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Should we be showing DT drugs with only one available brand as a possible saving? #27

Open sebbacon opened 7 years ago

sebbacon commented 7 years ago

An example which was confusing Sara from Oxford CCG.

How could she achieve a saving on Dalteparin?

Dalteparin Sod_Inj 25,000u/ml 0.72ml Pfs - savings >£14k. This strength is in the DT as Dalteparin sodium 18,000units/0.72ml solution for injection pre-filled syringes to be reimbursed at Fragmin price of £50.82 for 5. What is the suggested switch?

Should we exclude from our analysis VMPs which are in the DT and only have one available brand, on the grounds that there is no possible action that can be taken?

richiecroker commented 7 years ago

I've already replied re name. This was an np8 until recently, so was scalped.

On Thu, 2 Feb 2017, 11:49 Seb Bacon, notifications@github.com wrote:

An example which was confusing Sara from Oxford CCG.

How could she achieve a saving on Dalteparin?

Dalteparin Sod_Inj 25,000u/ml 0.72ml Pfs - savings >£14k. This strength is in the DT as Dalteparin sodium 18,000units/0.72ml solution for injection pre-filled syringes to be reimbursed at Fragmin price of £50.82 for 5. What is the suggested switch?

  • First, there's a problem with the named strength (which we took from the BNF name listed in the PDPI data) which I've noted in #26 https://github.com/ebmdatalab/price-per-dose/issues/26
  • Second, there is only one brand available. Therefore there should actually not be a variation in price at all. The fact there is troubles me as I can't work out why it might be.

Should we exclude from our analysis VMPs which are in the DT and only have one available brand, on the grounds that there is no possible action that can be taken?

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sebbacon commented 7 years ago

Thanks. So the question becomes if/how we should flag such cases.

Given the time lag (which we hope to make shorter, but it will still be the case), we will sometimes identify possible savings which will no longer be necessary given DT changes.

I know you've said that the NP8 thing will become less frequent, but presumably it will still happen for a few more months with the odd drug.

sebbacon commented 7 years ago

There were 145 drugs in the Sept analysis which were still NP8 in Dec, about £3m worth of savings, so even if the problem is being addressed, it's not really happening quickly enough. Here are some of the top few:

sebbacon commented 7 years ago

I propose that whenever a drug was NP8 at the time of the analysis, we highlight it with text to the effect "When we did this analysis, the drug was not in the Tariff. This means any price could have been paid. However, remember than new things are added to the Tariff every month, so this saving might no longer require action if this drug is added to the Tariff"

We could also add another sentence where we can see that something has been added to the Tariff.