The Patient And Medicine Journey

-by Veerle van Leemput and Greg Mills, Managing Directors at Analytic Health

It all starts with the patient

In this blog we’ll guide you through the Patient and Medicine Journey. The aim is to help you understand how patients in the United Kingdom get their medicines and where these medicines originate from. Pharmly Cloud Data offers a range of datasets that cover (parts of) this journey.

The Full Journey

Primary Care

The patient’s journey starts when they need medical support and generally begins in the Primary Care system at a General Practice (GP).

The GP can either be a practice that also dispenses medicines (known as Dispensing Doctors) or a practice that only writes prescriptions. If there is no specialist referral needed, the patient’s journey ends by collecting their medicines at a community pharmacy (or directly from the GP in the case of Dispensing Doctors).

All this data is available in Pharmly Cloud Data’s Prescribing dataset, either grouped by Primary Care Organisation (known as Clinical Commissioning Group (CCG) in England) or individual GP practice. Information about the volume and value going through a Dispensing Doctor is available in our Prescriptions Cost Analysis (PCA) data*.

Secondary Care

If the patient gets referred from Primary Care to a specialist, they arrive in a hospital (or other similar NHS Trust) for Secondary Care medical support. Depending on the urgency, the patient may have begun their journey in the Secondary Care system (e.g. accident and emergency (A&E)). Hospitals can both prescribe (for later use) and dispense (for immediate use) medicines to a patient.

Information about the number of patients admitted to hospitals is available in our Hospital Episodes Statistics (HES) data. The quantities and values of medicines used in hospitals are available in our Secondary Care Medicines Data (SCMD). Data on the prescriptions written in hospitals but dispensed at community pharmacies is available in our Hospital Prescriptions Dispensed in Community data*. This is particularly important in understanding the prescribing rates for each brand in each hospital.

Community Pharmacies And Pricing

Community pharmacies get their medicines supply from wholesalers (such as AAH Pharmaceuticals). They buy medicines at a certain price from the wholesaler and after dispensing to the patient they get financially reimbursed by the Department of Health and Social Care (DHSC) at the Drug Tariff price or, in case of a supply shortage, the Concessionary Price. Knowing these prices is important to understand buying decisions of community pharmacies and identify patterns of medicines shortages.

Pharmly Cloud Data provides access to Drug Tariff prices and Concessionary prices.

The Manufacturer And The Supply Chain

The medicines that the patient eventually receives are produced by a pharmaceutical manufacturer. The manufacturer sells their product to wholesalers, hospitals and pharmacy chains. When sold to hospitals, the manufacturer generally needs to be granted a tender for the supply.

The List Price is the basic price for a medicine, as defined by the manufacturer. Manufacturers sell their product using the List Price as a baseline but generally offer contractual discounts, depending on the level of competition or National Health Service (NHS) negotiations. This makes List Prices an important piece of information in the healthcare system.

All List Prices are available in our List Price dataset.

Dictionary Of Medicines And Devices

The Dictionary of Medicines and Devices (DM+D) is a large repository of all the medicines and devices used across the NHS. When any company would like to supply a medication or medical device they must first register their product, including detailed characteristics, with the DM+D; making the dataset a vital piece in understanding the market.

The full DM+D database is available via Pharmly Cloud Data.

The Pharmly Code

All the vital elements of this patient and medicine journey are covered in Pharmly Cloud Data and our Pharmly Code ties all the pieces together.

We developed our pharmaceutical coding system (the Pharmly Code), as an enhancement to the DM+D, out of a necessity to combine, manage and make available our wide range of healthcare data via Pharmly Cloud Data. Our Pharmly Code allows you to combine datasets and to identify Active Ingredients, Brands, Product Packs, Companies and more. It’s the underlying infrastructure of all the data in the patient and medicine journey.

Pharmly Cloud Data allows you to simply browse through all Pharmly Codes so you can easily identify the products and companies you need.

Want to keep this for reference? Download our Patient and Medicine Journey here!

_{*this is currently under development and expected in early 2022.}