GENERAL-PRACTICE FUNDHOLDERS PRESCRIBING SAVINGS IN ONE REGION OF THEUNITED-KINGDOM, 1991-1994

Since 1991, fundholding general practitioners in the UK have had a fin ancial incentive to contain prescribing costs. Research has confirmed that fundholding practices have contained their prescribing costs more effectively than non-fundholding practices, but how much fundholders have actually saved by changing their prescribing is difficult to quan tify. Fundholders are allocated a prescribing budget, and the underspe nd on this budget has been taken to represent savings produced by chan ging prescribing behaviour. However, this assumes accuracy of budget s etting, which has been questioned. The objective of this study was to estimate the true savings in prescribing made by fundholders during th e first 3 years of fundholding, without making assumptions about the a ccuracy of budget setting. We compare this to underspends on prescribi ng budgets. The results suggest that budget setting did not give fundh olders over-generous budgets and that budget underspends are justified by the true savings in prescribing. (C) 1997 Elsevier Science Ireland Ltd.