England 2024/25

Published 5 June 2025

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Key findings

In 2024/25, 1.26 billion prescription items were dispensed in the community in England at a cost of £11.2 billion.

The number of items dispensed in the community in England increased by 4% from 2023/24 while costs increased by 2%.

In England in 2024/25 the most dispensed chemical substance was Atorvastatin, a drug used to lower cholesterol and prevent heart disease, with 73 million items.

BNF Chapter 6 Endocrine System accounted for 19% of total costs in England in 2024/25.

BNF Chapter 2 Cardiovascular System accounted for 30% of all items dispensed in England in 2024/25.

Dapagliflozin, a medication mainly used to treat type 2 diabetes, was the chemical substance with the highest costs. In England in 2024/25, these costs were £333 million.

Forxiga 10mg tablets was the presentation with the largest increase in cost from 2023/24, with an increase of £97 million. Forxiga is a brand of the chemical substance dapagliflozin.

1. Things you should know

1.1. Scope

Prescription Cost Analysis (PCA) provides information about the costs and volumes of prescription items that have been dispensed in England.

These statistics cover prescription items submitted to the NHSBSA for reimbursement that were prescribed in England, Scotland, Wales, Northern Ireland or the Channel Islands, and subsequently dispensed in the community in England. By ‘dispensed in the community’ we mean it was dispensed at a pharmacy, by an appliance contractor, by a dispensing doctor, or as a personally administered item. Items dispensed in hospitals or prisons, for example, are not described as ‘dispensed in the community’. Items prescribed in England but dispensed elsewhere in the United Kingdom are not included in these statistics.

The Pharmacy First Clinical Pathways advanced service was launched on 31 January 2024. The service allows patients to get treatment for seven common conditions directly from their local pharmacy, without the need for a GP appointment or prescription. This includes medicines to treat:

  • sinusitis
  • sore throat
  • earache
  • infected insect bite
  • impetigo (a bacterial skin infection)
  • shingles
  • uncomplicated urinary tract infections in women

Data relating to medicines supplied as part of this advanced service have been included in this publication.

More information in the Pharmacy First service can be found on the NHS England website.

This publication is an accredited official statistic release. Accredited official statistic status means that PCA meets the highest standards of trustworthiness, quality and public value, and complies with all aspects of the Code of Practice for Statistics.

The designation of this publication as a National Statistic was confirmed in May 2021 following an assessment by the Office for Statistics Regulation (OSR). More information about this confirmation, and the assessment of these statistics, can be found on the OSR website.

1.2. Definitions

Item

A single unit of medication listed separately on a prescription form. For example, in this publication, an item might be listed as paracetamol 500mg tablets x28, distinct from other medications that may be prescribed on the same form.

NIC

The Net Ingredient Cost (NIC), referred to as costs, is the basic price of a single unit of a medication multiplied by the quantity prescribed. It does not include other fees incurred by dispensing contractors, such as controlled drug fees or the single activity fee. The basic price is determined by the Drug Tariff or by the manufacturer, wholesaler, or supplier of the product.

Classification

This publication uses the British National Formulary (BNF), which lists medicines used in the UK and classifies them according to their primary therapeutic use. Medication may also be prescribed for medical conditions other than their primary use. For example, certain antidepressants may be recommended to individuals experiencing chronic pain. The NHSBSA does not capture the clinical indication of a prescription during processing.

Generic prescribing

Generic prescribing is the prescribing of a drug by it’s non-proprietary name rather than a specific brand name. This allows for any suitable drug that meets the same standards as the brand name drug to be dispensed, which can result in cost savings. For example, paracetamol 500mg tablets.

Branded prescribing

Branded prescribing is the prescribing of a drug by specific brand name. For example, Panadol Advance 500mg tablets.

2. Results and commentary

2.1. Cost and number of prescription items dispensed in England

Cost of prescription items dispensed in England 2015/16 to 2024/25

Chart
Figure 1: The cost of prescription items dispensed in England has been increasing since 2018/19

Note: The y-axis does not start at zero. This is to emphasise relative changes rather than absolute values. Please consider the scale when interpreting the data.

Table
Table 1: The cost of prescription items dispensed in England has been increasing since 2018/19
Financial year Net ingredient cost (£)
2015/2016 9,288,532,955
2016/2017 9,193,912,890
2017/2018 9,095,228,452
2018/2019 8,833,869,091
2019/2020 9,281,576,939
2020/2021 9,605,773,673
2021/2022 9,689,467,770
2022/2023 10,425,820,708
2023/2024 10,926,112,867
2024/2025 11,151,362,174

Source: Summary Tables - Prescription Cost Analysis - National

Prescription items dispensed in the community in England in 2024/25 cost £11.2 billion.

