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Trends in thyroid hormone prescribing and consumption in the UK.

Mitchell AL, Hickey B, Hickey JL, Pearce SH - BMC Public Health (2009)

Bottom Line: The duration of prescriptions has reduced from 60 to 45 days, on average over the same time.Amongst users of levothyroxine, there is widespread patient dissatisfaction with 28-day prescription duration.Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Endocrine Unit, Royal Victoria Infirmary and Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK. annamitchell@doctors.org.uk

ABSTRACT

Background: Thyroid hormone replacement is one of the most commonly prescribed and cost effective treatments for a chronic disease. There have been recent changes in community prescribing policies in many areas of the UK that have changed patient access to necessary medications. This study aimed to provide a picture of thyroid hormone usage in the UK and to survey patient opinion about current community prescribing policies for levothyroxine.

Methods: Data on community prescriptions for thyroid hormones in England between 1998 and 2007, provided by the Department of Health, were collated and analysed. A survey of UK members of a patient support organisation (the British Thyroid Foundation) who were taking levothyroxine was carried out.

Results: The amount of prescribed thyroid hormones used in England has more than doubled, from 7 to almost 19 million prescriptions, over the last 10 years. The duration of prescriptions has reduced from 60 to 45 days, on average over the same time. Two thousand five hundred and fifty one responses to the patient survey were received. Thirty eight percent of levothyroxine users reported receiving prescriptions of 28 days' duration. 59% of respondents reported being dissatisfied with 28-day prescribing.

Conclusion: Amongst users of levothyroxine, there is widespread patient dissatisfaction with 28-day prescription duration. Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.

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Related in: MedlinePlus

Length of levothyroxine prescriptions. Panel A – Temporal trend in the mean prescription content, for levothyroxine 100 μg tablets, from 1998 to 2007 in England (PCA data). Panel B – Length of prescription issued to patients responding to BTF survey (n = 2551 responses).
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Figure 2: Length of levothyroxine prescriptions. Panel A – Temporal trend in the mean prescription content, for levothyroxine 100 μg tablets, from 1998 to 2007 in England (PCA data). Panel B – Length of prescription issued to patients responding to BTF survey (n = 2551 responses).

Mentions: The PCA data also reveal a change in the content of prescriptions over the 10-year period of observation (figure 2, panel A). During 1998, there were just over 2.8 million prescriptions for thyroxine 100 μg tablets in England and the mean content of each prescription was 59.7 tablets. This is sufficiently close to the figure of 56 tablets to assume that the mode prescription length was likely to be 56-days or 8 weeks. By 2007, there were 7.0 million prescriptions for levothyroxine 100 μg tablets and the mean content of each prescription was reduced to 44.9 days, slightly over 6 weeks.


Trends in thyroid hormone prescribing and consumption in the UK.

Mitchell AL, Hickey B, Hickey JL, Pearce SH - BMC Public Health (2009)

Length of levothyroxine prescriptions. Panel A – Temporal trend in the mean prescription content, for levothyroxine 100 μg tablets, from 1998 to 2007 in England (PCA data). Panel B – Length of prescription issued to patients responding to BTF survey (n = 2551 responses).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683823&req=5

Figure 2: Length of levothyroxine prescriptions. Panel A – Temporal trend in the mean prescription content, for levothyroxine 100 μg tablets, from 1998 to 2007 in England (PCA data). Panel B – Length of prescription issued to patients responding to BTF survey (n = 2551 responses).
Mentions: The PCA data also reveal a change in the content of prescriptions over the 10-year period of observation (figure 2, panel A). During 1998, there were just over 2.8 million prescriptions for thyroxine 100 μg tablets in England and the mean content of each prescription was 59.7 tablets. This is sufficiently close to the figure of 56 tablets to assume that the mode prescription length was likely to be 56-days or 8 weeks. By 2007, there were 7.0 million prescriptions for levothyroxine 100 μg tablets and the mean content of each prescription was reduced to 44.9 days, slightly over 6 weeks.

Bottom Line: The duration of prescriptions has reduced from 60 to 45 days, on average over the same time.Amongst users of levothyroxine, there is widespread patient dissatisfaction with 28-day prescription duration.Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Endocrine Unit, Royal Victoria Infirmary and Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK. annamitchell@doctors.org.uk

ABSTRACT

Background: Thyroid hormone replacement is one of the most commonly prescribed and cost effective treatments for a chronic disease. There have been recent changes in community prescribing policies in many areas of the UK that have changed patient access to necessary medications. This study aimed to provide a picture of thyroid hormone usage in the UK and to survey patient opinion about current community prescribing policies for levothyroxine.

Methods: Data on community prescriptions for thyroid hormones in England between 1998 and 2007, provided by the Department of Health, were collated and analysed. A survey of UK members of a patient support organisation (the British Thyroid Foundation) who were taking levothyroxine was carried out.

Results: The amount of prescribed thyroid hormones used in England has more than doubled, from 7 to almost 19 million prescriptions, over the last 10 years. The duration of prescriptions has reduced from 60 to 45 days, on average over the same time. Two thousand five hundred and fifty one responses to the patient survey were received. Thirty eight percent of levothyroxine users reported receiving prescriptions of 28 days' duration. 59% of respondents reported being dissatisfied with 28-day prescribing.

Conclusion: Amongst users of levothyroxine, there is widespread patient dissatisfaction with 28-day prescription duration. Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.

Show MeSH
Related in: MedlinePlus