Considering cost, waste and medicines optimisation in prescribing practice

Abstract

The updated Royal Pharmaceutical Society (2021) is “hot off the press” and was published in September 2021. Within the “Consultation domain” of this framework, Competency 4 (“Prescribe”) prompts the clinician to adhere to the following standards:
4.5. Accurately completes and routinely checks calculations relevant to prescribing and practical dosing.
4.6 Prescribes appropriate quantities and at appropriate intervals necessary to reduce the risk of unnecessary waste.
4.8 Uses up-to-date information about the availability, pack sizes, storage conditions, excipients, and costs of prescribed medicines.
In accordance with these standards, the British Medical Association & Royal Pharmaceutical Society (2021) and the National Institute for Health & Care Excellence (2015) advocate that an essential facet of prescribing practice is medicines optimisation. Medicine reviews should be a routine feature of prescribing and should include cost-effective decision-making, as advocated by the National Prescribing Centre (1999) EASE mnemonic. By appreciating the cost of medicines, not only to the NHS, but to the patient themselves, prescribers will ultimately reduce waste when working in an NHS with finite resources.