Rate of Return Regulation

Supply-side

• PPRS, Jul.’99-Jul.’04

• Price cut @4.5%: 1999 - 2001

• Free price modulation from January 2001

• Price control for generics

• Limited negative list

• PPRS judicial review

Demand-side

• NICE: binding clinical cost-effectiveness guidance

• Practice guidelines

• Extensive generic prescribing

• Cost conscious GPs

• Budgets for PCGs

• Prescription audit

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