South Tyneside Stop Smoking Service Review - A Medicines Optimisation Approach to Prioritisation
PHE ePoster Library. Carter S. Sep 12, 2019; 274410; 209
Mr. Steven Carter
Mr. Steven Carter
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Abstract Background
A review of the South Tyneside Stop Smoking Service was undertaken in 2018/19 to ensure the best possible outcomes could achieved within the programme spend and develop a sustainable, cost-effective service model which is flexible in light of future cultural/budgetary challenges. It was identified that key efficiencies could be achieved by undertaking a prioritization exercise in relation to nicotine replacement therapies via medicines optimisation.
Health economic approaches (program budgeting and marginal analysis) were used alongside priority-setting approaches to ensure that technical and allocative efficiencies are maximized and equity is not compromised when identifying efficiencies within a specific budget (nicotine-replacement drug costs). Prescribing costs and effectiveness were scrutinized to inform changes to prescribing guidance and NRT product formulary.
Analysis of NRT prescribing data has identified that Champix appears the most cost-effective and effective therapy (53% 4-week quit success rate from 941 total attempts) and informed key prescribing guidance for Stop Smoking Advisors. We have also identified that less popular/effective products could be removed from the formulary in an effort to reduce costs and promote prescribing of more effective products/combinations. Further guidance is in development and within Stop Smoking Advisor training to promote the prescribing of smaller NRT packs initially to test tolerance and suitability before larger product packs are prescribed if effective (in turn reducing dispensing fees).
Medicines optimisation approaches are an effective prioritisation tool in realising technical and allocative efficiencies within stop smoking services and should be considered as an integral element of service reviews. External funding details N/a
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