England 2024/25
Published 20 November 2025
Key findings
In 2024/25, NHS commissioners in England spent an estimated £20.9 billion for the issue of medicines, appliances, and medical devices, after £660 million in central rebates.
Before central rebates, the cost to NHS commissioners was an estimated £21.6 billion - up 5.3% from £20.5 billion in 2023/24.
This £21.6 billion is made up of:
- £10.3 billion for medicines prescribed in primary care and dispensed in the community
- £11.1 billion for medicines issued in hospitals
- £110 million for medicines prescribed in hospitals and dispensed in the community
- £32.3 million for medicines prescribed by dentists and dispensed in the community
- £27.8 million for medicines prescribed and dispensed in the Adult Secure Estate
These national totals are all Actual Costs. A definition of this measure for primary and secondary care can be found in Section 1.3 Definitions.
1. Things you should know
1.1 Scope
This publication includes:
- prescriptions issued by GP practices and community prescribers in England that were dispensed in the community in the UK (excluding Northern Ireland)
- prescriptions issued by hospitals in England that were dispensed in the community in the UK (excluding Northern Ireland)
- prescriptions issued by dental practitioners that were dispensed in the community in the UK (excluding Northern Ireland)
- medicines issued in hospitals in England that were dispensed via hospital pharmacies, homecare companies, or outsourced outpatient pharmacy partnerships
- medicines prescribed and dispensed in the Adult Secure Estate
This publication does not include:
- prescriptions issued through Armed Services health services in England commissioned by NHS England (NHSE) but not dispensed in the community
- medicines issued in hospitals in England but not managed via the hospital pharmacy service
- dressings and devices issued in secondary care, since these items are usually supplied via the NHS Supply Chain
This publication gives:
- cost breakdowns by financial year and month within each care setting
- cost breakdowns by BNF Chapter and BNF Section, by financial year and care setting
- financial year cost breakdowns by Integrated Care Board (ICB) within each care setting
- a combined view of the data by financial year, BNF Chapter, BNF Section and ICB
1.2 Data sources
Data for this publication is collated from two sources: the NHSBSA Enterprise Data Warehouse and the Define system operated by Rx-Info.
We obtain data on prescription items dispensed in the community from the NHSBSA Enterprise Data Warehouse. Actual Cost is used for national totals. Net Ingredient Cost (NIC) is used for national totals and breakdowns below national totals, such as ICB or BNF section, for items dispensed in the community. This is due to limitations in the availability of Actual Cost data at these levels for items dispensed in the community. Full definitions of Actual Costs and NIC can be found in Section 1.3 Definitions.
We obtain data on secondary care prescribing from Rx-Info. Rx-Info collect data from hospital pharmacy systems, including the actual costs paid with discounts. The data used for this publication was extracted from the Rx-Info Define system on 11 November 2025.
Data for Central Rebates is provided by the Medicines Value and Access Directorate at NHS England. Central rebate figures cannot be broken down by ICB or BNF category due to commercial confidentiality. The Central Rebates total includes rebates from arrangements NHS England have agreed with pharmaceutical companies following successful negotiations to commission a variety of treatments both in the cancer drugs fund (CDF) and in routine commissioning. This includes treatments for both rare diseases and more common conditions.
1.3 Definitions
Actual Costs Within Secondary Care
By costs within hospitals, we mean the Actual Cost (including applicable VAT but after any discount) of medicines, appliances, and medical devices issued in NHS hospitals in England by hospital pharmacies.
Actual Costs Within Primary Care
For prescription items dispensed in the community, Actual Cost is the
cost recharged to NHS commissioners for the provision of drugs,
appliances, and medical devices by dispensing contractors. Actual Cost
is calculated as the basic price of the drug, minus the National Average
Discount, plus payment for consumables, out-of-pocket expenses, and
payment for containers. Payment for consumables was previously known as
container allowance.
Actual Cost does not reflect the payment
made to a dispensing contractor for the cost of the individual drugs
dispensed, and excludes other fees paid that a prescription item may
attract.
National Average Discount Percentage (NADP)
The National Average Discount Percentage (NADP) is calculated using the discount rates applied to individual dispensing contractors, according to the Drug Tariff for England and Wales for pharmacy and appliance contractors, and Annex G Part 1 of the General Medical Services Statement of Financial Entitlements for dispensing doctors and personal administration accounts.
Net Ingredient Cost (NIC)
Net Ingredient Cost (NIC) for prescription items dispensed in the community is either the basic price given in the Drug Tariff, or is determined from prices published by manufacturers, wholesalers or suppliers. Basic price is set out in Parts VIII and IX of the Drug Tariff. For drugs not in Part VIII, the price is usually taken from the manufacturer, wholesaler or supplier of the product. Basic price also includes retained margin, where applicable. The retained medicine margin contributes to the provision of pharmaceutical services alongside the other agreed fees and allowances.
