University of Roehampton, Department of Life Sciences, UK; All -Party Parliamentary Group for Prescribed Drug Dependence (secretariat), Westminster, UK.
University of Greenwich, Faculty of Education, Health and Human Sciences, SE10 9LS, UK.
Addict Behav. 2022 Feb;125:107143. doi: 10.1016/j.addbeh.2021.107143. Epub 2021 Oct 18.
This cross-sectional study estimates the costs incurred by the National Health Service (NHS) in England as a consequence of the unnecessary prescribing (i.e. non-indicated or dispensable) of dependency-forming medicines (antidepressants, opioids, gabapentinoids, benzodiazepines, Z-drugs). It assesses prescribing in primary care from April 2015-March 2018. Analyses were based upon the following data sets: the number of adults continuously prescribed dependency forming medications and the duration of prescriptions (obtained from Public Health England); the Net Ingredient Cost (NIC) and the dispensing costs for each medicine (obtained from the NHS Business Service Authority [NHSBSA]). Consultation costs were calculated based on guideline recommendations and the number of consultations evidenced in prior research for long-term medication monitoring. Across opioids, gabapentinoids, benzodiazepines, Z-drugs the total estimated unnecessary cost over three years (April 2015-March 2018) was £1,367,661,104 to £1,555,234,627. For antidepressants the total estimated unnecessary cost for one year was £37,321,783 to £45,765,504. The data indicate that the NHS in England may incur a significant estimated mean annual loss of £455,887,035 to £518,411,542 for opioids, gabapentinoids, benzodiazepines, Z-drugs and an estimated annual loss of £37,321,783 to £45,765,504 for antidepressants. Combined, this gives an estimated annual loss of £493,208,818 to £564,177,046 as a result of non-indicated or dispensable prescribing of dependency-forming medicines. Estimates are conservative and figures could be higher.
这项横断面研究估计了英国国民保健服务体系（NHS）因不必要的处方（即非指征或非必需的）成瘾性药物（抗抑郁药、阿片类药物、加巴喷丁类药物、苯二氮䓬类药物、Z 类药物）而产生的成本。它评估了 2015 年 4 月至 2018 年 3 月期间初级保健中的处方情况。分析基于以下数据集：持续开处方成瘾性药物的成年人数量和处方持续时间（从英国公共卫生获取）；每种药物的净成分成本（NIC）和配药成本（从 NHS 商业服务管理局 [NHSBSA] 获取）。根据指南建议和先前研究中为长期药物监测记录的咨询次数计算了咨询费用。在阿片类药物、加巴喷丁类药物、苯二氮䓬类药物和 Z 类药物中，三年内（2015 年 4 月至 2018 年 3 月）估计的不必要总成本为 136766.11 万至 1555234.63 万英镑。对于抗抑郁药，一年的估计不必要总成本为 3732.1783 万至 4576.5504 万英镑。数据表明，英格兰国民保健制度每年可能会产生高达 45588.7035 万至 518411.542 万英镑的估计平均损失，用于治疗阿片类药物、加巴喷丁类药物、苯二氮䓬类药物和 Z 类药物，以及 3732.1783 万至 4576.5504 万英镑的估计年度损失用于治疗抗抑郁药。合计每年损失估计为 49320.8818 万至 56417.7046 万英镑，这是由于不必要或非必需的成瘾性药物处方。估计较为保守，实际数字可能更高。
