Items which should not routinely be prescribed in primary care - glucosamine and chondroitin

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 glucosamine and chondroitin per 1000 patients
Why it matters

NHS England guidance states:

Glucosamine and chondroitin are nutraceuticals used to improve pain associated with osteoarthritis. The BNF states: 'The mechanism of action is not understood and there is limited evidence to show it is effective'.

NICE guidance on osteoarthritis care and management has the following 'do not do' recommendation: Do not offer glucosamine or chondroitin products for the management of osteoarthritis.

Due to the recommendation from NICE and the lack of evidence as advised by the BNF, the joint clinical working group considered glucosamine and chondroitin suitable for inclusion in this guidance.

NHS England recommend that GPs:

  • Do not initiate.
  • Deprescribe in patients currently prescribed this medicine.
Tags Cost Saving, Efficacy, NHS England - items which should not routinely be prescribed in primary care, NICE
Implies cost savings Yes
Authored by richard.croker
Checked by christopher.wood
Last reviewed 2023-09-18
Next review due 2025-09-18
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 ("091200000AADGDG", "091200000AADIDI", "091200000AADJDJ", "091200000AADWDW", "091200000AADYDY", "091200000AAECEC", "091200000AAEEEE", "091200000AAEFEF", "091200000AAEGEG", "091200000AAELEL", "091200000AAEQEQ", "091200000AAEYEY", "091200000AAFJFJ", "091200000BDGPEC", "091200000BDWXFK", "091200000BEAWDJ", "091200000BEQMFJ", "091200000BERTDJ", "091200000BERVDY", "091200000BEWDDG", "091200000BEZVEL", "091200000BFIGDW", "091200000BFKCDI", "091200000BFKIDW", "091200000BFLEDW", "091200000BFMFDJ", "091200000BFMSEC", "091200000BFMTEE", "091200000BFNYDI", "091200000BFPAEC", "091200000BFPBDY", "091200000BFPSA0", "091200000BFPUEC", "091200000BFPWEQ", "091200000BFPYFI", "091200000BFQKA0", "091200000BFQLEU", "091200000BFQSEF", "091200000BFQXEF", "091200000BFRDEL", "091200000BFREEE", "091200000BFRFEC", "091200000BFRHDJ", "091200000BFRYEY", "091200000BFSXDY", "091200000BFUNDW", "1001050A0AAAAAA", "1001050A0AAABAB", "1001050A0AAACAC", "1001050A0AAADAD", "1001050A0AAAGAG", "1001050A0AAAHAH", "1001050A0AAAIAI", "1001050A0AAAJAJ", "1001050A0AAANAN", "1001050A0AAAPAP", "1001050A0AAAQAQ", "1001050A0BBAAAA", "1001050A0BFADA0", "1001050A0BLAAAI", "1001050A0BTABAD", "1001050B0AAAAAA")
 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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