Patients can receive their medicine from the NHS by a variety of routes and the data in this report covers the majority of this prescribing activity. The most common is to receive a prescription from their general practice and have it dispensed by a community pharmacy. However, there are many other ways.
IQVIA collects “issues” from Pharmacy Departments. When analysing primary care prescribing, the number of items is commonly used as a measure of frequency of prescribing and as a proxy for volume. There is no equivalent measure for hospital pharmacy issues, which are described in terms of packs or part packs. Issues will include supply of original packs as ward stock, dispensing for named patients, outpatient clinics and dispensing on discharge. Therefore the data does not include the physical quantity (though this can be deduced by looking at the pack description) and hence no equivalent to the number of Defined Daily Doses.
Not all hospitals contribute data to the HPAI. Some Trusts provided data too late for it to be included in the data used for this report. In such cases, previous data was used to estimate data for those months where data was missing. It excludes military and private hospitals, prisons and schools, but would include private wards within NHS hospitals and Private Hospitals holding an SLA with an NHS site. Outsourced pharmacies servicing chosen hospitals are also sourced and included as a separate site where possible. Homecare and department data are also captured.
IQVIA report coverage as at April 2018 is over 99% for England and approximately 99% for the UK.
The basic measure within the HPAI database is volume, measured in packs. IQVIA then calculates the cost of this volume using the current Drug Tariff (issued by the Department of Health and Social Care) or manufacturers’ price lists. An individual drug may be available in several different pack sizes and pack sizes can vary between medicines. In this report we have used cost since this is a measure which can be added together for different medicines.
The HPAI does not include data on some devices and appliances, for example, products such as nebuliser masks. There is only limited data on dressings. The Prescription Services Division data includes everything which appeared on an “FP10” prescription.
IQVIA releases data on a regular basis. Each IQVIA dataset includes data for 24 months and may include updates to earlier data. The dataset used in this report was last updated with IQVIA data release for September 2020.