Prescribing changes – what drugs are now being prescribed?
While prescribing trends have changed recently, different patterns can be seen across different types of drugs. In this section, we look at the changes across those categories, with a look in detail at some changes in respiratory medicines.
Some notable changes in prescribing patterns are:
• Cardiovascular, Central Nervous System and Endocrine system medicines saw the largest peak in March but have all reduced by May
• Cardiovascular costs have remained relatively high in April and May
• Skin and Infections have seen reductions in prescribing every month since January
Despite reductions in May, the number of prescriptions in the year so far remains above what we would expect to see in most BNF chapters. The promotion of good hand hygiene may have contributed to the reduction in prescribing related to skin and infection, this may also be an indicator of patients using alternatives to conventional primary care for milder illnesses such as using products that are available over the counter.
Changes by BNF Section
- The number of antidepressant items was high in March compared to the typical levels in recent years; but it has fallen back towards typical levels in April and May.
- Costs for antidepressant items have remained high after increasing sharply in April and May.
- The year to date has seen around 4m more antidepressant items prescribed than was typical of the same period in 2016-2019.
- Prescribing of drugs used in diabetes remains high for both items and costs in 2020 compared to previous years though in May prescribing has fallen back to typical levels.
Changes for Respiratory Items
Respiratory items increased sharply in March but have returned to typical levels by May overall. The top BNF presentations showed a large spike in Salbutamol (100mg/dose CFC Free) inhalers in March, at over 0.6M excess items. Fostair (100mcg/dose), Montelukast (10mg) and Centil Modulite (100mcg/dose) remain above expected levels by May, which suggests that while some of the noted changes may be due to patients ensuring they have an up to date inhaler at the beginning of the Covid crisis, this doesn’t account for all of the increased prescribing. More information about respiratory items is available on the Respiratory dashboard in ePACT2.
The Specialist Pharmacy Service (SPS) has issued guidance on some key medicines to monitor during Covid-19. To see how prevalent these are within your organisation we have developed the SPS Drug Monitoring during Covid-19 dashboard which is available in the sandbox area of ePACT2. This dashboard also includes links to advice regarding what support your patients may need during the pandemic.