Prescribing costs in dispensing practices.

OBJECTIVE To examine differences in prescribing between dispensing and non-dispensing practices. SETTING The 108 practices covered by Lincolnshire Family Health Services Authority. DESIGN Analysis of prescribing data for 1990-1 from PD2 reports from the Prescription Pricing Authority in relation to data on practice characteristics obtained from Lincolnshire Family Health Services Authority; and aggregated level 3 prescribing and cost information (PACT data) for 10 selected drugs from the Prescription Pricing Authority to examine amounts prescribed. MAIN OUTCOME MEASURES Prescribing cost per patient, items per patient, and cost per item in dispensing and non-dispensing practices. RESULTS Dispensing practices had higher prescribing costs per patient than non-dispensing practices. This difference held for non-dispensing patients within dispensing practices. Structural features failed to explain the differences in prescribing cost, except for the higher numbers of elderly patients in dispensing practices (which explained 13% of the difference) and the number of partners (5%). The main determinant of the difference was the lower use of generic drugs in dispensing practices (84%). Dispensing patients were prescribed lower quantities of drugs on average for each item. CONCLUSIONS Dispensing practices could reduce their prescribing expenditure to that of non-dispensing practices by increasing their prescribing of generic drugs. The shorter prescribing intervals for dispensing patients may be due to dispensing fees being related to the number of prescribed items.