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2026-05-12 16:40:03 +01:00
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+/*
+    Prescribing spend by patient template
+    =====================================
+
+    Purpose:
+    Rank patients by estimated prescribing cost over a selected period and
+    medicine definition.
+
+    Use this when looking for high-cost patients or checking the shape of cost
+    concentration before doing deeper clinical review.
+
+    Default source is the maintained unified prescribing table, which already
+    includes parsed quantity and estimated price. If that table is unavailable
+    or needs rebuilding, see 06_advanced_methods/product_price_and_quantity_parsing_template.sql.
+
+    Keep at least one medicine filter set. Leaving BNF, VTM, and VMP filters all
+    NULL can scan all prescribing and is usually not a useful starting point.
+*/
+
+SET START_DATE = '2025-04-01';
+SET END_DATE = '2026-03-31';
+SET BNF_PREFIX = '0403';
+SET VTM_SNOMED_CODE = NULL;
+SET VMP_SNOMED_CODE = NULL;
+SET TOP_N = 100;
+
+WITH products AS (
+    -- Keep at least one of the filters below populated so the product set is intentional.
+    SELECT DISTINCT
+        "ProductSnomedCode",
+        "ProductDescription",
+        "TherapeuticMoietyName",
+        "BNFCode",
+        "BNFParagraphCode"
+    FROM DATA_HUB.DWH."DimMedicineAndDevice"
+    WHERE ($BNF_PREFIX IS NOT NULL AND "BNFCode" LIKE $BNF_PREFIX || '%')
+       OR ($VTM_SNOMED_CODE IS NOT NULL AND "TherapeuticMoietySnomedCode" = $VTM_SNOMED_CODE)
+       OR ($VMP_SNOMED_CODE IS NOT NULL AND "MedicinalLatestSnomedCode" = $VMP_SNOMED_CODE)
+),
+patient_costs AS (
+    -- Aggregate first at patient/practice level so ranking is not inflated by joins.
+    SELECT
+        rx."PersonKey",
+        rx."CurrentGeneralPractice" AS "PracticeCode",
+        COUNT(*) AS "PrescriptionRows",
+        COUNT(DISTINCT prod."ProductSnomedCode") AS "DistinctProducts",
+        SUM(COALESCE(rx."EstPrice", 0)) AS "EstimatedCost"
+    FROM REPORTING_DATASETS_ICB.SCRATCHPAD."MEDS__UnifiedPrescribingTable" rx
+    INNER JOIN products prod
+        ON rx."SNOMEDCode" = prod."ProductSnomedCode"
+    WHERE rx."DateMedicationStart" BETWEEN $START_DATE AND $END_DATE
+      AND rx."PersonKey" IS NOT NULL
+    GROUP BY rx."PersonKey", rx."CurrentGeneralPractice"
+),
+practice_lookup AS (
+    -- De-duplicated practice labels prevent site-level duplicates in the ranking output.
+    SELECT
+        "OrganisationCode" AS "PracticeCode",
+        MIN("OrganisationName") AS "PracticeName",
+        MIN("PCNName") AS "PCNName",
+        MIN("PlaceName") AS "PlaceName",
+        MIN("AllianceName") AS "AllianceName"
+    FROM DATA_HUB.DWH."DimOrganisationAndSite"
+    WHERE "OrganisationSubType" = 'GP Practice'
+      AND "IsSiteActive" = 'Yes'
+      AND "IsSiteNorfolkAndSuffolk" = 'Yes'
+      AND "SiteCode" = "OrganisationCode"
+    GROUP BY "OrganisationCode"
+),
+ranked AS (
+    SELECT
+        ROW_NUMBER() OVER (ORDER BY pc."EstimatedCost" DESC NULLS LAST) AS "Rank",
+        gp."PracticeName",
+        gp."PCNName",
+        gp."PlaceName",
+        gp."AllianceName",
+        pc."PersonKey",
+        pc."PracticeCode",
+        pc."PrescriptionRows",
+        pc."DistinctProducts",
+        pc."EstimatedCost"
+    FROM patient_costs pc
+    INNER JOIN practice_lookup gp
+        ON pc."PracticeCode" = gp."PracticeCode"
+)
+SELECT
+    "Rank",
+    "PracticeName",
+    "PCNName",
+    "PlaceName",
+    "AllianceName",
+    "PersonKey",
+    "PracticeCode",
+    "PrescriptionRows",
+    "DistinctProducts",
+    "EstimatedCost"
+FROM ranked
+WHERE "Rank" <= $TOP_N
+ORDER BY "Rank";