There was a 2% increase in costs from 2023/24 to 2024/25.

In England, the cost of prescription items increased 20% from 2015/16 to 2024/25, an increase of £1.86 billion.

Number of prescription items dispensed in England 2015/16 to 2024/25

Chart
Figure 2: The number of prescription items dispensed in England has been increasing since 2020/21

Note: The y-axis does not start at zero. This is to emphasise relative changes rather than absolute values. Please consider the scale when interpreting the data.

Table
Table 2: The number of prescription items dispensed in England has been increasing since 2020/21
Financial year Items
2015/2016 1,087,850,504
2016/2017 1,108,964,988
2017/2018 1,106,422,102
2018/2019 1,109,083,306
2019/2020 1,132,043,735
2020/2021 1,110,587,234
2021/2022 1,139,276,571
2022/2023 1,177,346,927
2023/2024 1,212,798,906
2024/2025 1,260,859,843

Source: Summary Tables - Prescription Cost Analysis - National

In 2024/25, 1.26 billion items were dispensed in the community in England.

There was a 4% increase in items from 2023/24 to 2024/25.

In England, the number of prescription items dispensed increased by 16% from 2015/16 to 2024/25, an increase of 170 million items.

2.2. Cost and number of prescription items dispensed in England amongst BNF chapters

These statistics use the British National Formulary (BNF) to group medicines based on their primary therapeutic indication. The BNF has multiple levels, starting with the largest grouping called chapters, followed by sections, paragraphs, sub-paragraphs, chemical substances, products, and individual presentations.

The NHSBSA uses the BNF classification system implemented prior to the release of edition 70, which includes 6 additional chapters (18 to 23) created by NHS Prescription Services. These chapters are used to classify products that fall outside chapters 1 to 15, including dressings, appliances and medical devices.

However, presentations in chapters 20 to 23 do not have assigned BNF paragraphs, sub-paragraphs, chemical substances, or products.

Distribution of cost of items dispensed in England amongst BNF chapters 2024/25

Chart
Figure 3: In 2024/25, BNF Chapter 6 Endocrine System had the highest costs
Table
Table 3: In 2024/25, BNF Chapter 6 Endocrine System had the highest costs
BNF chapter code BNF chapter name Net ingredient cost (£)
01 Gastro-Intestinal System 755,272,912.53
02 Cardiovascular System 1,381,419,299.06
03 Respiratory System 1,218,511,901.26
04 Central Nervous System 1,687,187,014.97
05 Infections 242,198,760.82
06 Endocrine System 2,074,911,650.85
07 Obstetrics, Gynaecology and Urinary-Tract Disorders 276,487,949.88
08 Malignant Disease and Immunosuppression 177,659,695.63
09 Nutrition and Blood 914,829,966.07
10 Musculoskeletal and Joint Diseases 138,830,798.49
11 Eye 170,816,248.79
12 Ear, Nose and Oropharynx 101,858,896.63
13 Skin 318,009,296.86
14 Immunological Products and Vaccines 144,351,409.49
15 Anaesthesia 25,027,837.17
18 Preparations used in Diagnosis 17,762.50
19 Other Drugs and Preparations 10,289,219.34
20 Dressings 175,464,676.47
21 Appliances 833,368,382.82
22 Incontinence Appliances 67,740,835.95
23 Stoma Appliances 437,107,658.05

Source: Summary Tables - Prescription Cost Analysis - Chapter

BNF Chapter 6 Endocrine System accounted for 19% of total costs in 2024/25.

BNF Chapter 4 Central Nervous System accounted for 15% of total costs in 2024/25.

BNF Chapter 2 Cardiovascular System accounted for 12% of total costs in 2024/25.

In 2024/25, BNF Chapter 6 Endocrine System had the highest costs, totalling £2.07 billion. BNF Chapter 6 includes drugs used to treat diabetes and sex hormones. Chapter 4 Central Nervous System followed with costs of £1.69 billion. Chapter 2 Cardiovascular System had costs of £1.38 billion. The top 3 BNF Chapters by total costs remains consistent with 2023/24. However, Chapter 4 Central Nervous System has moved up to second place and BNF Chapter 2 Cardiovascular System down to third place.

Index of the BNF chapters with the largest percentage increase and decrease in costs from 2015/16 to 2024/25

These statistics only cover BNF Chapters 01 through to 15.

