FOI Ref: 0034FOI2021

16^th July 2020

Freedom of Information Act 2000 – Request for Information

We are pleased to respond to your request for information and our response is set out below:

Request/ Response

I note from the link provided that virtually no apomorphine is prescribed in your CCG, yet I am aware that these CCGs each have a normal distribution of Parkinson’s patients.

https://openprescribing.net/analyse/#org=CCG&numIds=0409010A0&denom=nothing&selectedTab=map

Request 1 – Does your CCGs not permit the prescribing of apomorphine? If not, can you explain the rationale behind this.

The CCG does allow GPs to prescribe it under shared care arrangements see here:

• https://www.intranet.sheffieldccg.nhs.uk/medicines-prescribing/traffic-light-drug-list.htm
• https://www.intranet.sheffieldccg.nhs.uk/Downloads/Medicines%20Management/medicines-prescribing/Parkinsons%20Disease%20SCP.pdf

Because the Open Prescribing data only shows information when a GP prescribes the drug there will be variation dependant on the individual patient, specialist consultant and GP.  The geographical location of a patient in relation to the hospital where they are treated can sometimes play a role in this too.

Request 2- I note that hospitals do prescribe Apomorphine. Could you confirm if whether there is a pass through or another method for NHS Trusts to pass the costs back to CCGS? If not, since it is a tariff drug and the Trusts have no other funding method, are you in fact driving inequity or postcode prescribing by preventing the use of apomorphine?

Hospitals do prescribe this drug (as per Request 1 they would be required to initiate patients on this where certain clinical conditions met). 

This drug is not on the list of ‘High Cost Drugs’ and as such would be funded either through the national tariff, or the local outpatient tariff price (depending on whether patient is an inpatient or outpatient and the specific treatment given at an appointment)

This means that the hospital may use the drug wherever appropriate and are funded accordingly, the fact that Sheffield CCG appears to have low GP prescribing (as in Request 1) may be offset by levels of prescribing at the hospital.  The CCG does not hold information about hospital prescribing costs for drugs unless they are ‘High Cost’ exclusions from tariff.