SlideShare ist ein Scribd-Unternehmen logo
1 von 25
Downloaden Sie, um offline zu lesen
The NHS’ vision for medicines
optimisation - the role for pharma in
driving adherence
Clare Howard | Deputy Chief Pharmaceutical Officer
NHS Commissioning
Medicines Optimisation
Clare Howard
Deputy Chief Pharmaceutical Officer
ABPI 19th June 2013
Medicines Optimisation
• Where are we now?/ the case for change
• Medicines optimisation
• Your role
NHS | Presentation to [XXXX Company] | [Type Date]3
The NHS, like health systems across the developed world, faces increasing
pressures
Quarter more over 85s by 2015
Diseases of modern lifestyles Rising consumer expectations
The opportunity and challenges of new technologies
Medicines Utilisation in Practice
Medicines still most common therapeutic
intervention and biggest cost after staff, but, for
example:
• -30 to 50% not taken as intended
• - Patients have insufficient supporting
information
• UK Literature suggests 5 to 8% of hospital
admissions due to preventable adverse effects
of medicines
• Medication errors across all sectors and age
groups at unacceptable levels
• Medicines wastage in primary care: £300M pa
with £150M pa avoidable
• NHS Atlas of Variation
• Relatively little effort towards understanding
clinical effectiveness of medicines in real
practice
• The threat of antimicrobial resistance
Annual Cost
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2000/1 2001/2 2002/3 2003/4 2004/5 2005/6 2006/7 2007/8 2008/9 2009/10 2010/11
£Million
Primary Care
Hospital
Items dispensed and dispensing fees received by community pharmacies
England, 1999-00 to 2010-11
450
500
550
600
650
700
750
800
850
900
1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Itemsdispensed/Feesreceived
Prescript ion it emsdispensed (millions)
Dispensing f eesreceived (millions)
Source: NHS Prescription Services of the NHS Business Service
NHS | Presentation to [XXXX Company] | [Type Date]6
Adherence
Avoidable medicines wastage in primary care is estimated to be £150 million per year (this is a
conservative estimate) (1)
Between 30 and 50% of medicines are not taken as recommended (2)
Ten days after starting a new medicine, 30% of patients are already non-adherent – of these 55%
of patients don’t realise they are not taking their medicines correctly, whilst 45% do (2)
Ten days after starting a new medicine, 61% of patients feel they are lacking information (3)
50% of patients report a problem with their medication at 10 days and at four weeks, in 22% of
cases , the problem is still there (3)
Just 16% of patients who are prescribed a new medicines are taking it as prescribed, experiencing
no problems and receiving as much information as they need (3)
NHS | Presentation to [XXXX Company] | [Type Date]7
Safety
Ambulatory care-sensitive conditions (i.e. Actively managed conditions which don’t normally
require hospitalisation) account for 1 in 6 emergency admissions at a cost of £42bn each year (4)
Adverse drug reactions account for 6.5% of hospital admissions and over 70% of these are
avoidable (5)
A study of the Use of Medicines in Care Homes found that 70% of residents were exposed to one
or more medication errors (6)
An estimated 180,000 people living with dementia are treated with antipsychotics each year of
which it has been estimated that less than 36,000 may derive some benefit from them at a cost
of 1,800 additional deaths and 1,620 cerebrovascular events (7)
The General Medical Council’s EQUIP study demonstrates a prescribing error rate of 8.9% in
medication orders in 19 acute hospitals. The study found that errors are associated with all levels
of doctors (8)
526,186 medication incidents were reported to the NPSA between 2005 and 2010. 16% involved
actual patient harm. Delayed or omitted doses (16%) and wrong dose 915%) are the commonest
categories (9)
An estimate of 1.7 million serious prescribing errors in general practice in England in 2010 (10)
NHS | Presentation to [XXXX Company] | [Type Date]8
Financial and
organisational risks
Financial and
organisational risks
Financial and organisational risks
Medicines are the most frequent healthcare intervention and the NHS spends £13.8 billion per
year on medicines (11)
The number of prescribed items is growing at 5.3% annually (12)
In secondary care, about 60% of medicines expenditure is on high cost medicines excluded from
the national Payment by results (PbR) tariff (13)
Care Quality Commission continues to highlight poor medicines management services as
contributory in some cases to failing services (14)
In 2008/09 more than half a million bed days were attributed to adverse events caused by
medicines, costing the NHS £235 million
At least 6% of emergency admissions are caused by medicines (15)
NRLS – Types of incidents
Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
National Reporting and Learning
System (NRLS) in England and Wales
medication incident reports 2005 - 10
Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
NRLS – who is reporting incidents?
11 Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
NRLS – Critical medicines
Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
NRLS – Error category
Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
Body of evidence to show why we need to improve and how.
14
What about adherence?
• Low adherence with prescribed treatments is common.
• In developed countries, adherence to long term therapies
in the general population is around 50% (WHO, 2003)
• In England, less than 50% of patients eligible for treatment
receive optimal therapy …..with low levels of adherence
believed to be a contributory facts (DH, 2007)
• Between half and one third of all medicines prescribed for
LTCs are not taken as intended(Horne et al 2005)
• LTCs with strong evidence of significant levels of non
adherence include asthma, diabetes, HIV/AIDS and
dyslipidaemia (WHO 2003)
NHS | Presentation to [XXXX Company] | [Type Date]15
Medication adherence rates for 7 chronic conditions during
the first year of therapy (Briesacher et al, 2008)
Disease Percentage of patients
achieving adherence
≥80%
Hypertension 72
Hyperthyroidism 68
Type 2 Diabetes 65
Seizure disorders 61
Hypercholesterolaemia 55
Osteoporosis 51
Gout 37
NHS | Presentation to [XXXX Company] | [Type Date]16
WHO - 5 interacting dimensions affecting
adherence.
• Social/ economic factors (Age, gender, inability to pay)
• Health systems/ health care team factors (poor quality of
instructions provided to the patient.
• Therapy –related factors (e.g. adverse effects for medicines,
complexity of regime)
• Patient related factors (e.g. patient disagreement of
necessity)
• Condition-related factors (e.g. dysphagia in Myasthenia
Gravis)
NHS | Presentation to [XXXX Company] | [Type Date]17
18
•Put patients at the heart of everything the NHS does
(“No Decision About Me Without Me”)
•Focus on continuously improving those things that
really matter to patients - the outcome of their
healthcare
•Empower and liberate clinicians to innovate, with the
freedom to focus on improving healthcare services
Specific extracts:
The community pharmacy contract, through payment
for performance, will incentivise and support high
quality and efficient services, including better value in
the use of medicines through better informed and
more involved patients.
Pharmacists working with doctors and other health
professionals, have an important and expanding
role in optimising the use of medicines and in
supporting better health
Medicines optimisation –The Policy Context
Medicines Optimisation
• Will be a focus for NHS England and system
• Aims to deliver much improved quality, value and outcomes from
medicines use
• Could operate at system and patient level: from planning and
policy development to individualisation of care
• Will require a level of patient and public engagement not previously
seen
• Will require a level of inter and intra professional collaboration not
previously seen
• Will require an enhanced, transparent and vfm approach to
partnership working
• Will require an enhanced level of patient centred professionalism
A wonderful harmony arises
from joining together the
seemingly unconnected.
(Heraclitus)
IT is important to delivery
Jeremy Hunt said:
“The NHS cannot be the last
man standing as the rest of the
economy embraces the
technology revolution.
“It is crazy that ambulance
drivers cannot access a full
medical history of someone
they are picking up in an
emergency – and that GPs and
hospitals still struggle to share
digital records.
“Previous attempts to crack
this became a top down project
akin to building an aircraft
carrier. We need to learn those
lessons – and in particular
avoid the pitfalls of a hugely
complex, centrally specified
approach
.
“Only with world class
information systems will the
NHS deliver world class care.”Published 16 January:
2013https://www.wp.dh.gov.uk/publications/files/2
013/01/Review-of-use-of-Information-and-
Technology.pdf
Medicines Optimisation Principles
A strategy might include…
• Patient Engagement
• Improving outcomes
• Value for money
• Partnership with Pharmaceutical Industry
• Medicines pathway
• Safety and assurance
22
Information and technology
The challenges and opportunities
• Mobilising the profession
• DH and NHS England working together
• Infrastructure in NHS England
• Secondary care – Monitor, CQC
• NHS Improving Quality – the NHS Change Model
• Matrix working
• Executive sponsorship
The role of Pharmaceutical Industry
• Recognition that adherence is a major problem
• Recognition of your role in the solutions
• Engage in Medicines Optimisation
• Support awareness raising with prescribers.
• Trials to address adherence
• Accept that the default position of non adherence
is more realistic.
• Collaboration and calibration. Can we work
together and measure?
NHS | Presentation to [XXXX Company] | [Type Date]24
The NHS’ vision for medicines optimisation -  the role for pharma in driving adherence

