England 2025/26
Published 4 June 2026
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Key findings
In England in 2025/26:
1.30 billion prescription items were dispensed in the community at a cost of £11.6 billion.
The number of items dispensed in the community increased by 3% from 2024/25 while costs increased by 4%.
The most dispensed chemical substance was Atorvastatin, a drug used to lower cholesterol and prevent heart disease, with 78 million items.
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.
Pharmacy contractors are able to issue certain medicines through advanced services that they provide to NHS patients, data relating to these services are included in these statistics.
1.1.1. Pharmacy First Clinical Pathways
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
More information in the Pharmacy First service can be found on the NHS England website.
1.1.2. NHS Pharmacy Contraception Service (PCS)
The PCS:
- offers people greater choice on accessing contraception
services
- helps address health inequalities by providing wider healthcare access for high-risk communities and vulnerable patients in their communities and signposting service users to local sexual health services
- creates extra capacity in primary care and sexual health clinics (or equivalent) to support meeting the demand for more complex assessments
More information in the PCS can be found on the NHS England website.
1.1.3. Seasonal Influenza Vaccination Service
The Seasonal Influenza Vaccination Advanced Service allows eligible patients in England to receive a free NHS flu jab at their local pharmacy. Commissioned by NHS England, it provides a convenient alternative to GP appointments for at-risk groups.
More information in the Seasonal Influenza Vaccination 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 2016/17 to 2025/26
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 (£) |
|---|---|
| 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 |
| 2025/2026 | 11,641,873,551 |
Source: Summary Tables - Prescription Cost Analysis - National
In England in 2025/26:
Prescription items dispensed in the community cost £11.6 billion.
There was a 4% increase in costs from 2024/25.
The cost of prescription items increased 27% from 2016/17, an increase of £2.4 billion.
Number of prescription items dispensed in England 2016/17 to 2025/26
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 |
|---|---|
| 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 |
| 2025/2026 | 1,297,516,707 |
Source: Summary Tables - Prescription Cost Analysis - National
In England in 2025/26:
There were 1.30 billion items dispensed in the community.
There was a 3% increase in items dispensed in the community from 2024/25.
The number of prescription items dispensed increased by 17% from 2016/17, an increase of 190 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 2025/26
Chart
Figure 3: In 2025/26, BNF Chapter 6 Endocrine System had the highest costs
Table
Table 3: In 2025/26, BNF Chapter 6 Endocrine System had the highest costs
| BNF chapter code | BNF chapter name | Net ingredient cost (£) |
|---|---|---|
| 01 | Gastro-Intestinal System | 740,386,441.53 |
| 02 | Cardiovascular System | 1,201,327,864.43 |
| 03 | Respiratory System | 1,251,217,381.32 |
| 04 | Central Nervous System | 1,658,678,166.68 |
| 05 | Infections | 237,354,471.76 |
| 06 | Endocrine System | 2,409,811,556.86 |
| 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | 304,439,667.38 |
| 08 | Malignant Disease and Immunosuppression | 182,255,426.89 |
| 09 | Nutrition and Blood | 968,488,385.75 |
| 10 | Musculoskeletal and Joint Diseases | 148,442,413.08 |
| 11 | Eye | 176,077,809.56 |
| 12 | Ear, Nose and Oropharynx | 97,620,115.30 |
| 13 | Skin | 330,646,286.56 |
| 14 | Immunological Products and Vaccines | 251,728,716.44 |
| 15 | Anaesthesia | 25,287,585.70 |
| 18 | Preparations used in Diagnosis | 10,587.50 |
| 19 | Other Drugs and Preparations | 11,626,309.82 |
| 20 | Dressings | 179,956,754.27 |
| 21 | Appliances | 940,617,978.75 |
| 22 | Incontinence Appliances | 70,769,292.65 |
| 23 | Stoma Appliances | 455,130,338.37 |
Source: Summary Tables - Prescription Cost Analysis - Chapter
In England in 2025/26:
BNF Chapter 6 Endocrine System accounted for 21% of total costs.
