Items which should not routinely be prescribed in primary care - doxazosin modified release

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 doxazosin modified release per 1000 patients
Why it matters

NHS England guidance states:

Doxazosin is an alpha-adrenoceptor blocking drug that can be used to treat hypertension and benign prostatic hyperplasia. There are two oral forms of the medication (immediate release and prolonged release) and both are taken once daily.

Prolonged-release doxazosin costs approximately six times more than doxazosin immediate release.

NICE guidance on hypertension recognises that doxazosin should be used in treatment but does not identify any benefits of prolonged release over immediate release.

NICE guidance recommends doxazosin as an option in men with moderate to severe lower urinary tract symptoms. It does not identify benefits of prolonged release over immediate release.

Due to the significant extra cost of prolonged-release doxazosin and the availability of once daily immediate-release doxazosin, the joint clinical working group considered prolonged-release doxazosin suitable for inclusion in this guidance.

For guidance on when prescribing may be appropriate in some exceptional circumstances, please see the full NHS England guidance document.
Tags Cardiovascular system, Cost Saving, NHS England - items which should not routinely be prescribed in primary care
Implies cost savings Yes
Authored by richard.croker
Checked by christopher.wood
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 ("0205040D0AAAQAQ", "0205040D0AAARAR", "0205040D0BBADAQ", "0205040D0BBAEAR", "0205040D0BDADAQ", "0205040D0BEAAAQ", "0205040D0BGABAQ", "0205040D0BIAAAQ", "0205040D0BJAAAQ", "0205040D0BKAAAQ")
 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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