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The Prescription Pricing Authority (PPA) is a special Health Authority within the National Health Service Executive (NHSE); its roots go back to 1913. Last year the Authority processed over 484 million prescription items, with a total cash value of over £4.5 billion. The annual growth in prescription volume was approximately 3%.
The PPA has four main functions:
- scrutinise, pricing and payment to contractors for the dispensing of National Health Service (NHS) prescriptions
- provision of prescribing and dispensing information to the NHS (excluding hospital dispensing)
- management of the National Health Services low income scheme
- prevention of prescribing and dispensing fraud within the NHS.
Information is provided in a variety of formats to prescribers. This includes the Department of Health (DoH), National Health Service Executive (NHSE), Regional Offices of the NHSE (ROs), Health Authorities (HAs), hospitals, Medical and Pharmaceutical Advisers, National Health Service Trusts, dispensers, police, auditors, Home Office and research groups.
There are four major information systems that provide a broad spectrum of prescribing information. These systems:
- Prescribing analysis and cost (PACT)
- Indicative prescribing scheme (IPS)
- Prescribing cost analysis (PCA)
- Electronic PACT (ePACT).
The Authority designed three drug coding systems in 1981 that all the projects revolve around. For high speed data capture operators use a simple velocity drug code of two to five digits. The more popular the drug, the shorter the code used to identify the drug.
The velocity code is converted to a structured code especially designed for the pricing of drug items in accordance with the drug tariff. This structured code is a nine digit code which links all packs and presentations of the same drug together. Several commercially available practice computer systems use the PPA's structured coding system.
The third coding system reflects the British National Formulary (BNF). This groups drugs for analysis purposes and enables all like drug, or chemical substances, to be identifiable under the same therapeutic classification. All PPA information service reports on prescribing are based on this coding system and an agreement has been reached with the authors of the BNF to keep the two standards in step.
Both the Welsh and Scottish Office have adopted the Authority's coding standards for their prescription pricing and information services.
The authority on prescribing
National Health Service (NHS) prescriptions for the supply of drugs, appliances and chemical reagents are issued to patients by General Practitioners (GPs) and other NHS prescribers. The prescriptions are dispensed by community pharmacies, dispensing GPs and appliance contractors under contract to the local HAs. These are collectively known as dispensing contractors. Prescriptions are also received from prescribing GPs for items that have been administered to the patient by the GP. For example influenza vaccines are usually referred to as personal administration items.
Dispensing contractors are required to despatch their prescriptions to the PPA no later than the fifth working day of the month following the month in which the drug was issued.
Remuneration and reimbursement paid to dispensing contractors for prescriptions dispensed varies according to contract type and is detailed in the Drug Tariff. Dispensing contractors receive reimbursement for the following:
- the total price of the drugs, appliances and chemical reagents supplied, less a deduction from the discount received by the contractors
- the professional fees for each item dispensed
- an allowance for containers and measuring devices.
Prescription charges that have been collected from patients by the pharmacy contractor are deducted from the payment.
The PPA calculates the payment from all the dispensing contractors in England, approximately 16,000. As from April 1997 the PPA will pay the dispensing contractors directly, rather than through the one hundred Health Authorities.
The PPA also calculates payments on an agency basis for the Isle of Man, Jersey and Guernsey.
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