BNF Chapter 4 Central Nervous System accounted for 14% of total costs.
BNF Chapter 3 Respiratory System accounted for 11% of total costs.
The share of costs attributed to BNF Chapter 6 Endocrine System increased by 2 percentage points, rising from 19% in 2024/25.
Index of the BNF chapters with the largest percentage increase and decrease in costs from 2016/17 to 2025/26
These statistics only cover BNF Chapters 01 through to 15.
Chart
Figure 4: BNF Chapter 14 Immunological Products and Vaccines has shown the largest percentage increase in costs from 2016/17 to 2025/26
Table
Table 4: BNF Chapter 14 Immunological Products and Vaccines has shown the largest percentage increase in costs from 2016/17 to 2025/26
| Financial year | 10 - Musculoskeletal and Joint Diseases | 14 - Immunological Products and Vaccines |
|---|---|---|
| 2016/2017 | 100.0 | 100.0 |
| 2017/2018 | 96.3 | 94.4 |
| 2018/2019 | 98.7 | 115.1 |
| 2019/2020 | 105.8 | 116.9 |
| 2020/2021 | 84.0 | 111.5 |
| 2021/2022 | 76.3 | 118.8 |
| 2022/2023 | 70.1 | 138.4 |
| 2023/2024 | 69.5 | 131.3 |
| 2024/2025 | 69.8 | 125.8 |
| 2025/2026 | 74.6 | 219.4 |
In England in 2025/26:
BNF Chapter 14 Immunological Products and Vaccines has shown the greatest percentage increase in costs from 2016/17 of 119%.
BNF Chapter 10 Musculoskeletal and Joint Diseases has shown the greatest percentage decrease in costs from 2016/17 of 25%.
This publication now includes data on items issued under the Seasonal Influenza Vaccination Service, these items all fall under BNF Chapter 14. This combined with changes in the types of products issued and price increase has caused the jump in costs in BNF Chapter 14 seen between 2024/25 and 2025/26.
Distribution of items dispensed in England amongst BNF chapters 2025/26
Chart
Figure 5: In 2025/26, BNF Chapter 2 Cardiovascular System had the highest number of items
Table
Table 5: In 2025/26, BNF Chapter 2 Cardiovascular System had the highest number of items
| BNF chapter code | BNF chapter name | Items |
|---|---|---|
| 01 | Gastro-Intestinal System | 120,856,411 |
| 02 | Cardiovascular System | 392,260,162 |
| 03 | Respiratory System | 75,291,533 |
| 04 | Central Nervous System | 242,802,890 |
| 05 | Infections | 40,770,492 |
| 06 | Endocrine System | 147,791,369 |
| 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | 37,272,664 |
| 08 | Malignant Disease and Immunosuppression | 4,714,310 |
| 09 | Nutrition and Blood | 73,602,005 |
| 10 | Musculoskeletal and Joint Diseases | 32,649,871 |
| 11 | Eye | 15,549,224 |
| 12 | Ear, Nose and Oropharynx | 11,830,777 |
| 13 | Skin | 27,043,811 |
| 14 | Immunological Products and Vaccines | 14,978,100 |
| 15 | Anaesthesia | 1,835,408 |
| 18 | Preparations used in Diagnosis | 47 |
| 19 | Other Drugs and Preparations | 581,897 |
| 20 | Dressings | 5,215,344 |
| 21 | Appliances | 41,517,499 |
| 22 | Incontinence Appliances | 2,798,692 |
| 23 | Stoma Appliances | 8,154,201 |
Source: Summary Tables - Prescription Cost Analysis - Chapter
In England in 2025/26:
BNF Chapter 2 Cardiovascular System accounted for 30% of all items dispensed.
BNF Chapter 4 Central Nervous System accounted for 19% of all items dispensed.
BNF Chapter 6 Endocrine System accounted for 11% of all items dispensed.
The proportion of items dispensed in England from the top three BNF chapters in 2025/26 remained unchanged from 2024/25.