Chart
Figure 4: BNF Chapter 1 Gastro-Intestinal System has shown the largest percentage increase in costs from 2015/16 to 2024/25
Table
Table 4: BNF Chapter 1 Gastro-Intestinal System has shown the largest percentage increase in costs from 2015/16 to 2024/25
Financial year 01 - Gastro-Intestinal System 10 - Musculoskeletal and Joint Diseases
2015/2016 100.0 100.0
2016/2017 97.1 89.8
2017/2018 93.1 86.5
2018/2019 92.4 88.6
2019/2020 102.6 95.0
2020/2021 115.8 75.4
2021/2022 125.1 68.5
2022/2023 144.4 62.9
2023/2024 158.6 62.4
2024/2025 155.2 62.6

BNF Chapter 1 Gastro-Intestinal System has shown the greatest percentage increase in costs from 2015/16 to 2024/25 of 55%.

BNF Chapter 10 Musculoskeletal and Joint Diseases has shown the greatest percentage decrease in costs from 2015/16 to 2024/25 of 37%.

Distribution of items dispensed in England amongst BNF chapters 2024/25

Chart
Figure 5: In 2024/25, BNF Chapter 2 Cardiovascular System had the highest number of items
Table
Table 5: In 2024/25, BNF Chapter 2 Cardiovascular System had the highest number of items
BNF chapter code BNF chapter name Items
01 Gastro-Intestinal System 117,655,483
02 Cardiovascular System 377,485,944
03 Respiratory System 77,638,604
04 Central Nervous System 237,646,133
05 Infections 42,448,722
06 Endocrine System 141,405,059
07 Obstetrics, Gynaecology and Urinary-Tract Disorders 35,099,429
08 Malignant Disease and Immunosuppression 4,621,717
09 Nutrition and Blood 71,207,550
10 Musculoskeletal and Joint Diseases 32,045,288
11 Eye 15,503,174
12 Ear, Nose and Oropharynx 11,748,001
13 Skin 27,282,149
14 Immunological Products and Vaccines 10,648,791
15 Anaesthesia 1,800,663
18 Preparations used in Diagnosis 83
19 Other Drugs and Preparations 614,375
20 Dressings 5,406,499
21 Appliances 40,057,113
22 Incontinence Appliances 2,678,902
23 Stoma Appliances 7,866,164

Source: Summary Tables - Prescription Cost Analysis - Chapter

BNF Chapter 2 Cardiovascular System accounted for 30% of all items dispensed in 2024/25.

BNF Chapter 4 Central Nervous System accounted for 19% of all items dispensed in 2024/25.

BNF Chapter 6 Endocrine System accounted for 11% of all items dispensed in 2024/25.

In 2024/25, BNF Chapter 2 Cardiovascular System had the highest number of prescription items dispensed in England, with a total of 377 million items. Chapter 4 Central Nervous System followed with 238 million items. Chapter 6 Endocrine System had 141 million items. This mirrors the trend for the top 3 BNF Chapters by items dispensed as in 2023/24,

Index of the BNF chapters with the largest percentage increase and decrease in items from 2015/16 to 2024/25

These statistics only cover BNF Chapters 01 through to 15.

Chart
Figure 6: BNF Chapter 6 Endocrine System has shown the greatest percentage increase in items from 2015/16 to 2024/25
Table
Table 6: BNF Chapter 6 Endocrine System has shown the greatest percentage increase in items from 2015/16 to 2024/25
Financial year 06 - Endocrine System 13 - Skin
2015/2016 100.0 100.0
2016/2017 103.6 96.8
2017/2018 105.3 89.2
2018/2019 107.9 82.3
2019/2020 112.2 77.7
2020/2021 110.2 69.3
2021/2022 114.8 69.9
2022/2023 122.3 69.5
2023/2024 128.7 71.6
2024/2025 136.1 73.7

BNF Chapter 6 Endocrine System has shown the greatest percentage increase in items from 2015/16 to 2024/25 of 36%.

BNF Chapter 13 Skin has shown the greatest percentage decrease in items from 2015/16 to 2024/25 of 26%.

2.3. Generic prescribing and dispensing in England

Many drugs are now prescribed generically even when they are not available in generic form. For example, drugs that are listed in Category C of the Drug Tariff.

Proportion of items prescribed generically and proportion of costs excluding appliances England 2015/16 to 2024/25

Chart
Figure 7: Between 2015/16 and 2024/25 the percentage of items prescribed generically has remained consistent

Note: The y-axis does not start at zero. This is to emphasise relative changes rather than absolute values. Please consider the scale when interpreting the data.

Table
Table 7: Between 2015/16 and 2024/25, the percentage of items prescribed generically has remained consistent
Financial year Items (%) Net ingredient cost (%)
2015/2016 85.1 67.0
2016/2017 84.8 64.5
2017/2018 84.4 63.0
2018/2019 84.1 60.8
2019/2020 84.2 61.1
2020/2021 84.8 63.1
2021/2022 84.3 60.6
2022/2023 85.0 62.0
2023/2024 85.3 61.5
2024/2025 85.7 58.9

Source: Additional Tables - Prescription Cost Analysis - table A5

Generic items made up 86% of the total items prescribed in 2024/25.

