4 CURRENT ISSUES

How useful are PACT data in UK general practice?

The usefulness of PACT (prescribing analyses and cost) data in the UK would be improved through the use of a unique patient identifier and diagnostic data on the prescription, comment UK-based investigators.

PACT data are derived from prescriptions dispensed and have traditionally been used by health authorities to set and monitor general practice budgets. However, PACT data are now increasingly being used for investigating variations and trends in prescribing costs, developing drug formularies, and improving methods for funding high-cost medicines.

Another relatively new use of PACT data is in the development of indicators of prescribing quality; examples of such markers are the ratio of inhaled corticosteroids to inhaled bronchodilators.

limitations of PACT data ... Although PACT data have several uses, they are

not without important limitations which include the following. • Only a limited amount of information is provided, primarily on

what drugs are prescribed and how much they cost. • Data cannot be linked to an individual patient's demographic

and/or clinical data. • There are no data on private prescriptions, hospital-based

preSCriptions or on prescriptions that are not subsequently dispensed.

• There is no accurate measure of the amount of drug prescribed.

· .. and how they can be improved Linking patients to their PACT data through the

inclusion of a unique patient identifier on prescriptions would enable age- and sex-specific prescribing rates to be calculated and users of high-cost drugs to be identified. This in turn could lead to the more accurate forecasting of prescribing budgets, note the investigators.

Furthermore, including diagnostic data on each prescription would enable prescribing for specific conditions to be analysed; this is particularly important for drugs that are used for more than one indication, they add.

Although both of these initiatives could reduce prescription fraud and generate cost savings, the investigators point out that lack of computerisation among all UK physicians and the issue of patient confidentiality mean that neither of these options are currently feasible. Majeed A, Evans N, Head P. What can PACT tell us about prescribing in general practice? British Medical Joumal315: 1515-1519,6 Dec 1997 '00",'000

PhannacoEconomics & Outcomes News 13 Dec 1997 No. 142 1173.5503197/0142.00041$01.00° Adl. International Limited 1997. All right. reserved