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 2016/17 to 2025/26
Table
Table 6: BNF Chapter 6 Endocrine System has shown the greatest percentage increase in items from 2016/17 to 2025/26
| Financial year | 06 - Endocrine System | 13 - Skin |
|---|---|---|
| 2016/2017 | 100.0 | 100.0 |
| 2017/2018 | 101.7 | 92.1 |
| 2018/2019 | 104.2 | 85.0 |
| 2019/2020 | 108.3 | 80.3 |
| 2020/2021 | 106.4 | 71.6 |
| 2021/2022 | 110.8 | 72.2 |
| 2022/2023 | 118.1 | 71.8 |
| 2023/2024 | 124.2 | 74.0 |
| 2024/2025 | 131.4 | 76.1 |
| 2025/2026 | 137.3 | 75.5 |
In England in 2025/26:
BNF Chapter 6 Endocrine System has shown the greatest percentage increase in items from 2016/17 to 2025/26 of 37%.
BNF Chapter 13 Skin has shown the greatest percentage decrease in items from 2016/17 to 2025/26 of 25%.
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.
Appliances are excluded from
analyses of generic prescribing because they do not have generic
equivalents.
Proportion of items prescribed generically and proportion of costs excluding appliances England 2016/17 to 2025/26
Chart
Figure 7: Between 2016/17 and 2025/26 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 2016/17 and 2025/26, the percentage of items prescribed generically has remained consistent
| Financial year | Items (%) | Net ingredient cost (%) |
|---|---|---|
| 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 |
| 2025/2026 | 86.1 | 55.7 |
Source: Additional Tables - Prescription Cost Analysis - table A5
In England in 2025/26:
Generic items made up 86% of the total items prescribed.
Generic prescribing accounted for 56% of costs.
The percentage of items prescribed generically has remained consistent between 2016/17 and 2025/26. There has been a 2 percentage point variation in the period, meaning it has stayed stable over the period. Note that these figures exclude preparation class 4 products - appliances.
Between 2016/17 and 2025/26 the percentage of costs which was accounted for by generic prescribing fell by 9 percentage points.
Sankey chart to show the flow of prescribing and dispensing volumes England 2025/26
Chart
Figure 8: In 2025/26, the majority of items were both prescribed and dispensed generically
Table
Table 8: In 2025/26, the majority of items were both prescribed and dispensed generically
| From | To | Items |
|---|---|---|
| Total items | Dressings and appliances | 63,443,445 |
| Total items | Prescribed generically | 1,063,056,405 |
| Total items | Prescribed proprietary | 171,496,034 |
| Prescribed generically | Dispensed generically | 1,014,885,454 |
| Prescribed generically | Dispensed proprietary | 47,691,774 |
| Prescribed proprietary | Dispensed proprietary | 171,496,034 |
In England in 2025/26:
48 million of the 1.06 billion items prescribed generically were dispensed as a proprietary item, this is 4% of items prescribed generically.
171 million items were prescribed proprietary.
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 2025/26
Chart
Figure 9: In England in 2025/26, tirzepatide was the chemical substance with the highest cost
Table
Table 9: In England in 2025/26, tirzepatide was the chemical substance with the highest cost
| Chemical substance name | Chemical substance BNF code | Net ingredient cost (£) |
|---|---|---|
| Tirzepatide | 0601023AZ | 574,302,390 |
| BeclometDiprop/Formoterol | 0302000AB | 284,750,095 |
| Dapagliflozin | 0601023AG | 261,018,352 |
| Influenza | 1404000H0 | 228,626,642 |
| Edoxaban | 0208020AA | 205,252,714 |
| Empagliflozin | 0601023AN | 186,934,242 |
| BeclometDiprop/Formoterol/Glycopyrronium (Corticosteroids) | 0302000AA | 183,679,936 |
| Sacubitril/valsartan | 0205052AE | 162,788,539 |
| Budesonide | 0302000K0 | 160,618,627 |
| Semaglutide | 0601023AW | 137,823,830 |
Source: Additional Tables - Prescription Cost Analysis - A2
In England in 2025/26:
Tirzepatide had the highest cost of £574 million. Tirzepatide is a medication primarily used to treat type 2 diabetes. It is also used to support weight loss in adults with obesity.
