Items which should not routinely be prescribed in primary care - perindopril arginine

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 perindopril arginine per 1000 patients
Why it matters

NHS England guidance states:

Perindopril is an ACE inhibitor used in heart failure, hypertension, diabetic nephropathy, and prophylaxis of cardiovascular events. The perindopril arginine salt version is more stable in extremes of climate than the perindopril erbumine salt, which gives it a longer shelf-life. However, perindopril arginine is significantly more expensive than perindopril erbumine and a PrescQIPP CIC review of the topic found no clinical advantage for the arginine salt.

NICE guidance on hypertension in adults recommends that prescribing costs are minimised.

Due to the significant extra costs of the arginine salt and the availability of the erbumine salt, the joint clinical working group considered perindopril arginine 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, Efficacy, 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 ("0205051Y0AAAAAA", "0205051Y0AAABAB", "0205051Y0AAACAC", "0205051Y0BBAAAA", "0205051Y0BBABAB", "0205051Y0BBACAC", "0205051Z0AAAAAA", "0205051Z0BBAAAA")
 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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