Generic prescribing accounted for 59% of costs in 2024/25.

The percentage of items prescribed generically has remained consistent between 2015/16 and 2024/25. There has been a 2 percentage point variation in the period between 2015/16 and 2024/25, meaning it has stayed stable over the period. Note that these figures exclude preparation class 4 products - appliances.

Between 2015/16 and 2024/25 the percentage of costs which was accounted for by generic prescribing fell by 8 percentage points.

Sankey chart to show the flow of prescribing and dispensing volumes England 2024/25

Chart
Figure 8: In 2024/25, the majority of items were both prescribed and dispensed generically
Table
Table 8: In 2024/25, the majority of items were both prescribed and dispensed generically
From To Items
Total items Dressings and appliances 62,121,773
Total items Prescribed generically 1,027,690,660
Total items Prescribed proprietary 171,568,807
Prescribed generically Dispensed generically 966,945,186
Prescribed generically Dispensed proprietary 60,224,077
Prescribed proprietary Dispensed proprietary 171,568,807

In 2024/25, 60 million of the 1.03 billion items prescribed generically were dispensed as a proprietary item, this is 6% of items prescribed generically.

In 2024/25, 172 million items were prescribed proprietary. This is 14% of the 1.26 billion items dispensed.

2.4. The 10 most dispensed chemical substances by costs and items in England

Drugs containing the same active ingredient are referred to by the same name, regardless of presentation type or if the product is branded or generic. For example, Omeprazole 20mg and Omeprazole 40mg capsules both contain the same active ingredient. The name used to identify the active substance, Omeprazole in this example, is referred to in this publication as ‘chemical substance’. Products such as dressings and appliances in BNF Chapters 20 to 23 do not have a chemical substance assigned to them.

The 10 most dispensed chemical substances by cost in 2024/25

Chart
Figure 9: In England in 2024/25, dapagliflozin was the chemical substance with the highest cost
Table
Table 9: In England in 2024/25, dapagliflozin was the chemical substance with the highest cost
Chemical substance name Chemical substance BNF code Net ingredient cost (£)
Dapagliflozin 0601023AG 333,131,611
Beclometasone dipropionate 0302000C0 317,589,524
Edoxaban 0208020AA 242,650,805
Empagliflozin 0601023AN 170,757,125
BeclometDiprop/Formoterol/Glycopyrronium (Corticosteroids) 0302000AA 160,094,046
Semaglutide 0601023AW 146,760,725
Sacubitril/valsartan 0205052AE 137,553,844
Budesonide 0302000K0 132,337,858
Influenza 1404000H0 123,300,888
Tirzepatide 0601023AZ 120,483,326

Source: Additional Tables - Prescription Cost Analysis - A2

Dapagliflozin had the highest cost in 2024/25 of £333 million. Dapagliflozin is a medication primarily used to treat type 2 diabetes. It is also used to treat adults with heart failure and chronic kidney disease.

Three of the top 10 chemical substances by cost in 2024/25 are used to treat type 2 diabetes.

Two of the top 10 chemical substances by cost in 2024/25 are glucagon-like peptide-1 (GLP-1) receptor agonists used to help lose weight.

Dapagliflozin has risen from the third placed chemical substance by costs in England in 2023/24. Both of the GLP-1 receptor agonists, semglutide and tirzepatide, are new entries into the 10 most dispensed chemical substances by cost in 2024/25.

The 10 most dispensed chemical substances by total items in 2024/25

Chart
Figure 10: In England in 2024/25, Atorvastatin was the chemical substance with the highest number of items
Table
Table 10: In England in 2024/25, Atorvastatin was the chemical substance with the highest number of items
Chemical substance name Chemical substance BNF code Items
Atorvastatin 0212000B0 72,827,712
Amlodipine 0206020A0 39,745,719
Lansoprazole 0103050L0 36,566,885
Omeprazole 0103050P0 35,965,281
Ramipril 0205051R0 35,128,125
Levothyroxine sodium 0602010V0 34,575,816
Bisoprolol fumarate 0204000H0 30,140,807
Colecalciferol 0906040G0 28,205,346
Metformin hydrochloride 0601022B0 26,569,154
Sertraline hydrochloride 0403030Q0 24,662,425

Source: Additional Tables - Prescription Cost Analysis - A3

Atorvastatin was the most dispensed chemical substance in 2024/25 with 73 million items. Atorvastatin is a type of statin commonly used to lower cholesterol and help prevent heart disease.