Four of the top 10 chemical substances by cost are primarily used as diabetes and weight‑loss drugs.
Three of the top 10 chemical substances by cost are primarily used to treat respiratory conditions.
Between 2024/25 and 2025/26, the number of tirzepatide items dispensed rose from 1.1 million to 3.1 million. Over the same period, the average cost per item increased from £108 to £187, adding to the overall increase in costs.
The 10 most dispensed chemical substances by total items in 2025/26
Chart
Figure 10: In England in 2025/26, 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 | 78,042,871 |
| Amlodipine | 0206020A0 | 41,208,448 |
| Lansoprazole | 0103050L0 | 37,868,775 |
| Ramipril | 0205051R0 | 36,339,463 |
| Omeprazole | 0103050P0 | 35,562,793 |
| Levothyroxine sodium | 0602010V0 | 34,992,603 |
| Bisoprolol fumarate | 0204000H0 | 31,266,076 |
| Colecalciferol | 0906040G0 | 29,221,677 |
| Metformin hydrochloride | 0601022B0 | 27,395,015 |
| Sertraline hydrochloride | 0403030Q0 | 25,770,008 |
Source: Additional Tables - Prescription Cost Analysis - A3
In England in 2025/26:
Atorvastatin was the most dispensed chemical substance with 78 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 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.
For this publication the ICB structure as at the end of
March 2026 was used.
Cost per person (£) by ICB 2025/26
Chart
Figure 11: The mean cost of items dispensed per person in England was £199 in 2025/26
Table
Table 11: The mean cost of items dispensed per person in England was £199 in 2025/26
| ICB name | Net ingredient cost (£) per person |
|---|---|
| NHS Cambridgeshire and Peterborough Integrated Care Board | 420.16 |
| NHS Herefordshire and Worcestershire Integrated Care Board | 358.56 |
| NHS West Yorkshire Integrated Care Board | 318.35 |
| NHS Nottingham and Nottinghamshire Integrated Care Board | 263.51 |
| NHS Cheshire and Merseyside Integrated Care Board | 233.99 |
| NHS Lincolnshire Integrated Care Board | 221.39 |
| NHS Greater Manchester Integrated Care Board | 218.67 |
| NHS Staffordshire and Stoke-on-Trent Integrated Care Board | 216.58 |
| NHS Sussex Integrated Care Board | 213.96 |
| NHS Black Country Integrated Care Board | 212.95 |
| NHS Lancashire and South Cumbria Integrated Care Board | 210.88 |
| NHS North East and North Cumbria Integrated Care Board | 208.31 |
| NHS Kent and Medway Integrated Care Board | 202.72 |
| NHS Somerset Integrated Care Board | 199.39 |
| NHS Humber and North Yorkshire Integrated Care Board | 199.14 |
| NHS Gloucestershire Integrated Care Board | 198.71 |
| NHS Birmingham and Solihull Integrated Care Board | 193.93 |
| NHS Norfolk and Waveney Integrated Care Board | 193.58 |
| NHS South Yorkshire Integrated Care Board | 193.52 |
| NHS Leicester, Leicestershire and Rutland Integrated Care Board | 193.51 |
| NHS Cornwall and the Isles of Scilly Integrated Care Board | 191.30 |
| NHS Suffolk and North East Essex Integrated Care Board | 190.70 |
| NHS Coventry and Warwickshire Integrated Care Board | 189.92 |
| NHS Mid and South Essex Integrated Care Board | 189.69 |
| NHS Shropshire, Telford and Wrekin Integrated Care Board | 186.11 |
| NHS Devon Integrated Care Board | 180.66 |
| NHS Hampshire and Isle of Wight Integrated Care Board | 179.14 |
| NHS Dorset Integrated Care Board | 177.56 |
| NHS Hertfordshire and West Essex Integrated Care Board | 171.49 |
| NHS Derby and Derbyshire Integrated Care Board | 171.42 |
| NHS Northamptonshire Integrated Care Board | 167.42 |
| NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board | 162.07 |
| NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board | 158.40 |
| NHS North West London Integrated Care Board | 154.50 |
| NHS Frimley Integrated Care Board | 153.00 |
| NHS North Central London Integrated Care Board | 152.93 |
| NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board | 152.32 |
| NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board | 149.69 |
| NHS North East London Integrated Care Board | 148.76 |
| NHS Surrey Heartlands Integrated Care Board | 140.02 |
| NHS South East London Integrated Care Board | 138.07 |
| NHS South West London Integrated Care Board | 137.38 |
Source: Summary Tables - Prescription Cost Analysis - ICB National | Office for National Statistics - Health geographies population estimates
In England in 2025/26:
NHS Cambridgeshire and Peterborough ICB continues to have the highest cost per person, this was £420
NHS South West London Integrated Care Board has the lowest cost per person, this was £137.
