The widely adopted practice of issuing 28 day rather than longer duration prescriptions for people with long-term conditions should be reconsidered, according to a study published in the British Journal of General Practice. Related research shows that considerable savings could be made by the NHS switching to longer prescriptions.
Over a billion NHS prescription items are issued each year by pharmacists in the community, at a cost of over £9 billion. Many of these medications are used for the management of long-term health conditions, such as diabetes or heart disease.
Prescriptions for these medications are issued through the ‘repeat prescribing’ system. This allows patients to request a further supply of medicines without needing to make another appointment with their doctor.
Local guidance by clinical commissioning groups in many parts of the country encourages GPs to issue shorter supplies of these repeat medications, partly to reduce wastage. Prescriptions are typically 28 days in length, but this policy has been questioned.
Longer prescriptions could save GPs’ time, which could in turn be used to increase time spent with patients. Savings to the NHS from lengthening all prescriptions for statin drugs alone (one of the most commonly prescribed medications) were estimated at £62 million per year.
However, Dr Payne also cautions that lengthening prescriptions could have undesirable consequences for pharmacists. “Community pharmacies receive a fee for every prescription they dispense. So simply switching every repeat prescription item from, for example, one month to three months, could result in a large reduction in pharmacy income.
Therefore, although the NHS may save money, it could lead to a loss of pharmacy services.
Changes to policy around the length of repeat prescriptions should also consider how pharmacies are reimbursed.”
