FOI 1314 080 Summary Issue – ACEI Prescribing Policy This information relates to Bristol Clinical Commissioning Group
Question Response
Please provide any documents / information which
Please note that records for the time period requested may be incomplete. Note also
indicates whether Bristol Teaching PCT had any
that Bristol PCT was formed in 2006 from a merger of Bristol North PCT and Bristol
particular policy in place in relation to the prescribing
South &West PCT so we have attempted to access the files from these other
of Angiotensin-Converting Enzyme Inhibitors (ACEIs)
organisations for the relevant time period. In earlier years paper records would have
for the period 2004-2009. In particular, please provide
been used much more than now, and these are no longer available.
any prescribing recommendations / guidance / drug
formularies encouraging a switch from perindopril to
We can be certain however that ACE inhibitor (ACEI) prescribing was influenced and
ramipril, lisinopril, enalapril or any other ACEI or
incentivised at points in the time period that you have specified. The NHS ‘Better
encouraging the prescription of low cost ACEIs (e.g.
Care, Better Value’ national agenda encouraged the prescribing of ACEI in
ramipril, lisinopril, enalapril) in place of more
preference to Angiotensin 2 receptor antagonists (A2RA) wherever possible, and this
was reflected in local formularies and prescribing incentive schemes (see below). We can see that the choice of ramipril and lisinopril as preferred ACEI was specifically encouraged and incentivised, and certainly prescribing of perindopril was discouraged owing to its prohibitive acquisition cost to the NHS, and its non-superior evidence base at the time. 2004/2005 The Bristol North PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found.
No records exist of any prescribing incentive scheme for Bristol South & West PCT and no record of any relevant ad-hoc projects can be found. 2005/2006
The Bristol North PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found. The Bristol South & West PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found. 2006/2007
The Bristol North PCT prescribing incentive scheme included an audit to assess compliance with NICE guidance but did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found. The Bristol South & West PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found. 2007/2008 The Bristol PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing and no record of any relevant ad-hoc projects can be found.
2008/2009 The Bristol PCT prescribing incentive scheme did incentivise practices to increase the proportion of ACEI prescribed as a proportion of all renin-angiotensin system (RAS) prescribing, and also to decrease the proportion of ACEI prescribing that perindopril represented. (see extract A) We have a copy of a Bristol PCT formulary on file that was produced in 2008. This clearly discourages prescribing of perindopril and encourages the use of other ACEI. (see extracts B to E) We also have records that show that Bristol PCT used ScriptSwitch software to encourage prescribing of preferred ACEI in in 2008 and 2009. 2009/2010 The Bristol PCT prescribing incentive scheme did not appear to incentivise any particular activity in relation to ACEI prescribing but the behaviours encouraged in the previous years’ work continued to be promoted on an ad-hoc basis, and via ScriptSwitch.
The information provided in this response is accurate as of 08/08/2013.
Zur Komorbidität von Aufmerksamkeitsdefizit/Hyperaktivitätssyndrom (ADHS) und Substanzstörungen Monika JOHANN*, Kirsten LANGE**, Susanne KÖNIG***, Rainer LAUFKÖTTER****, Willi UNGLAUB*****, Norbert WODARZ****** ZusammenfassungDas komorbide Auftreten eines Aufmerksamkeitsdefizit-/Hyperaktivitätssyn- droms (ADHS) wurde bei bis zu 1/3 der erwachsenen Kokainabhängigen ge-funden
McNeil Consumer Healthcare Announces Voluntary Recall of Certain OTC Infants’ and . Home> Safety> Recalls, Market Withdrawals, & Safety Alerts Recall -- Firm Press Release FDA posts press releases and other notices of recalls and market withdrawals from the firms involved as a service to consumers, the media, and other interested parties. FDA does not endorse either the product o