Weitere ähnliche Inhalte

Was ist angesagt?

Quality use medicine
Quality use medicineQuality use medicine
Quality use medicineFARAZULHODA
 
Medication Adherence in the Real World
Medication Adherence in the Real WorldMedication Adherence in the Real World
Medication Adherence in the Real WorldCognizant
 
Medication Adherence-DBediako
Medication Adherence-DBediakoMedication Adherence-DBediako
Medication Adherence-DBediakodannbetts
 
Electronic Medication Reconciliation - Improving patient safety through e-med...
Electronic Medication Reconciliation - Improving patient safety through e-med...Electronic Medication Reconciliation - Improving patient safety through e-med...
Electronic Medication Reconciliation - Improving patient safety through e-med...Health Informatics New Zealand
 
Workshop 2: Benchmarking solutions showcase
Workshop 2: Benchmarking solutions showcaseWorkshop 2: Benchmarking solutions showcase
Workshop 2: Benchmarking solutions showcaseaaltunalboro
 
The Role of the Pharmacy in Adherence Support
The Role of the Pharmacy in Adherence SupportThe Role of the Pharmacy in Adherence Support
The Role of the Pharmacy in Adherence Supporticapclinical
 
Richard Mendelsohn- Beyond 2010: SMART Living Panel
Richard Mendelsohn- Beyond 2010: SMART Living PanelRichard Mendelsohn- Beyond 2010: SMART Living Panel
Richard Mendelsohn- Beyond 2010: SMART Living Paneleventwithme
 
ECO 11: Medicines Optimisation Through Precision - Sir Munir Pirmohamed
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedECO 11: Medicines Optimisation Through Precision - Sir Munir Pirmohamed
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedInnovation Agency
 
The truth between the lines – Community pharmacists in improving the health o...
The truth between the lines – Community pharmacists in improving the health o...The truth between the lines – Community pharmacists in improving the health o...
The truth between the lines – Community pharmacists in improving the health o...inemet
 
Customized Patient Care through Patient Support Programs for Rare/Orphan Drugs
Customized Patient Care through Patient Support Programs for Rare/Orphan DrugsCustomized Patient Care through Patient Support Programs for Rare/Orphan Drugs
Customized Patient Care through Patient Support Programs for Rare/Orphan DrugsCanadian Organization for Rare Disorders
 
Medication Non Adherence X
Medication Non Adherence XMedication Non Adherence X
Medication Non Adherence XDavid Donohue
 
Mhealth for improved medication adherence
Mhealth for improved medication adherenceMhealth for improved medication adherence
Mhealth for improved medication adherenceRamkumar Kannan
 
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeLeveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeAlex Xiaoguang Zhu
 
Oxford medicines optimisation presentation
Oxford medicines optimisation presentationOxford medicines optimisation presentation
Oxford medicines optimisation presentationRichard Harris
 
Redefining the role of patient support programs: Shifting the focus towards p...
Redefining the role of patient support programs: Shifting the focus towards p...Redefining the role of patient support programs: Shifting the focus towards p...
Redefining the role of patient support programs: Shifting the focus towards p...SKIM
 
HCFOFindingsBriefFeb2014FINAL
HCFOFindingsBriefFeb2014FINALHCFOFindingsBriefFeb2014FINAL
HCFOFindingsBriefFeb2014FINALEmily Blecker
 

Was ist angesagt? (20)

Quality use medicine
Quality use medicineQuality use medicine
Quality use medicine
 
Medication Adherence in the Real World
Medication Adherence in the Real WorldMedication Adherence in the Real World
Medication Adherence in the Real World
 
Medication Adherence-DBediako
Medication Adherence-DBediakoMedication Adherence-DBediako
Medication Adherence-DBediako
 
Electronic Medication Reconciliation - Improving patient safety through e-med...
Electronic Medication Reconciliation - Improving patient safety through e-med...Electronic Medication Reconciliation - Improving patient safety through e-med...
Electronic Medication Reconciliation - Improving patient safety through e-med...
 
Workshop 2: Benchmarking solutions showcase
Workshop 2: Benchmarking solutions showcaseWorkshop 2: Benchmarking solutions showcase
Workshop 2: Benchmarking solutions showcase
 
The Role of the Pharmacy in Adherence Support
The Role of the Pharmacy in Adherence SupportThe Role of the Pharmacy in Adherence Support
The Role of the Pharmacy in Adherence Support
 
Richard Mendelsohn- Beyond 2010: SMART Living Panel
Richard Mendelsohn- Beyond 2010: SMART Living PanelRichard Mendelsohn- Beyond 2010: SMART Living Panel
Richard Mendelsohn- Beyond 2010: SMART Living Panel
 
Hta basic introduction
Hta basic introductionHta basic introduction
Hta basic introduction
 
ECO 11: Medicines Optimisation Through Precision - Sir Munir Pirmohamed
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedECO 11: Medicines Optimisation Through Precision - Sir Munir Pirmohamed
ECO 11: Medicines Optimisation Through Precision - Sir Munir Pirmohamed
 
Medication Adherence TECHNOLOGY Brief update 2016
Medication Adherence TECHNOLOGY Brief update 2016Medication Adherence TECHNOLOGY Brief update 2016
Medication Adherence TECHNOLOGY Brief update 2016
 
The truth between the lines – Community pharmacists in improving the health o...
The truth between the lines – Community pharmacists in improving the health o...The truth between the lines – Community pharmacists in improving the health o...
The truth between the lines – Community pharmacists in improving the health o...
 
