GP prescribing system overhaul after 'ghost branded generics' glitch

IT services provider TPP is overhauling its systems after it was revealed that GPs using the SystmOne electronic health record system were able to prescribe “ghost branded generics”, which could cost the NHS an extra £11.6m per year in reimbursement to community pharmacy, reports the Pharmaceutical Journal

The issue was raised by the Centre for Evidence-Based Medicine at the University of Oxford, which runs the OpenPrescribing project — a searchable interface for raw prescribing data files published by the NHS.

Brian MacKenna, a pharmacist in the NHS England Medicines and Diagnostics Policy Unit working with OpenPrescribing, said the NHS Business Services Authority coded generics from a specified manufacturer in such a way, “which means dispensers are reimbursed at the price of the manufacturer’s product as specified”.

Explaining the problem in this blog, he said that although GPs are prescribing generically, they “are specifying which manufacturer of the particular generic the pharmacy should supply, in brackets, after the name of the drug”.

“The pharmacy must supply this manufacturer’s brand, and they are then reimbursed at the specific price provided, not the drug tariff price that normally governs the pricing of generic medicines,” he added.

“So it is treated as a ‘branded generic’ for dispensing and reimbursement purposes, but is coded as a normal generic. We think this is inconsistent, and we are now calling these products ‘ghost branded generics’,” he said.

MacKenna has estimated ghost branded generic prescribing may be costing the NHS “as much as an extra £11.6m per year”.

John Parry, clinical director at TPP, told The Pharmaceutical Journal: “The changes delivered this month in SystmOne will enable our users to have a tight control over branded generic prescribing.”

This is not the first issue with SystmOne. In July last year, a data breach affecting some 150,000 patients compromised their personal records.

A separate problem, which was identified in August last year and affected up to 10,053 patients at 330 GP practices, meant repeat prescriptions that should have been cancelled continued to be provided. A separate problem occurred with the system, meaning doctors were seeing out of date information when deciding on which drugs to prescribe.