Dispensing GPs cheaper by £6+ per patient

By Dr Allan Tennant

Dispensing by GPs saves the NHS in England £6.11 per patient, compared to the total costs of dispensing in a pharmacy, latest analysis of PD1 reports for 2014-15 shows.

Overall, this represents a 3.5% saving to the NHS in England. The saving rises to 8.2% or £11.12 per patient, when fees and PA items are excluded, exclusive DDA analysis reveals. During 2014-15 dispensing GPs cost the NHS £125.16 per patient in terms of the cost of drugs supplied for dispensing, compared with the equivalent pharmacy cost of £136.28.

The report shows that during 2014-15 and compared to dispensing practice, pharmacies received fewer fees associated with the dispensing service (£37.66 per patient vs dispensing GPs’ £43.32) This reflects the movement of pharmacy remuneration towards pharmaceutical care services such as the New Medicines Service and Medicines Use Reviews. Pharmacy income for these services is not documented in the PD1, but should be considered when calculating the overall cost to the NHS of providing pharmacy services and when comparing to the total cost to the NHS of the GP dispensing service (which has no NMS or MUR equivalent service). Information on pharmacy service funding and statistics on the delivery of the NMS and MUR service are available from PSNC by clicking here.

Commenting, DDA chief executive Matthew Isom says: “These figures demonstrate that dispensing by GPs continues to offer the NHS excellent value for money, while ticking the box of patient-centred care.  We would urge the NHS to do all it can to allow dispensing GPs to continue to maximise dispensing efficiencies, for example, by fast-tracking our inclusion in the Electronic Prescription Service and by resolving long-standing challenges in the remuneration of the dispensing GP service.”

Notes and references

Per patient figures are as follows:

Dispensing patients: 3.25 million

Pharmacy patients: 53.504 million

Source:  NHS BSA quarterly patient list size

Click on the links below for PD1 reports (including April 15)
Dispensing practice items
Pharmacy items
Appliance contractor items

For more recent information on dispensing doctor pay, please visit our library of  NHS Statistical Reports

Explanation of terms 

The number of items refers to each item prescribed – there may be more than one item on each prescription.

The Net ingredient cost (NIC) refers to the cost (as defined in the Drug Tariff) of the drug before discounts and does not include any dispensing costs or fees.

The discount abatement (clawback) rate as a percentage of the NIC is the amount that is recouped by the Government to compensate for drug discounts.

The fee per item is the average fee provided by the Government to pharmacy, dispensary and appliance contractors for each item dispensed.

The clawback is deducted from the NIC, and the new total is added to the fee per item in order to calculate the cost to the NHS per item.

Taking away Personally Administered (PA) items: To compare dispensing practice dispensing figures with those in pharmacy, it is necessary to remove the PA items from dispensing practice data.