Customized Patient Care through Patient Support Programs for Rare/Orphan Drugs
Customized Patient Care through Patient Support Programs for Rare/Orphan DrugsCustomized Patient Care through Patient Support Programs for Rare/Orphan Drugs
Customized Patient Care through Patient Support Programs for Rare/Orphan Drugs
 
Medication Non Adherence X
Medication Non Adherence XMedication Non Adherence X
Medication Non Adherence X
 
Mhealth for improved medication adherence
Mhealth for improved medication adherenceMhealth for improved medication adherence
Mhealth for improved medication adherence
 
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeLeveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
 
Oxford medicines optimisation presentation
Oxford medicines optimisation presentationOxford medicines optimisation presentation
Oxford medicines optimisation presentation
 
adherence
adherenceadherence
adherence
 
Redefining the role of patient support programs: Shifting the focus towards p...
Redefining the role of patient support programs: Shifting the focus towards p...Redefining the role of patient support programs: Shifting the focus towards p...
Redefining the role of patient support programs: Shifting the focus towards p...
 
HCFOFindingsBriefFeb2014FINAL
HCFOFindingsBriefFeb2014FINALHCFOFindingsBriefFeb2014FINAL
HCFOFindingsBriefFeb2014FINAL
 
Ira Klein, Can Value-based Contracting Work for Pharma Companies?
Ira Klein, Can Value-based Contracting Work for Pharma Companies?Ira Klein, Can Value-based Contracting Work for Pharma Companies?
Ira Klein, Can Value-based Contracting Work for Pharma Companies?
 

Andere mochten auch

Innovative Implementation of Shared Medical Decision Making in a Clinic-based...
Innovative Implementation of Shared Medical Decision Making in a Clinic-based...Innovative Implementation of Shared Medical Decision Making in a Clinic-based...
Innovative Implementation of Shared Medical Decision Making in a Clinic-based...Informed Medical Decisions Foundation
 
Smart phones and how they affect our lives
Smart phones and how they affect our livesSmart phones and how they affect our lives
Smart phones and how they affect our livesckap5
 
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...Translational Medicine: Patterns of Response to Antidepressant Treatment and ...
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...Joanne Luciano
 
Palliative Pain Management
Palliative Pain ManagementPalliative Pain Management
Palliative Pain Managementmeducationdotnet
 
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...William Aruga
 
Palliative Symptom Management
Palliative Symptom ManagementPalliative Symptom Management
Palliative Symptom Managementmeducationdotnet
 
Clinical impact of pharmacist presence in icu medical team on mortality rate ...
Clinical impact of pharmacist presence in icu medical team on mortality rate ...Clinical impact of pharmacist presence in icu medical team on mortality rate ...
Clinical impact of pharmacist presence in icu medical team on mortality rate ...M. Luisetto Pharm.D.Spec. Pharmacology
 
Drug Use, Abuse And Misuse 2004
Drug Use, Abuse And Misuse 2004Drug Use, Abuse And Misuse 2004
Drug Use, Abuse And Misuse 2004Patty Melody
 
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare Howard
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare HowardMedicines Optimisation Polypharmacy Prescribing Comparators_Clare Howard
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare HowardHealth Innovation Wessex
 
Demystifying Artificial Intelligence
Demystifying Artificial IntelligenceDemystifying Artificial Intelligence
Demystifying Artificial IntelligenceScopernia
 
Progeria Syndrome
Progeria SyndromeProgeria Syndrome
Progeria Syndromeguest2718ea
 
Clinical Pharmacology in Orphan Drug Development
Clinical Pharmacology in Orphan Drug DevelopmentClinical Pharmacology in Orphan Drug Development
Clinical Pharmacology in Orphan Drug DevelopmentE. Dennis Bashaw
 
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...Innovation Agency
 
Anesthesia and diabetes
Anesthesia and diabetesAnesthesia and diabetes
Anesthesia and diabetesmarwa Mahrous
 

Andere mochten auch (20)

Innovative Implementation of Shared Medical Decision Making in a Clinic-based...
Innovative Implementation of Shared Medical Decision Making in a Clinic-based...Innovative Implementation of Shared Medical Decision Making in a Clinic-based...
Innovative Implementation of Shared Medical Decision Making in a Clinic-based...
 
Takotsubo Cardiomyopathy
Takotsubo CardiomyopathyTakotsubo Cardiomyopathy
Takotsubo Cardiomyopathy
 
Smart phones and how they affect our lives
Smart phones and how they affect our livesSmart phones and how they affect our lives
Smart phones and how they affect our lives
 
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...Translational Medicine: Patterns of Response to Antidepressant Treatment and ...
Translational Medicine: Patterns of Response to Antidepressant Treatment and ...
 
Palliative Pain Management
Palliative Pain ManagementPalliative Pain Management
Palliative Pain Management
 
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...
Takotsubo cardiomyopathy potential differential diagnosis in acute coronary s...
 
Palliative Symptom Management
Palliative Symptom ManagementPalliative Symptom Management
Palliative Symptom Management
 
Clinical impact of pharmacist presence in icu medical team on mortality rate ...
Clinical impact of pharmacist presence in icu medical team on mortality rate ...Clinical impact of pharmacist presence in icu medical team on mortality rate ...
Clinical impact of pharmacist presence in icu medical team on mortality rate ...
 
Cannabis
CannabisCannabis
Cannabis
 
Drug Use, Abuse And Misuse 2004
Drug Use, Abuse And Misuse 2004Drug Use, Abuse And Misuse 2004
Drug Use, Abuse And Misuse 2004
 
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare Howard
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare HowardMedicines Optimisation Polypharmacy Prescribing Comparators_Clare Howard
Medicines Optimisation Polypharmacy Prescribing Comparators_Clare Howard
 
Demystifying Artificial Intelligence
Demystifying Artificial IntelligenceDemystifying Artificial Intelligence
Demystifying Artificial Intelligence
 
Progeria Syndrome
Progeria SyndromeProgeria Syndrome
Progeria Syndrome
 
Equity, Health Quality and Shared Decision Making
Equity, Health Quality and Shared Decision MakingEquity, Health Quality and Shared Decision Making
Equity, Health Quality and Shared Decision Making
 
On Cannabis
On CannabisOn Cannabis
On Cannabis
 
Clinical Pharmacology in Orphan Drug Development
Clinical Pharmacology in Orphan Drug DevelopmentClinical Pharmacology in Orphan Drug Development
Clinical Pharmacology in Orphan Drug Development
 
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...
 
