diff --git a/openprescribing/measure_definitions/lpcoprox.json b/openprescribing/measure_definitions/lpcoprox.json index 24164b34d3..9c2f42058b 100644 --- a/openprescribing/measure_definitions/lpcoprox.json +++ b/openprescribing/measure_definitions/lpcoprox.json @@ -1,16 +1,28 @@ { - "name": "NHS England Low Priority Treatment - co-proxamol", - "title": [ - "Co-proxamol cost per 1000 patients" - ], - "description": [ - "Cost of co-proxamol per 1000 patients" - ], + "name": "Items which should not routinely be prescribed in primary care - co-proxamol", + "title": "Co-proxamol cost per 1000 patients", + "description": "Cost of co-proxamol per 1000 patients", "numerator_short": "Co-proxamol cost (£)", "denominator_short": "1000 patients", "why_it_matters": [ - "Co-proxamol is a painkiller which was withdrawn in 2005 due to safety concerns. All marketing authorisations were cancelled at the end of 2007. ", - "There remains some prescribing of co-proxamol (which is now unlicensed) at a cost of over £100 per box." + "

", + "NHS England guidance states:

", + "

The Medicines and Healthcare products Regulatory Agency (MHRA) fully withdrew the painkiller co-proxamol from the UK market in 2007 due to safety concerns. ", + "All use in the UK is now on an unlicensed basis. Prescribing an unlicensed medicine should be in line with ", + "General Medical Council (GMC) guidance, ", + "which states suitably licensed alternatives need to be considered and the prescriber must be satisfied that there is sufficient evidence or experience ", + "of using the medicine to demonstrate its safety and efficacy.

", + "

Since 1985 advice aimed at the reduction of co-proxamol toxicity and fatal overdose has been provided, but this was not effective and resulted in withdrawal ", + "of co-proxamol by the MHRA. In 2011 MHRA reported that the withdrawal of co-proxamol from the UK had saved an estimated 300 to 400 lives each year from self-poisoning, ", + "around a fifth of which would have been accidental. Since the withdrawal, further safety concerns have been raised, resulting in co-proxamol ", + "being withdrawn in other countries.

", + "

Due to the significant safety concerns, the joint clinical working group considered co-proxamol suitable for inclusion in this guidance. ", + "Co-proxamol is no longer manufactured or supplied in the UK and any use on an unlicensed basis requires it to be imported for individual use, ", + "at an increasing cost to the NHS and the environment. The average cost per item is £265 (January 2022), which is an increase of £44 since 2021.

", + "

NHS England recommend that GPs:", + "

" ], "tags": [ "cost", @@ -26,5 +38,12 @@ "numerator_bnf_codes_filter": [ "0407010Q0 # Co-Proxamol (Dextroprop HCl/Paracet)" ], - "denominator_type": "list_size" -} \ No newline at end of file + "denominator_type": "list_size", + "authored_by": "richard.croker@phc.ox.ac.uk", + "checked_by": "christopher.wood@phc.ox.ac.uk", + "date_reviewed": "2023-09-12", + "next_review": "2025-09-12", + "measure_complexity": "low", + "measure_type": "bnf_code", + "radar_exclude": false +}