Adult Secure Estate
By Adult Secure Estate, we mean adult prisons and detention centres. See Section 3.8 for more information.
British National Formulary (BNF)
These statistics use the therapeutic classifications defined in the British National Formulary (BNF) to group medicines together based on their primary therapeutic indication. The NHSBSA uses and maintains the classification system of the BNF implemented prior to the release of edition 70, including the six pseudo BNF Chapters (18 to 23) created by NHS Prescription Services to classify products that fall outside of BNF Chapters 1 to 15.
Integrated Care Board (ICB)
Integrated Care Boards (ICBs) are statutory organisations responsible for bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS. ICBs took over the functions of Sustainability and Transformation Partnerships (STPs) in July 2022.
Item
Prescribing volumes are not included in this publication. Unlike in primary care, where item-level data is available, secondary care data is collated as quantities issued. The concept of a prescription item does not exist for secondary care medicines data.
2. Results and commentary
The charts in this report are interactive. You can choose the categories to display in a chart by clicking them in the legend. For more information on using these charts, please see Section 3.9.
All figures in this section are presented before the deduction of central rebates.
2.1 Costs by setting
Actual Cost for items dispensed in the community, issued in hospitals, or dispensed in the Adult Secure Estate
Cost measure used in Figure 1
These figures are all Actual Costs.
Chart
Figure 1: Actual Costs have been increasing since 2020/21
Table
Table 1: Actual Costs have been increasing since 2020/21
| Financial year | Area | Actual Cost (GBP) |
|---|---|---|
| 2020/2021 | Hospital prescribing issued within hospitals (GBP) | 7,524,961,466.40 |
| 2020/2021 | Dental prescribing dispensed in the community (GBP) | 22,775,680.42 |
| 2020/2021 | Hospital prescribing dispensed in the community (GBP) | 82,053,392.47 |
| 2020/2021 | Primary care prescribing dispensed in the community (GBP) | 8,799,127,729.33 |
| 2020/2021 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 20,526,000.00 |
| 2020/2021 | Total (GBP) | 16,449,444,268.62 |
| 2021/2022 | Hospital prescribing issued within hospitals (GBP) | 8,778,844,575.61 |
| 2021/2022 | Dental prescribing dispensed in the community (GBP) | 29,265,839.04 |
| 2021/2022 | Hospital prescribing dispensed in the community (GBP) | 85,146,820.25 |
| 2021/2022 | Primary care prescribing dispensed in the community (GBP) | 8,896,638,531.32 |
| 2021/2022 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 20,135,000.00 |
| 2021/2022 | Total (GBP) | 17,810,030,766.22 |
| 2022/2023 | Hospital prescribing issued within hospitals (GBP) | 9,491,164,315.43 |
| 2022/2023 | Dental prescribing dispensed in the community (GBP) | 32,406,760.07 |
| 2022/2023 | Hospital prescribing dispensed in the community (GBP) | 93,568,223.62 |
| 2022/2023 | Primary care prescribing dispensed in the community (GBP) | 9,593,686,896.43 |
| 2022/2023 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 24,948,000.00 |
| 2022/2023 | Total (GBP) | 19,235,774,195.55 |
| 2023/2024 | Hospital prescribing issued within hospitals (GBP) | 10,263,580,522.35 |
| 2023/2024 | Dental prescribing dispensed in the community (GBP) | 32,832,756.81 |
| 2023/2024 | Hospital prescribing dispensed in the community (GBP) | 98,366,688.84 |
| 2023/2024 | Primary care prescribing dispensed in the community (GBP) | 10,092,529,499.36 |
| 2023/2024 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 27,210,000.00 |
| 2023/2024 | Total (GBP) | 20,514,519,467.36 |
| 2024/2025 | Hospital prescribing issued within hospitals (GBP) | 11,134,661,703.53 |
| 2024/2025 | Dental prescribing dispensed in the community (GBP) | 32,284,105.42 |
| 2024/2025 | Hospital prescribing dispensed in the community (GBP) | 109,567,506.65 |
| 2024/2025 | Primary care prescribing dispensed in the community (GBP) | 10,287,751,388.94 |
| 2024/2025 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 27,763,000.00 |
| 2024/2025 | Total (GBP) | 21,592,027,704.54 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 1
The Actual Cost of items prescribed in primary care in England in 2024/25 was £10.3 billion.
The Actual Cost of medicines issued in hospitals in England in 2024/25 was £11.1 billion.
In 2024/25, medicines prescribed in primary care made up 47.6% of total expenditure while those issued in hospitals made up 51.6%. This is in contrast to 2020/21, when primary care prescribing made up 53.5% (£8.80 billion) of total expenditure and secondary care prescribing made up 45.7% (£7.52 billion). The actual cost of medicines prescribed in both primary and secondary care has been gradually increasing since 2020/21.
There was an 8.5% increase in the Actual Cost of medicines issued in hospitals in England in 2024/25 compared to 2023/24 - an increase of £871 million from £10.3 billion. The Actual Cost of medicines prescribed in primary care and dispensed in the community increased by 1.9% compared to 2023/24. This was an increase of £195 million from £10.1 billion in 2023/24.
Net Ingredient Costs (NIC) for items dispensed in the community
Cost measures used in Figure 2
These figures are Net Ingredient Costs (NIC) for items dispensed in the community and Actual Costs for those issued in hospitals and the Adult Secure Estate.
Chart
Figure 2: The NIC of items prescribed in primary care and Actual Costs of medicines issued in hospitals have been increasing since 2020/21
Table
Table 2: The NIC of items prescribed in primary care and Actual Costs of medicines issued in hospitals have been increasing since 2020/21
| Financial year | Area | Net Ingredient Cost (GBP) |
|---|---|---|
| 2020/2021 | Hospital prescribing issued within hospitals (GBP) | 7,524,961,466.40 |
| 2020/2021 | Dental prescribing dispensed in the community (GBP) | 24,344,459.06 |
| 2020/2021 | Hospital prescribing dispensed in the community (GBP) | 87,908,107.32 |
| 2020/2021 | Primary care prescribing dispensed in the community (GBP) | 9,421,932,534.21 |
| 2020/2021 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 20,526,000.00 |
| 2020/2021 | Total (GBP) | 17,079,672,566.99 |
| 2021/2022 | Hospital prescribing issued within hospitals (GBP) | 8,778,844,575.61 |
| 2021/2022 | Dental prescribing dispensed in the community (GBP) | 31,221,424.86 |
| 2021/2022 | Hospital prescribing dispensed in the community (GBP) | 90,879,039.97 |
| 2021/2022 | Primary care prescribing dispensed in the community (GBP) | 9,491,981,850.77 |
| 2021/2022 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 20,135,000.00 |
| 2021/2022 | Total (GBP) | 18,413,061,891.21 |
| 2022/2023 | Hospital prescribing issued within hospitals (GBP) | 9,491,164,315.43 |
| 2022/2023 | Dental prescribing dispensed in the community (GBP) | 34,503,741.65 |
| 2022/2023 | Hospital prescribing dispensed in the community (GBP) | 99,631,982.66 |
| 2022/2023 | Primary care prescribing dispensed in the community (GBP) | 10,211,371,133.09 |
| 2022/2023 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 24,948,000.00 |
| 2022/2023 | Total (GBP) | 19,861,619,172.83 |
| 2023/2024 | Hospital prescribing issued within hospitals (GBP) | 10,263,580,522.35 |
| 2023/2024 | Dental prescribing dispensed in the community (GBP) | 34,818,934.60 |
| 2023/2024 | Hospital prescribing dispensed in the community (GBP) | 104,291,613.06 |
| 2023/2024 | Primary care prescribing dispensed in the community (GBP) | 10,697,467,986.90 |
| 2023/2024 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 27,210,000.00 |
| 2023/2024 | Total (GBP) | 21,127,369,056.91 |
| 2024/2025 | Hospital prescribing issued within hospitals (GBP) | 11,134,661,703.53 |
| 2024/2025 | Dental prescribing dispensed in the community (GBP) | 35,249,148.24 |
| 2024/2025 | Hospital prescribing dispensed in the community (GBP) | 113,566,530.33 |
| 2024/2025 | Primary care prescribing dispensed in the community (GBP) | 10,892,191,614.31 |
| 2024/2025 | Medicines prescribed and dispensed in the Adult Secure Estate (GBP) | 27,763,000.00 |
| 2024/2025 | Total (GBP) | 22,203,431,996.41 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 2
The NIC of items prescribed in primary care in England in 2024/25 was £10.9 billion, 49.1% of total expenditure.
The Actual Cost of medicines issued in hospitals in England in 2024/25 was £11.1 billion, 50.1% of total expenditure.
There was a 1.8% increase in the NIC of items prescribed in primary care in England in 2024/25 compared to the previous financial year - an increase of £195 million from £10.7 billion in 2023/24. There was a 15.6% increase of £1.47 billion from £9.42 billion in 2020/21. The NIC of items prescribed in primary care has been gradually increasing since 2020/21.
