Statin prescribing in Northern Ireland and England pre and post introduction of the quality and outcomes framework

Pharm World Sci. 2010 Feb;32(1):43-51. doi: 10.1007/s11096-009-9339-3. Epub 2009 Oct 31.


Objective: The objective of this research was to examine differences in patterns of statin prescribing between Northern Ireland and England both before and after the introduction of the Quality and Outcomes Framework (QOF).

Setting: Primary care practices in Northern Ireland and England. Method Northern Ireland practices were matched with practices in England, statin prescribing data and QOF achievement scores (for the first year post-QOF) were obtained. Crude prescribing data from matched practices were manipulated to provide a data set of Defined Daily Doses (DDDs)/1,000 patients and cost/DDD/1,000 patients for each statin drug entity covering 1 year before and after the introduction of QOF. QOF achievements were converted into percentage scores for matched practices.

Main outcome measure: Cost per defined daily dose (DDD) per 1,000 patients.

Results: Significantly less statins (DDD/1,000 patients) were dispensed in Northern Ireland compared with the matched region in England both before and after the introduction of QOF (P < 0.001). However, significantly more statins were dispensed in both regions after the introduction of QOF. As a result of the introduction of QOF, the cost/DDD/1,000 patients rose by pound13.17 in NI, but fell by pound3.76 in the matched region in England.

Conclusion: Strategies should be considered to educate prescribers on cost-effectiveness by increasing their awareness of the negative budgetary impact resulting from early adoption of new and expensive statins and by encouraging generic prescribing.

Publication types

  • Comparative Study

MeSH terms

  • Cost Control
  • Drugs, Generic / therapeutic use
  • England
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / drug therapy
  • Male
  • Northern Ireland
  • Practice Guidelines as Topic*
  • Practice Patterns, Physicians' / economics*
  • Practice Patterns, Physicians' / trends*
  • Process Assessment, Health Care / statistics & numerical data*
  • Quality Indicators, Health Care*
  • Research Design
  • Statistics as Topic


  • Drugs, Generic
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors