B2 Methadone prescription statistics
| Methadone Hydrochloride (methadone mixture) is the most commonly used pharmacological treatment for opioid dependence in Scotland. It is used primarily for the treatment of drug addiction1. There is no national routine information which reports the number of people in Scotland who are receiving Methadone Hydrochloride mixture, nor information on the cost per person to the NHS. In 2005 ISD Scotland published estimates on the number of people receiving Methadone Hydrochloride mixture for opiate dependence in Scotland and the prescribing costs per person. This section is an update based on a short paper published in August 20052. |
Key Points 2004
Number and costs of people receiving methadone prescription
- It was estimated that 19 227 people were prescribed methadone mixture in 2004 (Table B2.1).
- It was estimated that the cost per patient per year in 2004 was £673. This estimate includes only the cost of the medication and dispensing, and any clinical costs (Table B2.1 and B2.2).
- The cost of dispensing methadone mixture (dispensing fees and ingredients) was £2 547 per 1 000 population in 2004 (Table B2.3).
Five year trends -2000/01 to 2004/05
- Methadone prescribing rates have risen by 53 per cent over the last five years, from 53 prescriptions per 1 000 population in 2000/01 to 81 prescriptions per 1 000 population in 2004/05. Note that higher prescriptions rates do not necessarily mean more volume of methadone, actual doses prescribed could be smaller (Table B2.2).
- The increase in rate of prescribing varies between areas, for example rates increased in Lothian by 88 per cent from 2000/01 to 2004/05 and by 11 per cent in Tayside (Table B2.2).
- Estimates for the number of people receiving prescriptions show an increase between 2002 and 2004 (from 16 401 to 19 227) (Table B2.1).
Geographical profile
- It was estimated that 34 per cent of the individuals prescribed methadone in 2004 received their prescriptions from Glasgow NHS board (6 623 individuals). Lothian NHS board issued prescriptions to an estimated 3 104 individuals, Grampian NHS board to 1 591 individuals and Lanarkshire NHS board to an estimated 1 348 individuals (Table B2.1).
- Prescription rates vary across Scotland, from 157 and 128 prescriptions per 1 000 population for Greater Glasgow and Ayrshire and Arran respectively, to 10 per 1 000 population for the Borders (Table B2.2).
Background information
Prescribing medication is an important element of many drug treatment programmes. Methadone mixture for the treatment of opioid dependence comprises the majority of methadone prescribing. Other formulations of methadone are used in the treatment of severe pain and palliative care. For example, methadone may also be prescribed as linctus to control a distressful cough in terminal illness, and as tablets and injections to control severe pain in terminal illness.
There is no national routine information which reports the number of people in Scotland who are receiving Methadone Hydrochloride mixture, nor information on the cost per person to the NHS.
The Prescribing Information System (PIS) at Information Services (ISD Scotland), NHS National Services Scotland holds information derived from prescriptions dispensed in the community in Scotland (*). The system and information held constitute a key part of the pharmacy payment process. However, the PIS does not store patient identifiable information (e.g. name, date of birth, address) that can be used to count the number of people receiving particular medications. To overcome this limitation, information was extracted manually for a two month sample (June and July 2003) from all the prescriptions dispensed in the community for methadone mixture (approximately 65,000) and entered into a bespoke database.
To estimate the number of individuals receiving methadone for addiction, a process was undertaken whereby multiple prescriptions for single individuals were identified. The first initial of the clients’ first and surnames, their gender, their street name, and the dispenser code (representing the pharmacy where the mixture was dispensed) were extracted. This combination of parameters offered sufficient basis for identifying prescriptions for single individuals, whilst observing good practice for handling person identifiable data. In this way it was possible to estimate the number of people receiving methadone mixture in Scotland during 2003.
It was possible to extrapolate from the 2003 information to provide estimates for 2002 and 2004, using other information available from the prescriptions (i.e. the average daily dose and the total amount dispensed).
The formula applied was:
Once the number of individuals receiving a prescription for Methadone Hydrochloride mixture is known the average cost per client per year can be calculated.
The formula applied was:
References
1 Department of Health (1999). Drug misuse and dependence — guidelines on clinical management. The Scottish Office Department of Health, the Welsh Office and the Department of Health and Social Services, Northern Ireland. London: Stationery Office.
2 This paper can be found on www.drugmisuse.isdscotland.org/publications/local/isd_methadone.pdf
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