FOI-01406

##Request

For the period the 1st of June 2022 till the 31st of May 2023 can I have the following data.

For all of England can I know the total quantity of Enoxaparin prescribed by INN on FP10 broken down by the following strengths, 20mg, 40mg, 60mg, 80mg, 100mg , 120mg and 150mg.

While I appreciate you do not have perfect data sets can you also indicate where you capture the data either from scanning scripts or by receipt of electronic scripts the quantity Brands  dispensed for each strength.

As an example, I would expect to see

X Thousand syringe of 40mg written as enoxaparin of which Y quantity was Clexane and Z quantity Inhixa and P quantity we cannot define because we have no data

On 8 September 2023 you clarified the following:

1. For the time period of ‘1st of June 2022 till the 31st of May 2023' - is this 12 months accumulated or monthly data? accumulated

2. Is the data required to include:
    a. Prescribed in England - Dispensed in the community in England.  This Data set.
    b. Prescribed in England - Dispensed in the community in England, Wales, Scotland, Guernsey / Alderney, Jersey and Isle of Man.
    c. Prescribed in England, Wales, Scotland, Northern Ireland, Guernsey / Alderney, Jersey and Isle of Man - Dispensed in the community in England. 


##Response

A copy of the information is attached.

Prescribing of all strengths of Enoxaparin sodium solution for injection pre-filled syringes with the dispensed (reimbursed) at presentation level for June 2022 to May 2023 (accumulated)

NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors and Personal Administration with information then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over 1 billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health and Social Care users.

Data Source: ePACT2

Data in ePACT2 is sourced from the NHSBSA Data Warehouse and is derived from products prescribed on prescriptions and dispensed in the Community. The data captured from prescription processing is used to calculate reimbursement and remuneration. It includes items prescribed in England, Wales, Scotland, Northern Ireland, Guernsey / Alderney, Jersey, and Isle of Man which have been dispensed in the community in England. English prescribing that has been dispensed in Wales, Scotland, Guernsey / Alderney, Jersey, and Isle of Man is also included.

The Data excludes: 
• Items not dispensed, disallowed and those returned to the contractor for further clarification. 
• Prescriptions prescribed and dispensed in Prisons, Hospitals and Private prescriptions.
• Items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser.

Time Period: 

Accumulated data is from June 2022 to May 2023.

Organisation Data: 

The data is for prescriptions prescribed in England and dispensed in the community in England.

Data: 

This dataset is limited to the prescribing of Enoxaparin sodium solution for injection pre-filled syringes strengths, 20mg, 40mg, 60mg, 80mg, 100mg, 120mg and 150mg at presentation level. (Generic prescribing only) Split by paper prescription and electronic message prescriptions (EPS)
Included in the data is the dispensed presentation.

Please note that NHSBSA dispensed data represents reimbursement policy and does not necessarily mean that this is the product that is dispensed to the patient.

For this data all presentations of Enoxaparin are in the Drug Tariff Payment Category of Part VIIIA Category C. As there is only one pack size listed in Part VIIIA of the Drug Tariff then no endorsement of a brand/supplier is required to ensure correct payment as reimbursement will be made based on the Drug Tariff pack size and reimbursement price.

Any endorsements for branded products made against prescribed enoxaparin would be ignored in terms of payment but for reporting purposes there is an agreed methodology as to how generic prescribing will be reflected within the dispensing data.
 
The following link takes you to the NHS Business Services Authority, Prescription Cost Analysis, Background Information and Methodology document that explains how the methodology is applied and reported with any dispensing datasets.

Background Information and methodology (nhsbsa-opendata.s3.eu-west-2.amazonaws.com)

Please refer to section 2.1.2.2. Preparation class 2 drug with multiple class 3 equivalents – one-to many mappings and in particular the information on “Sometimes where a unique relationship between prices cannot be established, where more than one proprietary equivalent has a matching reimbursement price for that month. In these cases, we use the endorsement field present within the EPS message to try to determine which proprietary class 3 drug was dispensed” as this is the part that will currently apply to all strengths of Enoxaparin in the dataset provided. 
In these circumstances this is where we will use the endorsement field within the EPS message if it has been completed by the dispensing contractor. However as not all EPS messages return an endorsement of a brand and in such cases any generic prescribing cannot be attributed to one brand then this will be reported as generic within the dispensed data. 

For Enoxaparin products prescribed on a paper prescription where the prescription has been prescribed generically, any endorsement typically will not be captured, and the data would generally be reported as generic within the dispensed data. 

BNF Code:

The BNF Code is a 15-digit code in which the first seven digits are allocated according to the categories in the BNF, and the last 8 digits represent the medicinal product, form, strength, and the link to the generic equivalent product. NHS Prescription Services has created pseudo BNF chapters, which are not published, for items not included in BNF chapters 1 to 15. Many of such items are dressings and appliances which NHS Prescription Services has classified into four pseudo BNF chapters (20 to 23).

Total quantity: 

Total quantity is the number of items multiplied by the quantity prescribed. 
e.g., 2 items prescribed, one with a quantity of 2 and one with a quantity of 3, the total quantity would show as 5 (1 item x quantity of 2) + (1 item x quantity of 3).

Please note that this request and our response is published on our Freedom of Information disclosure log at:

https://opendata.nhsbsa.net/dataset/foi-01406


Tags: Enoxaparin, FP10, NHS Prescriptions
Organization: Freedom of Information Disclosure Log