Atorvastatin has been the most dispensed chemical substance by items since 2016/17.

Four of the top 10 chemical substances by items in 2024/25 belong to BNF Chapter 2 Cardiovascular System. These substances are Atorvastatin, Amlodipine, Ramipril, and Bisoprolol fumarate.

2.5. Cost and number of prescription items dispensed by Integrated Care Board (ICB) in England

ICBs are statutory NHS organisations responsible for developing a plan for meeting the health needs of the population, managing the NHS budget, and arranging for the provision of health services in a geographical area.

It is important to note that the ICB in these statistics is the location of the dispensing contract as listed in NHSBSA administrative records, rather than the prescribing organisation of an item.

Prescribing and dispensing trends vary regionally, and there are many factors that influence these trends, such as the presence of specialist dispensing contractors within a given area.

To find out more about ICBs and how they were used in these statistics, please refer to section 3.2 of the Background Information and Methodology note that accompanies this release.

Cost per person (£) by ICB 2024/25

Chart
Figure 11: The mean cost of items dispensed per person in England was £195 in 2024/25
Table
Table 11: The mean cost of items dispensed per person in England was £195 in 2024/25
ICB name Net ingredient cost (£) per person
NHS Cambridgeshire and Peterborough Integrated Care Board 416.52
NHS Herefordshire and Worcestershire Integrated Care Board 330.41
NHS West Yorkshire Integrated Care Board 282.08
NHS Nottingham and Nottinghamshire Integrated Care Board 256.03
NHS Cheshire and Merseyside Integrated Care Board 230.47
NHS Staffordshire and Stoke-on-Trent Integrated Care Board 219.18
NHS Greater Manchester Integrated Care Board 218.77
NHS Lincolnshire Integrated Care Board 217.73
NHS Black Country Integrated Care Board 209.58
NHS Lancashire and South Cumbria Integrated Care Board 208.88
NHS Sussex Integrated Care Board 207.62
NHS North East and North Cumbria Integrated Care Board 204.74
NHS Kent and Medway Integrated Care Board 203.20
NHS Gloucestershire Integrated Care Board 198.64
NHS Humber and North Yorkshire Integrated Care Board 195.72
NHS South Yorkshire Integrated Care Board 193.63
NHS Suffolk and North East Essex Integrated Care Board 192.32
NHS Norfolk and Waveney Integrated Care Board 191.99
NHS Birmingham and Solihull Integrated Care Board 189.38
NHS Cornwall and the Isles of Scilly Integrated Care Board 189.24
NHS Mid and South Essex Integrated Care Board 187.29
NHS Leicester, Leicestershire and Rutland Integrated Care Board 186.73
NHS Coventry and Warwickshire Integrated Care Board 185.73
NHS Dorset Integrated Care Board 184.74
NHS Somerset Integrated Care Board 184.73
NHS Shropshire, Telford and Wrekin Integrated Care Board 181.15
NHS Devon Integrated Care Board 181.06
NHS North West London Integrated Care Board 178.58
NHS Hampshire and Isle of Wight Integrated Care Board 177.16
NHS Derby and Derbyshire Integrated Care Board 170.99
NHS Hertfordshire and West Essex Integrated Care Board 168.29
NHS Northamptonshire Integrated Care Board 161.95
NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board 160.34
NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board 154.91
NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board 153.34
NHS Frimley Integrated Care Board 149.96
NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board 148.96
NHS North East London Integrated Care Board 148.00
NHS North Central London Integrated Care Board 144.05
NHS Surrey Heartlands Integrated Care Board 138.36
NHS South West London Integrated Care Board 134.55
NHS South East London Integrated Care Board 132.88

Source: Summary Tables - Prescription Cost Analysis - ICB National | Office for National Statistics - Health geographies population estimates

NHS Cambridgeshire and Peterborough ICB continues to have the highest cost per person, in 2024/25 this was £417.

NHS South East London ICB continues to have the lowest cost per person, in 2024/25 this was £133.

As in 2023/24, NHS Cambridgeshire and Peterborough ICB’s cost per person is more than double the national average. Dispensing contractors in this ICB offer specialist stoma care, 35% of their total costs of £387 million in 2024/25 were in BNF Chapter 23 Stoma Appliances.

