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Budget impact of acetylcysteine vs carbocisteine

The purpose of this bulletin is to highlight the difference in cost between acetylcysteine and carbocisteine when used as mucolytics, and to raise awareness of savings which could be achieved within ICBs. The bulletin considers the potential budget impact to primary care prescribing budgets based on current prescribing of carbocisteine across the ICSs in the […]

Inhaler Carbon Impact Assessment Tool

Overview The NHS Long Term Plan outlines that 4% of the total NHS carbon footprint savings are expected to be realised through a ‘shift to lower carbon inhalers’ equivalent to a 50% reduction in the inhaler carbon footprint. 1,2 The RDTC has developed an inhaler carbon impact assessment tool in response to these targets. It […]

Respiratory System

This report looks at prescribing trends in primary care for the Respiratory System at SICBL and ICB level with particular focus on bronchodilators and corticosteroids. Prescribing data is weighted with QOF registers, and also uses HES data to measure prescribing to outcomes. The report also calculates the potential opportunity cost for respiratory drugs based on […]

Cost Comparison Charts

Overview The charts included within this report are organised by BNF classification (legacy) and show comparative costs at the NHS basic price1,2 (as of January 2024) for selected agents. Except where indicated otherwise, each chart shows the cost of 1 year3 of treatment at a commonly prescribed daily dose (shown in brackets). The doses given […]

NHS Medicines Optimisation Opportunities Dashboard 2023-24

At the end of July 2023 NHSE published guidance titled “National medicines optimisation opportunities 2023/24”. This guidance describes the 16 national medicines optimisation opportunities for the NHS in 2023/24, and signposts to resources to help with their implementation. It recommends Integrated Care Boards (ICBs) choose at least five medicines optimisation opportunities to focus and deliver […]

Sustainability: Environmental impact of inhaler disposal

The NHS Long-Term Plan sets out a commitment to reduce NHS carbon emissions by 51% by 2025, and ultimately to become the world’s first Net-Zero health service. Good-quality data comparing the environmental impact of different types of inhalers is essential if patients and prescribers are to make informed decisions about their choice of inhalers in […]

Considerations for Sustainable Inhaler Prescribing

Inhalers account for approximately 3% of all NHS carbon emissions. Reducing the carbon impact from inhaler prescribing has been identified as a significant area of focus for delivering a net zero NHS. This document aims to outline strategies that can be considered to promote optimal respiratory care, while minimising the environmental impact from inhalers and […]

Reducing the carbon impact of inhalers across the North of England

This bulletin provides baseline figures on the current Inhaler Carbon Footprint at ICS level in the North of England, in order that systems can identify the level of response to be undertaken. It examines the current carbon footprint attributed to Inhalers in the North East and Yorkshire and the North West. It also analyses the […]

Omalizumab and dupilumab for chronic rhinosinusitis with nasal polyps

Overview Evaluation reports aim to give objective information and guidance on medicines and medical devices to commissioners of health services, prescribers and others. They include efficacy, adverse effects, place in treatment and arrangements for prescribing. Omalizumab and dupilumab are indicated as an add-on therapy with intranasal corticosteroids for the treatment of adults with severe chronic […]

Inhaler carbon footprint; significance, focus & action

The impact of climate change on health is increasing, as global warming continues to rise. 1 Within the health and social care sector, pressurised metered dose inhalers (pMDIs) and breath-actuated pMDIs (BA-pMDIs) have been identified as a significant contributing factor to the NHS carbon footprint. This publication reviews current inhaler prescribing in the context of […]