Cost effective healthcare in medical imaging
Cost effective healthcare in medical imagingCost effective healthcare in medical imaging
Cost effective healthcare in medical imaging
 
dr. Pongparade - Pain Management as Part of Palliative Care
dr. Pongparade - Pain Management as Part of Palliative Caredr. Pongparade - Pain Management as Part of Palliative Care
dr. Pongparade - Pain Management as Part of Palliative Care
 
Anesthesia and diabetes
Anesthesia and diabetesAnesthesia and diabetes
Anesthesia and diabetes
 

Ähnlich wie The NHS’ vision for medicines optimisation - the role for pharma in driving adherence

Orphan Drugs – High Prices: Is there a Way Forward?
Orphan Drugs – High Prices: Is there a Way Forward?Orphan Drugs – High Prices: Is there a Way Forward?
Orphan Drugs – High Prices: Is there a Way Forward?Office of Health Economics
 
Tackling wasteful-spending-on-health-highlights-revised OECD
Tackling wasteful-spending-on-health-highlights-revised OECDTackling wasteful-spending-on-health-highlights-revised OECD
Tackling wasteful-spending-on-health-highlights-revised OECDCarlo Favaretti
 
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...Office of Health Economics
 
Deloitte_ES_Sanidad-sanidad-en-europa.pdf
Deloitte_ES_Sanidad-sanidad-en-europa.pdfDeloitte_ES_Sanidad-sanidad-en-europa.pdf
Deloitte_ES_Sanidad-sanidad-en-europa.pdfjanethlopez72
 
The value partnership between NHS, industry and other providers
The value partnership between NHS, industry and other providersThe value partnership between NHS, industry and other providers
The value partnership between NHS, industry and other providersGS1 UK
 
OHE Lecturing for Professional Training at International Centre of Parliament...
OHE Lecturing for Professional Training at International Centre of Parliament...OHE Lecturing for Professional Training at International Centre of Parliament...
OHE Lecturing for Professional Training at International Centre of Parliament...Office of Health Economics
 
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine LecturePeter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lectureuabsom
 
Unlock Your Global Business Potential
Unlock Your Global Business PotentialUnlock Your Global Business Potential
Unlock Your Global Business PotentialEuroBioForum
 
Leveraging Consumer-Facing Technologies to Improve Health Outcomes
Leveraging Consumer-Facing Technologies to Improve Health OutcomesLeveraging Consumer-Facing Technologies to Improve Health Outcomes
Leveraging Consumer-Facing Technologies to Improve Health OutcomesCognizant
 
Laboratory Medicine And Pathology Services
Laboratory Medicine And Pathology ServicesLaboratory Medicine And Pathology Services
Laboratory Medicine And Pathology ServicesDeborah Gastineau
 
Partners’ Care Management Strategy: A 10-Year Journey
Partners’ Care Management Strategy: A 10-Year JourneyPartners’ Care Management Strategy: A 10-Year Journey
Partners’ Care Management Strategy: A 10-Year JourneyHealth Catalyst
 
Iihi us use_of_meds_for_2013
Iihi us use_of_meds_for_2013Iihi us use_of_meds_for_2013
Iihi us use_of_meds_for_2013Georgi Daskalov
 
Gpdpr seminar june 2021
Gpdpr seminar june 2021Gpdpr seminar june 2021
Gpdpr seminar june 2021Azeem Majeed
 
Strategy Report on NHS and Recommendations - Gaspare Mura
Strategy Report on NHS and Recommendations - Gaspare MuraStrategy Report on NHS and Recommendations - Gaspare Mura
Strategy Report on NHS and Recommendations - Gaspare MuraGaspare Mura
 
the extent of the medications error problem
  the extent of the medications error problem  the extent of the medications error problem
the extent of the medications error problemMEEQAT HOSPITAL
 

Ähnlich wie The NHS’ vision for medicines optimisation - the role for pharma in driving adherence (20)

ABPI white paper
ABPI white paperABPI white paper
ABPI white paper
 
Orphan Drugs – High Prices: Is there a Way Forward?
Orphan Drugs – High Prices: Is there a Way Forward?Orphan Drugs – High Prices: Is there a Way Forward?
Orphan Drugs – High Prices: Is there a Way Forward?
 
ABPI big data road map
ABPI big data road mapABPI big data road map
ABPI big data road map
 
Tackling wasteful-spending-on-health-highlights-revised OECD
Tackling wasteful-spending-on-health-highlights-revised OECDTackling wasteful-spending-on-health-highlights-revised OECD
Tackling wasteful-spending-on-health-highlights-revised OECD
 
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...
 
Deloitte_ES_Sanidad-sanidad-en-europa.pdf
Deloitte_ES_Sanidad-sanidad-en-europa.pdfDeloitte_ES_Sanidad-sanidad-en-europa.pdf
Deloitte_ES_Sanidad-sanidad-en-europa.pdf
 
The value partnership between NHS, industry and other providers
The value partnership between NHS, industry and other providersThe value partnership between NHS, industry and other providers
The value partnership between NHS, industry and other providers
 
OHE Lecturing for Professional Training at International Centre of Parliament...
OHE Lecturing for Professional Training at International Centre of Parliament...OHE Lecturing for Professional Training at International Centre of Parliament...
OHE Lecturing for Professional Training at International Centre of Parliament...
 
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine LecturePeter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
 
PROJECT REPORT
PROJECT REPORTPROJECT REPORT
PROJECT REPORT
 
Unlock Your Global Business Potential
Unlock Your Global Business PotentialUnlock Your Global Business Potential
Unlock Your Global Business Potential
 
Leveraging Consumer-Facing Technologies to Improve Health Outcomes
Leveraging Consumer-Facing Technologies to Improve Health OutcomesLeveraging Consumer-Facing Technologies to Improve Health Outcomes
Leveraging Consumer-Facing Technologies to Improve Health Outcomes
 
Tackling Wasteful Spending on Health: Presentation
Tackling Wasteful Spending on Health: PresentationTackling Wasteful Spending on Health: Presentation
Tackling Wasteful Spending on Health: Presentation
 
IPHA Healthcare Facts And Figures 2009
IPHA Healthcare Facts And Figures 2009IPHA Healthcare Facts And Figures 2009
IPHA Healthcare Facts And Figures 2009
 
Laboratory Medicine And Pathology Services
Laboratory Medicine And Pathology ServicesLaboratory Medicine And Pathology Services
Laboratory Medicine And Pathology Services
 
Partners’ Care Management Strategy: A 10-Year Journey
Partners’ Care Management Strategy: A 10-Year JourneyPartners’ Care Management Strategy: A 10-Year Journey
Partners’ Care Management Strategy: A 10-Year Journey
 
Iihi us use_of_meds_for_2013
Iihi us use_of_meds_for_2013Iihi us use_of_meds_for_2013
Iihi us use_of_meds_for_2013
 
Gpdpr seminar june 2021
Gpdpr seminar june 2021Gpdpr seminar june 2021
Gpdpr seminar june 2021
 
Strategy Report on NHS and Recommendations - Gaspare Mura
Strategy Report on NHS and Recommendations - Gaspare MuraStrategy Report on NHS and Recommendations - Gaspare Mura
Strategy Report on NHS and Recommendations - Gaspare Mura
 
the extent of the medications error problem
  the extent of the medications error problem  the extent of the medications error problem
the extent of the medications error problem
 

Mehr von PM Society

Executive's Sleepless NIghts - Can Drugs Help?
Executive's Sleepless NIghts - Can Drugs Help?Executive's Sleepless NIghts - Can Drugs Help?
Executive's Sleepless NIghts - Can Drugs Help?PM Society
 
Industry and the NHS - survey results
Industry and the NHS - survey resultsIndustry and the NHS - survey results
Industry and the NHS - survey resultsPM Society
 
Industry and the NHS - survey results
Industry and the NHS - survey resultsIndustry and the NHS - survey results
Industry and the NHS - survey resultsPM Society
 
Can Promotion and Partnership Coexist?
Can Promotion and Partnership Coexist?Can Promotion and Partnership Coexist?
Can Promotion and Partnership Coexist?PM Society
 
