a good enough data set at pre-implementation to be able to understand what the baseline is and therefore are unable to manage the benefits. That poses the quandary of should the staff be paid to help them to get a good dataset to use as a baseline. This is something that will need to be determined differently at individual trusts and may reflect business case and other local requirements
  • Outpatient prescribing cannot be monitored in the same way as inpatient prescribing, so the normal process of auditing doesn’t apply, therefore trusts need to consider how they might follow up pharma outcomes, e.g. monitor the cost effectiveness of prescribing habits on longer term outcomes for example by following up with Community Pharmacists