As in 2024/25, 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 £401 million in 2025/26 were in BNF Chapter 23 Stoma Appliances.
Dispensed items per person by ICB 2025/26
Chart
Figure 12: The mean number of items dispensed per person in England was 22 in 2025/26
Table
Table 12: The mean number of items dispensed per person in England was 22 in 2025/26
| ICB name | Items per person |
|---|---|
| NHS West Yorkshire Integrated Care Board | 38.7 |
| NHS Lincolnshire Integrated Care Board | 30.5 |
| NHS North East and North Cumbria Integrated Care Board | 29.6 |
| NHS South Yorkshire Integrated Care Board | 27.0 |
| NHS Humber and North Yorkshire Integrated Care Board | 25.3 |
| NHS Norfolk and Waveney Integrated Care Board | 25.2 |
| NHS Cheshire and Merseyside Integrated Care Board | 25.1 |
| NHS Lancashire and South Cumbria Integrated Care Board | 25.1 |
| NHS Suffolk and North East Essex Integrated Care Board | 24.9 |
| NHS Staffordshire and Stoke-on-Trent Integrated Care Board | 24.7 |
| NHS Cambridgeshire and Peterborough Integrated Care Board | 24.5 |
| NHS Cornwall and the Isles of Scilly Integrated Care Board | 23.8 |
| NHS Greater Manchester Integrated Care Board | 23.8 |
| NHS Nottingham and Nottinghamshire Integrated Care Board | 23.2 |
| NHS Coventry and Warwickshire Integrated Care Board | 22.9 |
| NHS Leicester, Leicestershire and Rutland Integrated Care Board | 22.4 |
| NHS Black Country Integrated Care Board | 22.3 |
| 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 | 21.0 |
| NHS Derby and Derbyshire Integrated Care Board | 20.7 |
| NHS Sussex Integrated Care Board | 20.2 |
| NHS Dorset Integrated Care Board | 20.2 |
| NHS Somerset Integrated Care Board | 19.9 |
| NHS Shropshire, Telford and Wrekin Integrated Care Board | 19.9 |
| NHS Hertfordshire and West Essex 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 North West London Integrated Care Board | 19.3 |
| NHS Mid and South Essex Integrated Care Board | 19.2 |
| NHS North East London Integrated Care Board | 18.9 |
| NHS Kent and Medway Integrated Care Board | 18.6 |
| NHS Hampshire and Isle of Wight Integrated Care Board | 18.5 |
| NHS North Central London Integrated Care Board | 17.8 |
| NHS South West London Integrated Care Board | 17.1 |
| NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board | 16.5 |
| NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board | 16.4 |
| NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board | 15.9 |
| NHS Frimley Integrated Care Board | 15.5 |
| NHS South East London Integrated Care Board | 15.2 |
| NHS Surrey Heartlands Integrated Care Board | 14.0 |
Source: Summary Tables - Prescription Cost Analysis - ICB National | Office for National Statistics - Mid-year population estimates
In England in 2025/26:
NHS West Yorkshire ICB continues to have the highest dispensed items per person, this was 39.