Dispensed items per person by ICB 2024/25

Chart
Figure 12: The mean number of items dispensed per person in England was 22 in 2024/25
Table
Table 12: The mean number of items dispensed per person in England was 22 in 2024/25
ICB name Items per person
NHS West Yorkshire Integrated Care Board 35.1
NHS Lincolnshire Integrated Care Board 30.1
NHS North East and North Cumbria Integrated Care Board 29.5
NHS South Yorkshire Integrated Care Board 27.1
NHS Cheshire and Merseyside Integrated Care Board 25.4
NHS Lancashire and South Cumbria Integrated Care Board 25.2
NHS Humber and North Yorkshire Integrated Care Board 25.1
NHS Suffolk and North East Essex Integrated Care Board 25.1
NHS Norfolk and Waveney Integrated Care Board 25.0
NHS Staffordshire and Stoke-on-Trent Integrated Care Board 24.9
NHS Cambridgeshire and Peterborough Integrated Care Board 24.4
NHS Cornwall and the Isles of Scilly Integrated Care Board 24.1
NHS Greater Manchester Integrated Care Board 24.1
NHS Nottingham and Nottinghamshire Integrated Care Board 23.1
NHS Coventry and Warwickshire Integrated Care Board 22.6
NHS Black Country Integrated Care Board 22.4
NHS Leicester, Leicestershire and Rutland Integrated Care Board 22.2
NHS North West London Integrated Care Board 22.1
NHS Northamptonshire Integrated Care Board 21.9
NHS Gloucestershire Integrated Care Board 21.7
NHS Devon Integrated Care Board 21.5
NHS Herefordshire and Worcestershire Integrated Care Board 20.8
NHS Derby and Derbyshire Integrated Care Board 20.6
NHS Dorset Integrated Care Board 20.4
NHS Sussex Integrated Care Board 20.1
NHS Shropshire, Telford and Wrekin Integrated Care Board 19.7
NHS Hertfordshire and West Essex Integrated Care Board 19.6
NHS Somerset Integrated Care Board 19.6
NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board 19.5
NHS Birmingham and Solihull Integrated Care Board 19.4
NHS Mid and South Essex Integrated Care Board 19.3
NHS Kent and Medway Integrated Care Board 18.8
NHS North East London Integrated Care Board 18.7
NHS Hampshire and Isle of Wight Integrated Care Board 18.4
NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board 17.1
NHS North Central London Integrated Care Board 17.0
NHS South West London Integrated Care Board 16.9
NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board 16.7
NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board 16.0
NHS Frimley Integrated Care Board 15.6
NHS South East London Integrated Care Board 14.7
NHS Surrey Heartlands Integrated Care Board 13.8

Source: Summary Tables - Prescription Cost Analysis - ICB National | Office for National Statistics - Mid-year population estimates

NHS West Yorkshire ICB continues to have the highest dispensed items per person, in 2024/25 this was 35.

NHS Surrey Heartlands ICB continues to have the lowest dispensed items per person, in 2024/25 this was 14.

2.6. Top presentations by changes in unit and total costs

Presentation is the name given to the specific type, strength, and formulation of a drug, or the specific type of an appliance. For example, paracetamol 500mg tablets.

The charts in this section have been limited to presentations with a total cost in 2024/25 greater than £1 million.

A unit cost for a presentation is calculated by dividing the total cost of items dispensed in the period by the total quantity.

Price concessions can be granted by the Department of Health and Social Care (DHSC) for medicines that pharmacists are struggling to obtain at or below the price set out in the Drug Tariff. These concessions can have large impacts on the unit costs of drugs.

Top 10 presentations by percentage increase in unit cost 2023/24 to 2024/25

Chart
Figure 13: Hydrocortisone 0.5% cream had the highest increase in unit cost from 2023/24 to 2024/25
Table
Table 13: Hydrocortisone 0.5% cream had the highest increase in unit cost from 2023/24 to 2024/25
Presentation name Unit of measure Unit cost increase (%)
Hydrocortisone 0.5% cream gram 2,241
Oxytetracycline 250mg tablets tablet 853
Pregabalin 50mg capsules capsule 547
Quetiapine 150mg tablets tablet 452
Erythromycin 250mg gastro-resistant tablets tablet 451
Quetiapine 200mg tablets tablet 442
Quetiapine 100mg tablets tablet 433
Nicorandil 20mg tablets tablet 423
Terbinafine 250mg tablets tablet 351
Telmisartan 80mg tablets tablet 309

Source: Additional Tables - Prescription Cost Analysis - A11

Hydrocortisone 0.5% cream had the highest increase in unit cost from 2023/24 to 2024/25, an increase of 2,241%. Hydrocortisone 0.5% cream is used to treat skin conditions such as eczema, psoriasis, and insect bites. Hydrocortisone 0.5% cream was removed from the Drug Tariff in March 2024.