The way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnThe way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnPM Society
 
So what is medicines optimisation
So what is medicines optimisationSo what is medicines optimisation
So what is medicines optimisationPM Society
 
Joint working the 7 step framework
Joint working the 7 step frameworkJoint working the 7 step framework
Joint working the 7 step frameworkPM Society
 
Moving forward with the greater manchester formulary
Moving forward with the greater manchester formularyMoving forward with the greater manchester formulary
Moving forward with the greater manchester formularyPM Society
 
Joint working varied success!
Joint working   varied success!Joint working   varied success!
Joint working varied success!PM Society
 
Engagement within the new system
Engagement within the new systemEngagement within the new system
Engagement within the new systemPM Society
 
Creating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberCreating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberPM Society
 
A vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnA vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnPM Society
 
So what is medicines optimisation
So what is medicines optimisationSo what is medicines optimisation
So what is medicines optimisationPM Society
 
The way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnThe way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnPM Society
 
Joint working the 7 step framework
Joint working the 7 step frameworkJoint working the 7 step framework
Joint working the 7 step frameworkPM Society
 
Moving forward with the greater manchester formulary
Moving forward with the greater manchester formularyMoving forward with the greater manchester formulary
Moving forward with the greater manchester formularyPM Society
 
Joint working varied success!
Joint working   varied success!Joint working   varied success!
Joint working varied success!PM Society
 
Engagement within the new system
Engagement within the new systemEngagement within the new system
Engagement within the new systemPM Society
 
Creating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberCreating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberPM Society
 
A vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnA vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnPM Society
 

Mehr von PM Society (20)

Executive's Sleepless NIghts - Can Drugs Help?
Executive's Sleepless NIghts - Can Drugs Help?Executive's Sleepless NIghts - Can Drugs Help?
Executive's Sleepless NIghts - Can Drugs Help?
 
Industry and the NHS - survey results
Industry and the NHS - survey resultsIndustry and the NHS - survey results
Industry and the NHS - survey results
 
Industry and the NHS - survey results
Industry and the NHS - survey resultsIndustry and the NHS - survey results
Industry and the NHS - survey results
 
Can Promotion and Partnership Coexist?
Can Promotion and Partnership Coexist?Can Promotion and Partnership Coexist?
Can Promotion and Partnership Coexist?
 
The way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnThe way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsn
 
So what is medicines optimisation
So what is medicines optimisationSo what is medicines optimisation
So what is medicines optimisation
 
Joint working the 7 step framework
Joint working the 7 step frameworkJoint working the 7 step framework
Joint working the 7 step framework
 
Moving forward with the greater manchester formulary
Moving forward with the greater manchester formularyMoving forward with the greater manchester formulary
Moving forward with the greater manchester formulary
 
Joint working varied success!
Joint working   varied success!Joint working   varied success!
Joint working varied success!
 
Engagement within the new system
Engagement within the new systemEngagement within the new system
Engagement within the new system
 
Creating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberCreating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humber
 
A vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnA vision for cheshire and mersey clrn
A vision for cheshire and mersey clrn
 
So what is medicines optimisation
So what is medicines optimisationSo what is medicines optimisation
So what is medicines optimisation
 
The way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsnThe way forward for greater manchester academic health science network ahsn
The way forward for greater manchester academic health science network ahsn
 
Joint working the 7 step framework
Joint working the 7 step frameworkJoint working the 7 step framework
Joint working the 7 step framework
 
Moving forward with the greater manchester formulary
Moving forward with the greater manchester formularyMoving forward with the greater manchester formulary
Moving forward with the greater manchester formulary
 
Joint working varied success!
Joint working   varied success!Joint working   varied success!
Joint working varied success!
 
Engagement within the new system
Engagement within the new systemEngagement within the new system
Engagement within the new system
 
Creating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humberCreating successful partnerships in yorkshire and humber
Creating successful partnerships in yorkshire and humber
 
A vision for cheshire and mersey clrn
A vision for cheshire and mersey clrnA vision for cheshire and mersey clrn
A vision for cheshire and mersey clrn
 

Kürzlich hochgeladen

Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdf
Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdfTalent Management research intelligence_13 paradigm shifts_20 March 2024.pdf
Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdfCharles Cotter, PhD
 
Tata Kelola Bisnis perushaan yang bergerak
Tata Kelola Bisnis perushaan yang bergerakTata Kelola Bisnis perushaan yang bergerak
Tata Kelola Bisnis perushaan yang bergerakEditores1
 
Borderless Access - Global B2B Panel book-unlock 2024
Borderless Access - Global B2B Panel book-unlock 2024Borderless Access - Global B2B Panel book-unlock 2024
Borderless Access - Global B2B Panel book-unlock 2024Borderless Access
 
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John Meulemans
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John MeulemansBCE24 | Virtual Brand Ambassadors: Making Brands Personal - John Meulemans
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John MeulemansBBPMedia1
 
Plano de marketing- inglês em formato ppt
Plano de marketing- inglês  em formato pptPlano de marketing- inglês  em formato ppt
Plano de marketing- inglês em formato pptElizangelaSoaresdaCo
 
Mihir Menda - Member of Supervisory Board at RMZ
Mihir Menda - Member of Supervisory Board at RMZMihir Menda - Member of Supervisory Board at RMZ
Mihir Menda - Member of Supervisory Board at RMZKanakChauhan5
 
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdf
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdfAMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdf
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdfJohnCarloValencia4
 
Borderless Access - Global Panel book-unlock 2024
Borderless Access - Global Panel book-unlock 2024Borderless Access - Global Panel book-unlock 2024
Borderless Access - Global Panel book-unlock 2024Borderless Access
 
PDT 89 - $1.4M - Seed - Plantee Innovations.pdf
PDT 89 - $1.4M - Seed - Plantee Innovations.pdfPDT 89 - $1.4M - Seed - Plantee Innovations.pdf
PDT 89 - $1.4M - Seed - Plantee Innovations.pdfHajeJanKamps
 
Lecture_6.pptx English speaking easyb to
Lecture_6.pptx English speaking easyb toLecture_6.pptx English speaking easyb to
Lecture_6.pptx English speaking easyb toumarfarooquejamali32
 
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISING
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISINGUNLEASHING THE POWER OF PROGRAMMATIC ADVERTISING
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISINGlokeshwarmaha
 
Slicing Work on Business Agility Meetup Berlin
Slicing Work on Business Agility Meetup BerlinSlicing Work on Business Agility Meetup Berlin
Slicing Work on Business Agility Meetup BerlinAnton Skornyakov
 
Data skills for Agile Teams- Killing story points
Data skills for Agile Teams- Killing story pointsData skills for Agile Teams- Killing story points
Data skills for Agile Teams- Killing story pointsyasinnathani
 
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for Business
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for BusinessQ2 2024 APCO Geopolitical Radar - The Global Operating Environment for Business
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for BusinessAPCO
 
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...Brian Solis
 
Project Brief & Information Architecture Report
Project Brief & Information Architecture ReportProject Brief & Information Architecture Report
Project Brief & Information Architecture Reportamberjiles31
 