NHS Surrey Heartlands ICB continues to have the lowest dispensed items per person, 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 2024/25 to 2025/26
Chart
Figure 13: Paxlovid 150mg/100mg tablets had the highest increase in unit cost from 2024/25 to 2025/26
Table
Table 13: Paxlovid 150mg/100mg tablets had the highest increase in unit cost from 2024/25 to 2025/26
| Presentation name | Unit of measure | Unit cost increase (%) |
|---|---|---|
| Paxlovid 150mg/100mg tablets | tablet | 30,768 |
| Trihexyphenidyl 2mg tablets | tablet | 2,468 |
| Pioglitazone 45mg tablets | tablet | 1,095 |
| Acetazolamide 250mg tablets | tablet | 672 |
| Trihexyphenidyl 5mg tablets | tablet | 522 |
| Chlorphenamine 2mg/5ml oral solution sugar free | ml | 462 |
| Codeine 15mg/5ml linctus sugar free | ml | 401 |
| Nystatin 100,000units/ml oral suspension | ml | 378 |
| Nabumetone 500mg tablets | tablet | 364 |
| Trimethoprim 100mg tablets | tablet | 364 |
Source: Additional Tables - Prescription Cost Analysis - A11
Paxlovid 150mg/100mg tablets had the highest increase in unit cost from 2024/25 to 2025/26, an increase of 30,768%.
Between April 2025 and May 2025 the unit cost of Paxlovid 150mg/100mg increased from around 8 pence per tablet to around £28 per tablet. This is as the manufacturer set a new list price per pack of £829.
Top 10 presentations by percentage decrease in unit cost 2024/25 to 2025/26
Chart
Figure 14: Rivaroxaban 20mg tablets had the highest decrease in unit cost from 2024/25 to 2025/26
Table
Table 14: Rivaroxaban 20mg tablets had the highest decrease in unit cost from 2024/25 to 2025/26
| Presentation name | Unit of measure | Unit cost decrease (%) |
|---|---|---|
| Rivaroxaban 20mg tablets | tablet | -92.8 |
| Rivaroxaban 15mg tablets | tablet | -92.5 |
| Rivaroxaban 10mg tablets | tablet | -92.5 |
| Pregabalin 50mg capsules | capsule | -77.5 |
| Promethazine hydrochloride 25mg tablets | tablet | -76.3 |
| Terbinafine 250mg tablets | tablet | -76.1 |
| Ezetimibe 10mg tablets | tablet | -75.6 |
| Sulfasalazine 500mg gastro-resistant tablets | tablet | -75.1 |
| Melatonin 1mg/ml oral solution sugar free | ml | -71.1 |
| Erythromycin 250mg gastro-resistant tablets | tablet | -68.4 |
Source: Additional Tables - Prescription Cost Analysis - A12
Rivaroxaban 20mg tablets had the highest decrease in unit cost from 2024/25 to 2025/26, a decrease of 93%. Rivaroxaban came off patent and was made a generic in 2024.
