What happens after a medicine has been dispensed matters – here’s why

The Scottish Parliament’s Health and Sport Committee is investigating how Scotland’s medicines supply and demand system works. For us, it’s an opportunity to raise the importance of poor patient adherence and explain why we believe it must be a public health priority.

It’s always a pleasure to give evidence, especially if this can enhance Parliamentarians understanding of the complex issues at play within our sector.

Usually, opportunities like this emerge when discussion focuses on areas under our direct control or influence, such as purchasing or research.

Its welcome to be asked about what happens once our medicines leave the shelf.

It also demonstrates how far the industry has come.

It’s clear to everyone that we no longer are, if ever were, content to supply treatments without a concrete understanding as to who, why and how patients are taking them.

Of the four elements of this committee inquiry – purchasing, prescribing, dispensing and consumption – it’s the last one we have the least knowledge about.

Clearly, there is wastage in the system. Anecdotal evidence alone suggests that the elderly and chronically ill have cabinets stuffed full of repeat prescriptions.

However, we still don’t know the whole picture. We can only point at estimates, not quantifiable numbers, and it will be for the health service to work out just how big, or little, the problem is.

Regardless of this, we do know that more can be done to improve efficiency within the medicines budget.

This sounds obvious, but medicines don’t work in patients who don’t take them. Understanding poor patient adherence and turning this around must be a public health priority.

Social prescribing is important, as is de-prescribing, but ultimately patients need to be empowered and educated to take their medicines effectively.

Patients must also feel encouraged to have honest conversations about their treatment as well as regular reviews to ensure that they are on the most appropriate medicine.

However, this isn’t about blaming the patient, it’s about having a grown-up conversation where the whole system can work together to forge a collective solution. 

A lot of this goes back to appropriate prescribing and this is something the industry supports.  Medicines should only be prescribed at the right time and to the right patient.

The Scottish Government agrees with this approach and this mantra underpins their flagship “Realistic Medicine” policy.

But we need to take this a step further. We need to understand what happens once a medicine is dispensed and doing so will require better data collection.

In September 2018 the Scottish Government released their Data Scoping Taskforce Report which aimed to provide five clear recommendations for the creation of a data driven NHS.

ABPI Scotland supports these recommendations and believe that if enacted, the healthcare system would have a far better understanding of medicines and their outcomes.

This would not only reduce waste, by understanding what medicines derive the most benefit, but also provide electronic solutions for ensuring patients have the tools to take their medicine at the right time.

We might sound like a broken record, but better data collection really can help maximise efficiency within the medicines budget and enable patients to benefit from the latest treatments.

Let’s make it happen.

Dr Sheuli Porkess is Executive Director, Research, Medical and Innovation at the ABPI and will be giving evidence to the Health and Sport Committee on Tuesday 17 February 2020.