Items which should not routinely be prescribed in primary care - lidocaine plasters

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 lidocaine plasters per 1000 patients
Why it matters

NHS England guidance states:

Lidocaine plasters are licensed for symptomatic relief of neuropathic pain associated with previous herpes zoster infection (PHN) in adults.

NICE guidance on chronic pain does not recommend lidocaine plasters for treating neuropathic pain.

The joint clinical working group also considered a PrescQIPP CIC review, and during the consultation more evidence was provided and an up to date evidence summary was deemed necessary and prepared by the Specialist Pharmacy Service to inform the joint clinical working group’s recommendations. Based on this review, lidocaine plasters can be prescribed only for patients who are intolerant of first-line systemic therapies for PHN or where these therapies have been ineffective.

Lidocaine plasters are not an alternative to an opioid-based medicine when concerned about dependence and withdrawal.

For guidance on when prescribing may be appropriate in some exceptional circumstances, please see the full NHS England guidance document.
Tags Cost Saving, Efficacy, NHS England - items which should not routinely be prescribed in primary care, NICE, Pain
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 ("1502010J0AAELEL", "1502010J0BSAAEL", "1502010J0BWAAEL")
 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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