Top 10 presentations by increase in total cost 2024/25 to 2025/26
Chart
Figure 15: FreeStyle Libre 2 Plus Sensor kit had the highest increase in total costs from 2024/25 to 2025/26
Table
Table 15: FreeStyle Libre 2 Plus Sensor kit had the highest increase in total costs from 2024/25 to 2025/26
| Presentation name | Unit of measure | Total cost absolute increase (£) |
|---|---|---|
| FreeStyle Libre 2 Plus Sensor | kit | 254,630,250 |
| Dapagliflozin 10mg tablets | tablet | 183,171,006 |
| Mounjaro KwikPen 5mg/0.6ml inj 2.4ml pre-filled pens | pre-filled disposable injection | 165,676,808 |
| Adjuvanted trivalent flu vacc (SA, inact) inj 0.5ml pfs | pre-filled disposable injection | 116,063,053 |
| Mounjaro KwikPen 7.5mg/0.6ml inj 2.4ml pre-filled pens | pre-filled disposable injection | 113,306,072 |
| Mounjaro KwikPen 10mg/0.6ml inj 2.4ml pre-filled pens | pre-filled disposable injection | 86,083,619 |
| Trivalent Flu/Vac/SA inj 0.5ml pfs | pre-filled disposable injection | 60,146,798 |
| Prostap 3 DCS 11.25mg pdr and solvent for prolonged-rel inj | pre-filled disposable injection | 46,243,482 |
| Mirabegron 50mg modified-release tablets | tablet | 36,803,743 |
| Mounjaro KwikPen 15mg/0.6ml inj 2.4ml pre-filled pens | pre-filled disposable injection | 35,701,710 |
Source: Additional Tables - Prescription Cost Analysis - A13
Between 2024/25 and 2025/26, the total costs of FreeStyle Libre 2 Plus Sensor kits increased by £255 million, the highest increase of all presentations. FreeStyle Libre 2 Plus Sensor kits continuous glucose monitoring sensors are used by people with diabetes to track glucose levels without routine finger‑prick testing.
Dapagliflozin 10mg tablets had the second largest increase in total costs between 2024/25 and 2025/26. Dapagliflozin is the generic form of Forxiga which came off patent in 2025 and is shown in figure 16 to have the highest decrease in total costs over the same period.
Top 10 presentations by decrease in total cost 2024/25 to 2025/26
Chart
Figure 16: Forxiga 10mg tablets had the highest decrease in total costs from 2024/25 to 2025/26
Table
Table 16: Forxiga 10mg tablets had the highest decrease in total costs from 2024/25 to 2025/26
| Presentation name | Unit of measure | Total cost absolute decrease (£) |
|---|---|---|
| Forxiga 10mg tablets | tablet | -249,366,339 |
| FreeStyle Libre 2 Sensor | kit | -191,374,342 |
| Rivaroxaban 20mg tablets | tablet | -66,512,057 |
| Adjuvanted quadrivalent flu vacc (SA, inact) inj 0.5ml pfs | pre-filled disposable injection | -65,895,026 |
| Influenza vaccine (surface antigen, inact) inj 0.5ml pfs | pre-filled disposable injection | -30,468,063 |
| Famotidine 20mg tablets | tablet | -27,899,228 |
| Lixiana 60mg tablets | tablet | -25,155,403 |
| Ezetimibe 10mg tablets | tablet | -22,948,859 |
| Apixaban 5mg tablets | tablet | -20,820,840 |
| Brilique 90mg tablets | tablet | -19,781,593 |
Source: Additional Tables - Prescription Cost Analysis - A14
Between 2024/25 and 2025/26, the total costs of Forxiga 10mg tablets decreased by £249 million, the highest decrease of all presentations. Forxiga came off patent and was made a generic in 2025.
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) 2024
mid-year population estimates to calculate per-person figures for the
2024/25 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 2024/2025
Chart
Figure 17: England had the lowest prescription item cost per person in 2024/25
Table
Table 17: England had the lowest prescription item cost per person in 2024/25
| Country | Cost per person (£) |
|---|---|
| Northern Ireland | 261.24 |
| Scotland | 237.66 |
| Wales | 224.18 |
| England | 190.23 |
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 2024/25 at £190.
Northern Ireland had the highest prescription item cost per person in 2024/25 at £261.
Items per person for the UK nations 2024/2025
Chart
Figure 18: Scotland had the fewest items dispensed per person in 2024/25
Table
Table 18: Scotland had the fewest items dispensed per person in 2024/25
| Country | Items per person |
|---|---|
| Wales | 26.9 |
| Northern Ireland | 23.9 |
| England | 21.5 |
| Scotland | 21.0 |
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 2024/25 at 21 items.
Wales had the highest number of prescription items dispensed per person in 2024/25 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
Information on items dispensed via the PCS and the Seasonal Influenza Vaccination Service 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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