Items which should not routinely be prescribed in primary care - aliskiren

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Cost of Aliskiren per 1000 patients
Why it matters

NHS England guidance states:

Aliskiren is a direct renin inhibitor; renin converts angiotensinogen to angiotensin. It is indicated for essential hypertension either alone or in combination with other antihypertensives. The patent expired April 2020 but no generics are available yet.

NICE states there is insufficient evidence of its effectiveness to determine its suitability for use in resistant hypertension.

While aliskiren has shown comparable efficacy to other antihypertensive agents in terms of blood pressure reduction, its effects on mortality and long-term morbidity are currently unknown.

For guidance on when prescribing may be appropriate in some exceptional circumstances, please see the full NHS England guidance document.
Tags Cost Saving, Cardiovascular system, NHS England - items which should not routinely be prescribed in primary care, NICE
Implies cost savings Yes
Authored by richard.croker
Checked by andrew.brown
Last reviewed 2024-03-05
Next review due 2026-03-05
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(actual_cost) AS numerator
 FROM hscic.normalised_prescribing
 WHERE bnf_code IN ("0205053A0AAAAAA", "0205053A0AAABAB", "0205053A0BBAAAA", "0205053A0BBABAB")
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(total_list_size / 1000.0) AS denominator
 FROM hscic.practice_statistics
 GROUP BY month, practice_id
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