Tag Archives: England

What’s driving prescription drug expenditures down in England?

In financial year (FY) 2018/19, National Health Service England (NHSE) spent almost £8 billion on drugs prescribed by general practitioners to their patients. This level of expenditure has decreased by nearly 2.7% from FY 2017/18.

The reduction in prescription drug expenditure is driven by a combination of lower average costs and lower levels of activity. The per person per month (PPPM) costs for central nervous system, endocrine and respiratory conditions have decreased, largely driven by a reduction in the average cost per item. Cardiovascular system drugs, however, have experienced a PPPM increase driven by a 3.2% increase in cost per item.

In this paper, Milliman’s Joanne Buckle and Tanya Hayward investigate the drivers of the PPPM trend at a drug class and regional level using actuarial principles.

How capitation arrangements can be applied to deliver the NHS Sustainability and Transformation Plans

Capitation arrangements are traditionally used as an alternative to fee-for-service reimbursement to facilitate a transfer of risk from the funder to providers of healthcare services. The objective of introducing risk sharing between funders and providers is to encourage the delivery of efficient and patient-centred care by incentivising the integration of services and minimising unwarranted variation in care. This paper by Milliman’s Joanne Buckle and Tanya Hayward explores how the principles of a traditional capitation arrangement may apply in a regional National Health Service system where the stakeholder roles differ and the implementation of various key capitation principles is not possible.