Request

I wanted to make a request under the Freedom of Information Act.

Could you tell me, from your prescribing data and for each of the past ten years:

1/ How many women under 55 were prescribed each of these drugs?

• Lamotrigine

• Levetiracetam

• Carbamazepine

• Phenobarbital

• Phenytoin

• Topiramate

• Zonisamide

• Gabapentin

• Pregabalin

• Clobazam

2/ How many of those were prescribed each of those drugs for the first time?

I am interested in these drugs particularly as they are used to treat epilepsy. If there is any way to give me the information only on prescriptions for that indication, excluding prescriptions for other reasons, that would be ideal. But if that is not possible, I would still like the overall prescribing data.

On the 10 October 2022 you clarified the following

I'm happy to receive data by calendar year or by financial year, whichever is the easiest to get out of your systems. Since 2015 is fine, if that is the earliest available.

Yes, please limit Gabapentin to BNF section 0408

That's fine, please use EPS

Yes, I think splitting by chemical substance would be perfect, thank you.

I do want the data here for women under-55, so I think it makes sense to proceed as you suggest. Do most records tend to have gender and age linked to them?

Response

Patient counts/age etc pre April 2015

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHS Business Services Authority. We only hold patient information from April 2015 onwards.

Reason for Prescribing

I have established that the information you requested on patient condition is not held by the NHS Business Services Authority. No data is captured relating to the clinical indication a prescription is intended for. Some of these products can be used for a variety of clinical indications and therefore the drugs prescribed may have been prescribed for a different condition.

Remaining Information

A copy of the information is attached.

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 - The data source was the NHSBSA Information Services Data Warehouse.

Exclusions - 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 - Answers are based on April 2015 to March 2022 data

For first prescribing data is taken from all data held in the data warehouse, the first prescribing in the data warehouse for the described BNF sections with an identified patient is April 2015. Patients may have had prescribing prior to this but the data is not available prior to this point.

Drugs - Limited to the following BNF Chemical substances;

0408010Z0 - Phenytoin

0408010P0 - Phenobarbital sodium

0408010AD - Zonisamide

0408010G0 - Gabapentin

0408020T0 - Phenytoin sodium

0408010AE - Pregabalin

040801050 - Topiramate

040801060 - Clobazam

0408010N0 - Phenobarbital

0408010A0 - Levetiracetam

0408010C0 - Carbamazepine

0408010Q0 - Phenytoin sodium

0408010H0 - Lamotrigine

Organisation Data - Only items that were dispensed in the community in England have been included

Patient identified - Data is limited to prescriptions where an NHS Number was captured during NHSBSA prescription processing, the following shows the percentages of prescription items with an identified NHS Number per financial year:

2015/2016 94.84%

2016/2017 96.97%

2017/2018 97.79%

2018/2019 98.12%

2019/2020 98.46%

2020/2021 99.24%

2021/2022 99.31%

Patient Gender - Patient gender is as captured during NHSBSA prescription processing. The data is limited to prescriptions with a gender identification of female. The following shows the percentages of prescription items with an identified gender per financial year:

2015/2016 94.51%

2016/2017 96.89%

2017/2018 97.76%

2018/2019 98.03%

2019/2020 98.37%

2020/2021 99.17% 2021/2022 99.24%

Patient age - Patient age is as captured during NHSBSA prescription processing. The data is limited to prescriptions with an age lower than 55. The following shows the percentages of prescription items with an age captured per financial year:

2015/2016 97.65%

2016/2017 98.43%

2017/2018 98.79%

2018/2019 98.93%

2019/2020 99.12%

2020/2021 99.52%

2021/2022 99.54%

Questions are answered in separated csv as follows

FOI27693_Q1

FOI27693_Q2

The NHSBSA does not hold data showing a patient’s first prescribing of a given drug. This has been calculated by finding a patients’ first prescribing of each chemical substance within the limitations of this dataset. Patients may have first prescribing in different chemical substances in different financial years.