HC Deb 19 September 2003 vol 410 cc1259-61W
Dr. Gibson

To ask the Secretary of State for Health (1) how many Alzheimer's patients are in(a) private and (b) NHS care homes in the United Kingdom;[129514]

(2) how many Alzheimer's patients entered (a) private and (b) NHS care homes in the United Kingdom in each of the last three years;[129515]

(3) what the average care home costs were to the NHS for each Alzheimer's patient in each of the last three years;[129516]

Number of prescription items (thousand) and net ingredient cost (£000) of drugs used for dementia that are dispensed in the community in England, 2000–02
2000 2001 2002
Drugs for dementia Prescription items (thousand) Net ingredient cost (£000) Prescription items (thousand) Net ingredient cost (£000) Prescription items (thousand) Net ingredient cost (£000)
Drugs used for mild to moderate Alzheimer's disease
Donepezil Hydrochloride 43.6 4,178.2 91.2 8,815.3 169.3 16,078.3
Galantamine 0.2 13.6 11.3 880.2 31.1 2,469.9
Rivastigmine 9.9 681.0 19.7 1,309.2 30.5 1,997.9
Drugs used for moderate to severe Alzheimer's disease
Memantine Hydrochloride 0.3 21.1
All drugs for dementia 53.8 4,872.8 122.1 11,004.6 231.3 20,567.1

Notes:

1. The prescription information was obtained from the Prescription Cost Analysis (PCA) system and is based on a full analysis of all prescriptions dispensed in the community, ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Total prescriptions include not only prescriptions originating from general medical practitioners in England but also from hospital doctors, nurses, and dentists, provided they were dispensed in the community. Also inclined are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospital or private prescriptions.

2. Drugs used for dementia are those defined in the British National Formulary (BNF) section 4.11 "Drugs for dementia". Drugs used for dementia have been grouped into those used for mild to moderate and moderate to severe Alzheimer's disease in line with the NICE guidance on drugs for Alzheimers disease. Please refer to the NICE website at www.nice.org.uk for more details.

3. Doctors, dentists or nurses write prescriptions on a prescription form. Each single item written on the form is counted as a prescription item.

4. Net ingredient cost refers to the basic cost (which the dispenser is reimbursed) of the drug before discounts and does not include any dispensing costs or fees.

Data Source:

Prescription Cost Analysis (PCA) data from the Prescription Pricing Authority (PPA).

(4) how much was spent by the NHS on care home costs for Alzheimer's disease patients in each of the last three years;[129517]

(5) how many (a) moderate and (b) severe Alzheimer's disease patients were diagnosed in the United Kingdom in each of the last three years. [129518]

Dr. Ladyman

Data are not collected on the number of people with Alzheimer's disease, in the population generally or in care homes in particular, or about the care home costs of people with Alzheimer's.

Research evidence shows that about five per cent, of the population who are aged over 65 have dementia. This represents about 600,000 people in the United Kingdom. Alzheimer's disease causes up to 60 per cent. of cases of dementia.

While data are not available specifically about care home costs for people with Alzheimer's, the average weekly fee for residential care in England at March 2003 was £336.50.

Dr. Gibson

To ask the Secretary of State for Health how much was spent by the NHS on drug treatments for(a) moderate and (b) severe Alzheimer's disease patients in each of the last three years.[129519]

Dr. Ladyman

The table shows how much was spent, over the last three years, on drug treatments for mild to moderate and moderate to severe Alzheimer's disease. This data cover all prescription items that were dispensed in the community in England. This includes drugs that were prescribed in hospitals or clinics, which are dispensed in the community. However, the data do not include drugs that are dispensed in hospitals/clinics or private prescriptions.

Dr. Gibson

To ask the Secretary of State for Health what instructions have been offered to PCTs regarding drug prescribing practices for Alzheimer's disease patients.[129520]

Dr. Ladyman

In January 2001, the National Institute for Clinical Excellence (NICE) recommended that donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl) should be made available on the national health service as one component of the management of those people with mild to moderate Alzheimer's disease.

Directions have been issued obliging health authorities and primary care trusts to provide appropriate funding for treatments recommended by NICE. The directions came into effect on 1 January 2002.

Hospital, Public Health Medicine and Community Health Services (HCHS): Anaesthetists (including intensive care) by grade; September 1998 to March 2003
England1 Numbers (headcount)
1998 1999 2000 2001 2002 March 2003
All staff 6,817 7,010 7,264 7,680 8,233 n/a
Consultant 2,978 3,168 3,322 3,595 3,874 3,977
Associate Specialist/Staff Grade 625 681 754 817 885 n/a
Registrar Group 1,629 1,621 1,646 1,686 1,758 n/a
Senior House Officer 1,274 1,248 1,288 1,378 1,498 n/a
House Officer 1 13 21 14 31 n/a
Hospital Practitioner/Clinical Assistant 309 278 233 188 179 n/a
Other Hospital grades 1 1 0 0 0 n/a
Other CHS grades 0 0 0 2 8 n/a

1 As at 30 September each year except for 2003, which is as at 31 March. n/a—not available

Source:

Department of Health medical and dental workforce census.