Upgrade Your Banking Experience with Advanced Core Banking Applications
Upgrade Your Banking Experience with Advanced Core Banking ApplicationsUpgrade Your Banking Experience with Advanced Core Banking Applications
Upgrade Your Banking Experience with Advanced Core Banking ApplicationsIntellect Design Arena Ltd
 
NASA CoCEI Scaling Strategy - November 2023
NASA CoCEI Scaling Strategy - November 2023NASA CoCEI Scaling Strategy - November 2023
NASA CoCEI Scaling Strategy - November 2023Steve Rader
 
A flour, rice and Suji company in Jhang.
A flour, rice and Suji company in Jhang.A flour, rice and Suji company in Jhang.
A flour, rice and Suji company in Jhang.mcshagufta46
 

Kürzlich hochgeladen (20)

Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdf
Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdfTalent Management research intelligence_13 paradigm shifts_20 March 2024.pdf
Talent Management research intelligence_13 paradigm shifts_20 March 2024.pdf
 
Tata Kelola Bisnis perushaan yang bergerak
Tata Kelola Bisnis perushaan yang bergerakTata Kelola Bisnis perushaan yang bergerak
Tata Kelola Bisnis perushaan yang bergerak
 
Borderless Access - Global B2B Panel book-unlock 2024
Borderless Access - Global B2B Panel book-unlock 2024Borderless Access - Global B2B Panel book-unlock 2024
Borderless Access - Global B2B Panel book-unlock 2024
 
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John Meulemans
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John MeulemansBCE24 | Virtual Brand Ambassadors: Making Brands Personal - John Meulemans
BCE24 | Virtual Brand Ambassadors: Making Brands Personal - John Meulemans
 
Plano de marketing- inglês em formato ppt
Plano de marketing- inglês  em formato pptPlano de marketing- inglês  em formato ppt
Plano de marketing- inglês em formato ppt
 
Mihir Menda - Member of Supervisory Board at RMZ
Mihir Menda - Member of Supervisory Board at RMZMihir Menda - Member of Supervisory Board at RMZ
Mihir Menda - Member of Supervisory Board at RMZ
 
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdf
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdfAMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdf
AMAZON SELLER VIRTUAL ASSISTANT PRODUCT RESEARCH .pdf
 
Borderless Access - Global Panel book-unlock 2024
Borderless Access - Global Panel book-unlock 2024Borderless Access - Global Panel book-unlock 2024
Borderless Access - Global Panel book-unlock 2024
 
PDT 89 - $1.4M - Seed - Plantee Innovations.pdf
PDT 89 - $1.4M - Seed - Plantee Innovations.pdfPDT 89 - $1.4M - Seed - Plantee Innovations.pdf
PDT 89 - $1.4M - Seed - Plantee Innovations.pdf
 
Lecture_6.pptx English speaking easyb to
Lecture_6.pptx English speaking easyb toLecture_6.pptx English speaking easyb to
Lecture_6.pptx English speaking easyb to
 
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISING
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISINGUNLEASHING THE POWER OF PROGRAMMATIC ADVERTISING
UNLEASHING THE POWER OF PROGRAMMATIC ADVERTISING
 
Investment Opportunity for Thailand's Automotive & EV Industries
Investment Opportunity for Thailand's Automotive & EV IndustriesInvestment Opportunity for Thailand's Automotive & EV Industries
Investment Opportunity for Thailand's Automotive & EV Industries
 
Slicing Work on Business Agility Meetup Berlin
Slicing Work on Business Agility Meetup BerlinSlicing Work on Business Agility Meetup Berlin
Slicing Work on Business Agility Meetup Berlin
 
Data skills for Agile Teams- Killing story points
Data skills for Agile Teams- Killing story pointsData skills for Agile Teams- Killing story points
Data skills for Agile Teams- Killing story points
 
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for Business
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for BusinessQ2 2024 APCO Geopolitical Radar - The Global Operating Environment for Business
Q2 2024 APCO Geopolitical Radar - The Global Operating Environment for Business
 
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...
The End of Business as Usual: Rewire the Way You Work to Succeed in the Consu...
 
Project Brief & Information Architecture Report
Project Brief & Information Architecture ReportProject Brief & Information Architecture Report
Project Brief & Information Architecture Report
 
Upgrade Your Banking Experience with Advanced Core Banking Applications
Upgrade Your Banking Experience with Advanced Core Banking ApplicationsUpgrade Your Banking Experience with Advanced Core Banking Applications
Upgrade Your Banking Experience with Advanced Core Banking Applications
 
NASA CoCEI Scaling Strategy - November 2023
NASA CoCEI Scaling Strategy - November 2023NASA CoCEI Scaling Strategy - November 2023
NASA CoCEI Scaling Strategy - November 2023
 
A flour, rice and Suji company in Jhang.
A flour, rice and Suji company in Jhang.A flour, rice and Suji company in Jhang.
A flour, rice and Suji company in Jhang.
 

The NHS’ vision for medicines optimisation - the role for pharma in driving adherence

  • 1. The NHS’ vision for medicines optimisation - the role for pharma in driving adherence Clare Howard | Deputy Chief Pharmaceutical Officer NHS Commissioning
  • 2. Medicines Optimisation Clare Howard Deputy Chief Pharmaceutical Officer ABPI 19th June 2013
  • 3. Medicines Optimisation • Where are we now?/ the case for change • Medicines optimisation • Your role NHS | Presentation to [XXXX Company] | [Type Date]3
  • 4. The NHS, like health systems across the developed world, faces increasing pressures Quarter more over 85s by 2015 Diseases of modern lifestyles Rising consumer expectations The opportunity and challenges of new technologies
  • 5. Medicines Utilisation in Practice Medicines still most common therapeutic intervention and biggest cost after staff, but, for example: • -30 to 50% not taken as intended • - Patients have insufficient supporting information • UK Literature suggests 5 to 8% of hospital admissions due to preventable adverse effects of medicines • Medication errors across all sectors and age groups at unacceptable levels • Medicines wastage in primary care: £300M pa with £150M pa avoidable • NHS Atlas of Variation • Relatively little effort towards understanding clinical effectiveness of medicines in real practice • The threat of antimicrobial resistance Annual Cost 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 2000/1 2001/2 2002/3 2003/4 2004/5 2005/6 2006/7 2007/8 2008/9 2009/10 2010/11 £Million Primary Care Hospital Items dispensed and dispensing fees received by community pharmacies England, 1999-00 to 2010-11 450 500 550 600 650 700 750 800 850 900 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 Itemsdispensed/Feesreceived Prescript ion it emsdispensed (millions) Dispensing f eesreceived (millions) Source: NHS Prescription Services of the NHS Business Service
  • 6. NHS | Presentation to [XXXX Company] | [Type Date]6 Adherence Avoidable medicines wastage in primary care is estimated to be £150 million per year (this is a conservative estimate) (1) Between 30 and 50% of medicines are not taken as recommended (2) Ten days after starting a new medicine, 30% of patients are already non-adherent – of these 55% of patients don’t realise they are not taking their medicines correctly, whilst 45% do (2) Ten days after starting a new medicine, 61% of patients feel they are lacking information (3) 50% of patients report a problem with their medication at 10 days and at four weeks, in 22% of cases , the problem is still there (3) Just 16% of patients who are prescribed a new medicines are taking it as prescribed, experiencing no problems and receiving as much information as they need (3)
  • 7. NHS | Presentation to [XXXX Company] | [Type Date]7 Safety Ambulatory care-sensitive conditions (i.e. Actively managed conditions which don’t normally require hospitalisation) account for 1 in 6 emergency admissions at a cost of £42bn each year (4) Adverse drug reactions account for 6.5% of hospital admissions and over 70% of these are avoidable (5) A study of the Use of Medicines in Care Homes found that 70% of residents were exposed to one or more medication errors (6) An estimated 180,000 people living with dementia are treated with antipsychotics each year of which it has been estimated that less than 36,000 may derive some benefit from them at a cost of 1,800 additional deaths and 1,620 cerebrovascular events (7) The General Medical Council’s EQUIP study demonstrates a prescribing error rate of 8.9% in medication orders in 19 acute hospitals. The study found that errors are associated with all levels of doctors (8) 526,186 medication incidents were reported to the NPSA between 2005 and 2010. 16% involved actual patient harm. Delayed or omitted doses (16%) and wrong dose 915%) are the commonest categories (9) An estimate of 1.7 million serious prescribing errors in general practice in England in 2010 (10)
  • 8. NHS | Presentation to [XXXX Company] | [Type Date]8 Financial and organisational risks Financial and organisational risks Financial and organisational risks Medicines are the most frequent healthcare intervention and the NHS spends £13.8 billion per year on medicines (11) The number of prescribed items is growing at 5.3% annually (12) In secondary care, about 60% of medicines expenditure is on high cost medicines excluded from the national Payment by results (PbR) tariff (13) Care Quality Commission continues to highlight poor medicines management services as contributory in some cases to failing services (14) In 2008/09 more than half a million bed days were attributed to adverse events caused by medicines, costing the NHS £235 million At least 6% of emergency admissions are caused by medicines (15)
  • 9. NRLS – Types of incidents Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
  • 10. National Reporting and Learning System (NRLS) in England and Wales medication incident reports 2005 - 10 Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
  • 11. NRLS – who is reporting incidents? 11 Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
  • 12. NRLS – Critical medicines Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
  • 13. NRLS – Error category Cousins D, Gerrett D, Warner B. Br J Clin Pharmacol. 2012
  • 14. Body of evidence to show why we need to improve and how. 14
  • 15. What about adherence? • Low adherence with prescribed treatments is common. • In developed countries, adherence to long term therapies in the general population is around 50% (WHO, 2003) • In England, less than 50% of patients eligible for treatment receive optimal therapy …..with low levels of adherence believed to be a contributory facts (DH, 2007) • Between half and one third of all medicines prescribed for LTCs are not taken as intended(Horne et al 2005) • LTCs with strong evidence of significant levels of non adherence include asthma, diabetes, HIV/AIDS and dyslipidaemia (WHO 2003) NHS | Presentation to [XXXX Company] | [Type Date]15
  • 16. Medication adherence rates for 7 chronic conditions during the first year of therapy (Briesacher et al, 2008) Disease Percentage of patients achieving adherence ≥80% Hypertension 72 Hyperthyroidism 68 Type 2 Diabetes 65 Seizure disorders 61 Hypercholesterolaemia 55 Osteoporosis 51 Gout 37 NHS | Presentation to [XXXX Company] | [Type Date]16
  • 17. WHO - 5 interacting dimensions affecting adherence. • Social/ economic factors (Age, gender, inability to pay) • Health systems/ health care team factors (poor quality of instructions provided to the patient. • Therapy –related factors (e.g. adverse effects for medicines, complexity of regime) • Patient related factors (e.g. patient disagreement of necessity) • Condition-related factors (e.g. dysphagia in Myasthenia Gravis) NHS | Presentation to [XXXX Company] | [Type Date]17
  • 18. 18 •Put patients at the heart of everything the NHS does (“No Decision About Me Without Me”) •Focus on continuously improving those things that really matter to patients - the outcome of their healthcare •Empower and liberate clinicians to innovate, with the freedom to focus on improving healthcare services Specific extracts: The community pharmacy contract, through payment for performance, will incentivise and support high quality and efficient services, including better value in the use of medicines through better informed and more involved patients. Pharmacists working with doctors and other health professionals, have an important and expanding role in optimising the use of medicines and in supporting better health Medicines optimisation –The Policy Context
  • 19. Medicines Optimisation • Will be a focus for NHS England and system • Aims to deliver much improved quality, value and outcomes from medicines use • Could operate at system and patient level: from planning and policy development to individualisation of care • Will require a level of patient and public engagement not previously seen • Will require a level of inter and intra professional collaboration not previously seen • Will require an enhanced, transparent and vfm approach to partnership working • Will require an enhanced level of patient centred professionalism A wonderful harmony arises from joining together the seemingly unconnected. (Heraclitus)
  • 20. IT is important to delivery Jeremy Hunt said: “The NHS cannot be the last man standing as the rest of the economy embraces the technology revolution. “It is crazy that ambulance drivers cannot access a full medical history of someone they are picking up in an emergency – and that GPs and hospitals still struggle to share digital records. “Previous attempts to crack this became a top down project akin to building an aircraft carrier. We need to learn those lessons – and in particular avoid the pitfalls of a hugely complex, centrally specified approach . “Only with world class information systems will the NHS deliver world class care.”Published 16 January: 2013https://www.wp.dh.gov.uk/publications/files/2 013/01/Review-of-use-of-Information-and- Technology.pdf
  • 22. A strategy might include… • Patient Engagement • Improving outcomes • Value for money • Partnership with Pharmaceutical Industry • Medicines pathway • Safety and assurance 22 Information and technology
  • 23. The challenges and opportunities • Mobilising the profession • DH and NHS England working together • Infrastructure in NHS England • Secondary care – Monitor, CQC • NHS Improving Quality – the NHS Change Model • Matrix working • Executive sponsorship
  • 24. The role of Pharmaceutical Industry • Recognition that adherence is a major problem • Recognition of your role in the solutions • Engage in Medicines Optimisation • Support awareness raising with prescribers. • Trials to address adherence • Accept that the default position of non adherence is more realistic. • Collaboration and calibration. Can we work together and measure? NHS | Presentation to [XXXX Company] | [Type Date]24