Top 10 presentations by percentage decrease in unit cost 2023/24 to 2024/25

Chart
Figure 14: Sitagliptin 100mg tablets had the highest decrease in unit cost from 2023/24 to 2024/25
Table
Table 14: Sitagliptin 100mg tablets had the highest decrease in unit cost from 2023/24 to 2024/25
Presentation name Unit of measure Unit cost decrease (%)
Sitagliptin 100mg tablets tablet -86.2
Sulfasalazine 500mg tablets tablet -85.9
Apixaban 2.5mg tablets tablet -82.3
Apixaban 5mg tablets tablet -81.4
Ivabradine 5mg tablets tablet -76.5
Ranolazine 500mg modified-release tablets tablet -71.0
Ranolazine 750mg modified-release tablets tablet -70.8
Ranolazine 375mg modified-release tablets tablet -70.4
Aripiprazole 5mg tablets tablet -63.3
Prucalopride 2mg tablets tablet -62.0

Source: Additional Tables - Prescription Cost Analysis - A12

Sitagliptin 100mg tablets had the highest decrease in unit cost from 2023/24 to 2024/25, a decrease of 86%. Sitagliptin came off patent and was made a generic in June 2023. Sitagliptin is used primarily to treat type 2 diabetes.

Top 10 presentations by increase in total cost 2023/24 to 2024/25

Chart
Figure 15: Forxiga 10mg tablets had the highest increase in total costs from 2023/24 to 2024/25
Table
Table 15: Forxiga 10mg tablets had the highest increase in total costs from 2023/24 to 2024/25
Presentation name Unit of measure Total cost absolute increase (£)
Forxiga 10mg tablets tablet 97,234,454
Rivaroxaban 20mg tablets tablet 72,091,653
Mounjaro KwikPen 5mg/0.6ml inj 2.4ml pre-filled pens pre-filled disposable injection 62,686,776
FreeStyle Libre 2 Plus Sensor kit 41,797,388
Creon 25000 gastro-resistant capsules (Viatris) capsule 40,838,824
Mounjaro KwikPen 2.5mg/0.6ml inj 2.4ml pre-filled pens pre-filled disposable injection 30,401,584
Mirabegron 50mg modified-release tablets tablet 29,097,867
Rybelsus 7mg tablets tablet 25,439,654
FreeStyle Libre 2 Sensor kit 25,436,787
Alogliptin 25mg tablets tablet 22,536,927

Source: Additional Tables - Prescription Cost Analysis - A13

Between 2023/24 and 2024/25, the total costs of Forxiga 10mg tablets increased by £97 million, the highest increase of all presentations. This is the second year in a row where Forxiga 10mg tablets have shown the highest increase in costs following an increase of £90 million between 2022/23 and 2023/24. Forxiga 10mg tablets is the proprietary version of Dapagliflozin 10mg tablets, primarily used to control blood sugar levels in people with type 2 diabetes.

Top 10 presentations by decrease in total cost 2023/24 to 2024/25

Chart
Figure 16: Apixaban 5mg tablets had the highest decrease in total costs from 2023/24 to 2024/25
Table
Table 16: Apixaban 5mg tablets had the highest decrease in total costs from 2023/24 to 2024/25
Presentation name Unit of measure Total cost absolute decrease (£)
Apixaban 5mg tablets tablet -131,367,757
Apixaban 2.5mg tablets tablet -57,333,491
Omeprazole 20mg gastro-resistant capsules capsule -54,323,121
Sitagliptin 100mg tablets tablet -32,025,446
Vipidia 25mg tablets tablet -26,449,898
Atorvastatin 20mg tablets tablet -23,510,528
Trulicity 1.5mg/0.5ml solution for injection pre-filled pens pre-filled disposable injection -22,600,991
Victoza 6mg/ml solution for injection 3ml pre-filled pens pre-filled disposable injection -22,110,681
Betmiga 50mg modified-release tablets tablet -20,950,362
Ozempic 0.5mg/0.37ml inj 1.5ml pre-filled pens pre-filled disposable injection -20,916,538

Source: Additional Tables - Prescription Cost Analysis - A14

Between 2023/24 and 2024/25, the total costs of Apixaban 5mg tablets decreased by £131 million, the highest decrease of all presentations. This is the second year in a row where Apixaban 5mg tablets have shown the highest decrease in costs following a decrease of £120 million between 2022/23 and 2023/24. A generic version of Apixiban was made available in May 2022. Apixiban is an anticoagulant primarily used to lower the risk of blood clots developing in patients who have a condition called atrial fibrillation.

3. UK comparisons

Prescription Cost Analysis statistics are produced separately by each UK nation, and there are differences in data collection, healthcare structures, and methodology. Therefore, it’s important to be cautious when comparing PCA data of different UK nations, and to consider the broader context of the UK’s health and social care landscape.

