stress and anxiety related prescriptions national trend

Summary

The request sought patient prescription numbers for stress and anxiety medications by dose over five years and a comparison with other jurisdictions. The Department of Health and Social Care disclosed aggregate item counts and costs for antidepressants, hypnotics, and proton pump inhibitors but refused to provide patient-specific data or international comparisons due to data limitations.

Key Facts

• The authority cannot link specific drugs to conditions like stress or anxiety as they are used for multiple purposes.
• Data provided is from the EPACT2 system and contains no patient details or diagnoses.
• International comparisons with the UK, Republic of Ireland, Jersey, and Guernsey were refused as the Department does not hold that data.
• The request for information by dose and patient count was partially refused under Section 11(3)(b) as it would require creating new information.
• Aggregate prescription data was provided for the financial years 2014/2015 through 2018/2019.

Data Disclosed

• 2014/2015
• 2015/2016
• 2016/2017
• 2017/2018
• 2018/2019
• 80,939
• 664,171.96
• 100,522
• 336,603.17
• 59,168
• 292,862.76
• 74,989
• 236,641.26
• 1231682
• 2020-03-16
• 2020-04-17

Exemptions Cited

• Section 11(3)(b) - Information not held or would require creation/derivation
• Section 11(3)(a) - Practical refusal reason (information not held)

Original Request

Question: How many patients were prescribed each medicine by dose (low to high) typically used to treat stress and anxiety related issues such as sleeping problems, anti-depressants and stomach ulcers in each of the previous 5 years, what is the national trend and how does it generally compare to the UK, the Republic of Ireland, Jersey and Guernsey?

Data Tables (3)

Full Response Text

Chief Executive: Kathryn Magson Freedom of Information Team Department of Health & Social Care Chief Executive's Office Crookall House Demesne Road Douglas Isle of Man IM1 3QA Tel: (01624) 642621 Email: dhsc@foi.gov.im Website: www.gov.im/dhsc Our ref: 1231682 17th April 2020

Dear ###

We write further to your request which was received on the 16th March 2020 and states:

Question 1 How many patients were prescribed each medicine by dose (low to high) typically used to treat stress and anxiety related issues such as sleeping problems, anti-depressants and stomach ulcers in each of the previous 5 years? Question 2 What is the national trend and how does it generally compare to the UK, the Republic of Ireland, Jersey and Guernsey? While our aim is to provide information whenever possible, in this instance the public authority does not hold or cannot, after taking reasonable steps to do so, find some of the information that you have requested. The statutory exemption sections are shown as part of the corresponding answers below.

I have detailed below the information that is held.

Question 1 How many patients were prescribed each medicine by dose (low to high) typically used to treat stress and anxiety related issues such as sleeping problems, anti-depressants and stomach ulcers in each of the previous 5 years? Complying with the request for information would require the public authority to do one or more of the matters mentioned in section 8(3) (things a public authority is not required to do by the Act S11(3)(b). While our aim is to provide information whenever possible, in this instance, complying with your request for information would require us to create or derive information from information that we hold.

The data we can access is called EPACT2 (please see the tables below) and is completely without patient details, diagnosis and the indication it is being used for. All of the drugs in the classes asked about are used for multiple purposes and cannot be linked to one index condition i.e. there can be no definitive links made to a condition such as stress or anxiety. EPACT2 only informs us how much of a particular medicine has been prescribed for our locality. Antidepressants 2014/2015 to 2018/2019 Financial Year Country plus Code BNF Section Items Net Ingredient Cost 2014/2015 ISLE OF MAN (4) Antidepressant drugs 80,939 664,171.96 2015/2016 ISLE OF MAN (4) Antidepressant drugs 89,009 710,418.97 2016/2017 ISLE OF MAN (4) Antidepressant drugs 92,863 591,132.27 2017/2018 ISLE OF MAN (4) Antidepressant drugs 97,226 408,803.65 2018/2019 ISLE OF MAN (4) Antidepressant drugs 100,522 336,603.17 Hypnotics and Anxiolytics 2014/2015 to 2018/2019 Financial Year Country plus Code BNF Section Items Net Ingredient Cost 2014/2015 ISLE OF MAN (4) Hypnotics and anxiolytics 59,168 292,862.76 2015/2016 ISLE OF MAN (4) Hypnotics and anxiolytics 57,263 257,784.52 2016/2017 ISLE OF MAN (4) Hypnotics and anxiolytics 56,874 224,601.74 2017/2018 ISLE OF MAN (4) Hypnotics and anxiolytics 57,392 220,810.65 2018/2019 ISLE OF MAN (4) Hypnotics and anxiolytics 59,578 218,718.70

Proton pump inhibitors 2014/2015 to 2018/2019 Financial Year Country plus Code BNF Paragraph Items Net Ingredient Cost 2014/2015 ISLE OF MAN (4) Proton pump inhibitors 74,989 236,641.26 2015/2016 ISLE OF MAN (4) Proton pump inhibitors 78,078 234,045.00 2016/2017 ISLE OF MAN (4) Proton pump inhibitors 79,638 201,620.25 2017/2018 ISLE OF MAN (4) Proton pump inhibitors 80,002 183,182.04 2018/2019 ISLE OF MAN (4) Proton pump inhibitors 78,527 163,973.20 Question 2 What is the national trend and how does it generally compare to the UK, the Republic of Ireland, Jersey and Guernsey? While our aim is to provide information whenever possible, in this instance Department of Health and Social Care (“the Department”) is unable to provide the information you have requested. This is in line with section 11(3)a of the Act, as a practical refusal reason applies; namely we do not hold or cannot, after taking reasonable steps to do so, find the information that you have requested. Unfortunately the national trend cannot be compared to other jurisdictions as we do not have access to their data. Please quote the reference number 1231682 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on; 1. Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act 2015; or 2. Whether we are justified in refusing to give you the information requested.
In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision. More detailed information on your right to a review can be found on the Information Commissioner’s website at www.inforights.im. Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.

Yours sincerely