Hinweis der Redaktion

  1. http://php.york.ac.uk/inst/yhec/web/news/documents/Evaluation_of_NHS_Medicines_Waste_Nov_2010.pdfhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/data-briefing-emergency-hospital-admissions-for-ambulatory-care-sensitive-conditions-apr-2012.pdfhttp://www.bmj.com/content/329/7456/15http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS025CHUMS-FinalReportwithappendices.pdfhttp://www.ic.nhs.uk/dementiaaudithttp://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/22188210http://www.gmc-uk.org/about/research/12996.aspOffice of Health Economics Health Statistics and Informationhttp://www.nhsbsa.nhs.uk/PrescriptionServices/Documents/Volume_and_cost_year_to_Mar_2010.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/PbR.pdfhttp://www.cqc.org.uk/sites/default/files/media/documents/20120626_cqc_market_report_issue_1_for_website_final_0.pdfPirmohamed M, James S, Meakin S, Green C, Scott A K, Walley TJ, Farrar K, Park BK, Breckenridge AM. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004;329:15–19.COI/ Department of Health. 2008. Community Pharmacy Use: Quantitative and qualitative research. Market Research Reporthttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescription-cost-analysis-england--2011
  2. http://php.york.ac.uk/inst/yhec/web/news/documents/Evaluation_of_NHS_Medicines_Waste_Nov_2010.pdfhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/data-briefing-emergency-hospital-admissions-for-ambulatory-care-sensitive-conditions-apr-2012.pdfhttp://www.bmj.com/content/329/7456/15http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS025CHUMS-FinalReportwithappendices.pdfhttp://www.ic.nhs.uk/dementiaaudithttp://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/22188210http://www.gmc-uk.org/about/research/12996.aspOffice of Health Economics Health Statistics and Informationhttp://www.nhsbsa.nhs.uk/PrescriptionServices/Documents/Volume_and_cost_year_to_Mar_2010.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/PbR.pdfhttp://www.cqc.org.uk/sites/default/files/media/documents/20120626_cqc_market_report_issue_1_for_website_final_0.pdfPirmohamed M, James S, Meakin S, Green C, Scott A K, Walley TJ, Farrar K, Park BK, Breckenridge AM. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004;329:15–19.COI/ Department of Health. 2008. Community Pharmacy Use: Quantitative and qualitative research. Market Research Reporthttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescription-cost-analysis-england--2011
  3. http://php.york.ac.uk/inst/yhec/web/news/documents/Evaluation_of_NHS_Medicines_Waste_Nov_2010.pdfhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://qualitysafety.bmj.com/content/13/3/172.full.htmlhttp://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/data-briefing-emergency-hospital-admissions-for-ambulatory-care-sensitive-conditions-apr-2012.pdfhttp://www.bmj.com/content/329/7456/15http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS025CHUMS-FinalReportwithappendices.pdfhttp://www.ic.nhs.uk/dementiaaudithttp://www.gmc-uk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/22188210http://www.gmc-uk.org/about/research/12996.aspOffice of Health Economics Health Statistics and Informationhttp://www.nhsbsa.nhs.uk/PrescriptionServices/Documents/Volume_and_cost_year_to_Mar_2010.pdfhttp://www.npc.nhs.uk/local_decision_making/resources/PbR.pdfhttp://www.cqc.org.uk/sites/default/files/media/documents/20120626_cqc_market_report_issue_1_for_website_final_0.pdfPirmohamed M, James S, Meakin S, Green C, Scott A K, Walley TJ, Farrar K, Park BK, Breckenridge AM. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004;329:15–19.COI/ Department of Health. 2008. Community Pharmacy Use: Quantitative and qualitative research. Market Research Reporthttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescription-cost-analysis-england--2011
  4. Over 900million items are dispensed in the community each year Primary care reported error rates vary from <1% to >40% 26% of general practice incidents reported to NRLS are related to medicines. 25% of adverse incidents resulting in litigation claims in general practice in 2000 were a result of medication errors. Over 16 % are dispensing but mostly hospital.
  5. We now have a body of evidence that shows us that placing pharmacist at the right place in the pathway can reduce harmPINCERPharmacist-led interventions can lead to resolution of medication-related problems in 55-93% of patients Educational outreach is a moderately powerful tool for changing professional behaviour. Multifaceted interventions aimed at different barriers to change are more effective than single interventions non-selective non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to those with a history of peptic ulcer without co-prescription of a proton-pump inhibitor; β blockers prescribed to those with a history of asthma; long-term prescription of angiotensin converting enzyme (ACE) inhibitor or loop diuretics to those 75 years or older without assessment of urea and electrolytes in the preceding 15 months. CHUMSThe 256 residents recruited in 55 homes were taking a mean of 8.0 medicines. One hundred and seventy-eight (69.5%) of residents had one or more errors. The mean number per resident was 1.9 errors. The mean potential harm from prescribing, monitoring, administration and dispensing errors was 2.6, 3.7, 2.1 and 2.0 (0=no harm, 10=death), respectively. Contributing factors from the 89 interviews included doctors who were not accessible, did not know the residents and lacked information in homes when prescribing; home staff’s high workload, lack of medicines training and drug round interruptions; lack of team work among home, practice and pharmacy; inefficient ordering systems; inaccurate medicine records and prevalence of verbal communication; and difficult to fill (and check) medication administration systems.Conclusions: That two thirds of residents were exposed to one or more medication errors is of concern. The will to improve exists, but there is a lack of overall responsibility. Action is required from all concerned.PRACTICEPrevalence of prescribing errors was found to be: 12% for all patients 17.8% for patients who had received at least one medication 38% for patients aged 75 yrs & over who had received at least one medication 30.1% for patients who had received 5 or more drugs over the data collection period 47% for patients who had received 10 or more drugs over the data collection period Prevalence of prescriptions with prescribing or monitoring errors was 4.9% (CI 4.4-5.4%) EQUIP Large empirical evaluation of the prevalence and nature of prescribing errors made by FY1 trainees: Pharmacists in 19 participating hospital trusts identified prescribing errors in all newly prescribed inpatient medication orders as part of their routine pharmacy practice. Qualitative exploration of the causes of prescribing errors: In depth 2 part interviews with prescribers who had made errors. First a critical incident debrief on one or more specific errors and then a discussion of education. Errors were grouped according to Reason’s Accident Causation framework. A pictogram methodology was used for in-depth analysis of interacting causes of errors by proxy. Brief telephone interviews with leaders of the undergraduate programmes in which the FY1 trainees had been educated were undertaken to place the interview data into the wider context of the respondent’s basic medical education. A programmatic approach was used whereby the results of the individual studies were compared with one another and drawn into a form which could be easily interpreted and from which recommendations could be made. Findings from the literature suggests: Median error rate: o 7% (2-14%) of medication orders, o 52 (8-227)errors per 100 admissions, o 24 (6-212) errors per 1000 patient days. Most errors are intercepted and reported before they caused harm Errors are commonest with antimicrobials and more common in adults than children Incorrect dosage is the commonest error. Overall, prescribing errors are a common occurrence affecting 7% of orders, 2% of patient days and 50% of hospital admissions
  6. Having now led a regional programme and a national programme I think the starting point has to be a sense of purpose and a clear strategy. I don’t mean a big document I mean some headings under which you work. Driver diagrams help people visualise the goals.I'm not saying these are to totality of the project but they are some of what I feel should be the early markers
  7. Sven-Olof has worked at Jönköping County Council since 1972, holding the post of Chief Finance Officer and Chief Executive Officer for the last 19 years.From 1986-1997, Sven-Olof was the Chairman for the National Investigation on Drugs and Medication Costs and in 1993-94, the National Investigator and Project Director to the Swedish Government to develop the system of tax equalization.In 2000, Sven-Olof was appointed Chairman of Carelink, a national organisation dedicated to homogeneous and integrated IT-infrastructure in healthcare. In 2005 he became a member of SBU – The Swedish Council on Technology Assessment in Health Care. Sven-Olof has a long experience of high-quality workmanship on a managerial level, and is now a senior fellow of the Institute for Healthcare Improvement advising on the concepts concerning management development.Sven-Olof presented at the Nuffield Trust's Annual Health Strategy Summit 2009.