We have chosen a few high-level measures that allow for broad comparisons across the devolved administrations. For more detailed information, please refer to each country’s official PCA publication

Our comparisons are based on the most recent PCA data available at the time of analysis and use the Office for National Statistics (ONS) 2023 mid-year population estimates to calculate per-person figures for the 2023/24 financial year.

For Wales, the figures reflect prescriptions issued by Welsh GPs and dispensed either in Wales or elsewhere in the UK.

For Northern Ireland the PCA data used is for the calendar year 2024.

Cost per person for the UK nations 2023/2024

Chart
Figure 17: England had the lowest prescription item cost per person in 2023/24
Table
Table 17: England had the lowest prescription item cost per person in 2023/24
Country Cost per person (£)
Northern Ireland 260.60
Scotland 237.74
Wales 222.54
England 189.39

Source: Additional Tables - Prescription Cost Analysis - A1 | Public Health Scotland - Dispenser payments and prescription cost analysis | Welsh Government - Prescriptions in Wales | HSC Business Services Organisation - General pharmaceutical services and prescribing statistics | Office for National Statistics - Mid-year population estimates

England had the lowest prescription item cost per person in 2023/24 at £189.

Northern Ireland had the highest prescription item cost per person in 2023/24 at £261

Items per person for the UK nations 2023/2024

Chart
Figure 18: Scotland had the fewest items dispensed per person in 2023/24
Table
Table 18: Scotland had the fewest items dispensed per person in 2023/24
Country Items per person
Wales 26.7
Northern Ireland 23.9
England 21.0
Scotland 20.7

Source: Additional Tables - Prescription Cost Analysis - A1 | Public Health Scotland - Dispenser payments and prescription cost analysis | Welsh Government - Prescriptions in Wales | HSC Business Services Organisation - General pharmaceutical services and prescribing statistics | Office for National Statistics - Mid-year population estimates

Scotland had the lowest number of prescription items dispensed per person in 2023/24 at 21 items.

Wales had the highest number of prescription items dispensed per person in 2023/24 at 27 items.

4. About these statistics

4.1. Monthly PCA data

The NHSBSA publishes a monthly administrative management information dataset for PCA using the same methodology as these statistics. However, while our annual PCA is an Official Statistic, the monthly dataset is not.

There is a slight difference between the annual National Statistics and the monthly administrative data for PCA. The annual publication uses the geographical structure as of the 31 March for that year, while the monthly data uses the structure at the end of the month. If a dispensing contractor changes parent organisation during the year, this may affect the ICB level total in the aggregated monthly data compared to the annual National Statistics, but it will not affect the national totals. However, such cases are rare.

4.2. Uses of these statistics

These statistics serve several purposes, including:

  • providing a national overview of community prescription costs and volumes in England for both the financial year and the calendar year

  • analysing cost and volume trends across different levels of the BNF hierarchy

  • allowing public scrutiny of national prescribing habits

  • monitoring uptake of new to market proprietary presentations

  • monitoring the proportion of prescriptions dispensed generically

4.3. Changes to this publication

For this release, we have included supporting tables aggregated by NHS region.

The supporting tables now include population figures at all levels. These have been used to provide a measure of ‘Items Per 1,000 Population’ at all levels of data.

Information on items dispensed via the Pharmacy First Clinical Pathway is included in the BNF presentation level data and SNOMED level data tables of the supplementary tables.

For full details of the changes made please refer to the Background Information and Methodology note released alongside these statistics.

4.4. Timeliness of this publication

This publication is released in June of each year, when March data becomes available. This allows us to provide a full financial year overview. Calendar year data is published in February of each year when December data becomes available on the NHSBSA Open Data Portal (ODP).

4.5. Price concessions

When community pharmacies cannot source a drug at or below the reimbursement price as set out in the Drug Tariff, the DHSC can introduce a price concession at the request of Community Pharmacy England. A price concession can be requested for any drugs listed in Part VIIIA, Part VIIIB, and Part VIIID of the Drug Tariff. For any drugs granted price concessions, contractors are automatically reimbursed at the new prices for that month.

5. Rounding

The high-level figures in this statistical summary have been rounded as per the table below:

From To Round to nearest
0 1,000 1
1,001 10,000 100
10,001 100,000 1,000
100,001 1,000,000 10,000
1,000,001 10,000,000 100,000
10,000,001 100,000,000 1,000,000
100,000,001 10,000,000,000 10,000,000
10,000,000,001 100,000,000,000 100,000,000

All changes and totals are calculated prior to rounding. Percentage changes are calculated prior to rounding and then are rounded to the nearest whole number. Since all figures within this statistical summary have been rounded, they may not match totals elsewhere when aggregated.

The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.

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