In 2024/25, the total expenditure on drugs, dressings, appliances and medical devices was £22.2 billion, where total expenditure is the sum of the NIC of items dispensed anywhere in the community and the Actual Cost of items issued within hospitals. This was a 5.1% increase of £1.08 billion from the £21.1 billion costs in 2023/24 and a 30.0% increase of £5.12 billion from the £17.1 billion costs in 2020/21.
2.2 Costs by BNF Chapter
Costs by BNF Chapter in the 2024/2025 financial year
Cost measures and care settings included in Figure 3
These figures use Net Ingredient Costs (NIC) for items dispensed in the community and Actual Costs for those issued in hospitals. These figures do not include data on costs of prescribing in the Adult Secure Estate as this data is not available for BNF Chapter breakdowns.
Chart
Figure 3: In 2024/25, BNF Chapter 8 Malignant Disease and Immunosuppression had the highest total costs
Table
Table 3: In 2024/25, BNF Chapter 8 Malignant Disease and Immunosuppression had the highest total costs
| Financial year | BNF Chapter code | BNF Chapter name | Area | Cost (GBP) |
|---|---|---|---|---|
| 2024/2025 | 01 | Gastro-Intestinal System | Hospital prescribing issued within hospitals (GBP) | 380,202,546.52 |
| 2024/2025 | 01 | Gastro-Intestinal System | Dental prescribing dispensed in the community (GBP) | 244.44 |
| 2024/2025 | 01 | Gastro-Intestinal System | Hospital prescribing dispensed in the community (GBP) | 7,750,884.40 |
| 2024/2025 | 01 | Gastro-Intestinal System | Primary care prescribing dispensed in the community (GBP) | 747,338,153.91 |
| 2024/2025 | 01 | Gastro-Intestinal System | Total (GBP) | 1,135,291,829.27 |
| 2024/2025 | 02 | Cardiovascular System | Hospital prescribing issued within hospitals (GBP) | 536,906,506.82 |
| 2024/2025 | 02 | Cardiovascular System | Dental prescribing dispensed in the community (GBP) | 4.53 |
| 2024/2025 | 02 | Cardiovascular System | Hospital prescribing dispensed in the community (GBP) | 5,732,647.95 |
| 2024/2025 | 02 | Cardiovascular System | Primary care prescribing dispensed in the community (GBP) | 1,375,519,746.44 |
| 2024/2025 | 02 | Cardiovascular System | Total (GBP) | 1,918,158,905.74 |
| 2024/2025 | 03 | Respiratory System | Hospital prescribing issued within hospitals (GBP) | 944,001,528.72 |
| 2024/2025 | 03 | Respiratory System | Dental prescribing dispensed in the community (GBP) | 663.10 |
| 2024/2025 | 03 | Respiratory System | Hospital prescribing dispensed in the community (GBP) | 3,084,730.64 |
| 2024/2025 | 03 | Respiratory System | Primary care prescribing dispensed in the community (GBP) | 1,215,369,946.87 |
| 2024/2025 | 03 | Respiratory System | Total (GBP) | 2,162,456,869.33 |
| 2024/2025 | 04 | Central Nervous System | Hospital prescribing issued within hospitals (GBP) | 455,098,808.31 |
| 2024/2025 | 04 | Central Nervous System | Dental prescribing dispensed in the community (GBP) | 49,102.88 |
| 2024/2025 | 04 | Central Nervous System | Hospital prescribing dispensed in the community (GBP) | 48,948,919.52 |
| 2024/2025 | 04 | Central Nervous System | Primary care prescribing dispensed in the community (GBP) | 1,637,646,316.28 |
| 2024/2025 | 04 | Central Nervous System | Total (GBP) | 2,141,743,146.99 |
| 2024/2025 | 05 | Infections | Hospital prescribing issued within hospitals (GBP) | 719,187,522.04 |
| 2024/2025 | 05 | Infections | Dental prescribing dispensed in the community (GBP) | 4,608,342.74 |
| 2024/2025 | 05 | Infections | Hospital prescribing dispensed in the community (GBP) | 7,085,093.66 |
| 2024/2025 | 05 | Infections | Primary care prescribing dispensed in the community (GBP) | 225,132,948.44 |
| 2024/2025 | 05 | Infections | Total (GBP) | 956,013,906.88 |
| 2024/2025 | 06 | Endocrine System | Hospital prescribing issued within hospitals (GBP) | 254,092,548.97 |
| 2024/2025 | 06 | Endocrine System | Dental prescribing dispensed in the community (GBP) | 41,719.84 |
| 2024/2025 | 06 | Endocrine System | Hospital prescribing dispensed in the community (GBP) | 6,005,355.44 |
| 2024/2025 | 06 | Endocrine System | Primary care prescribing dispensed in the community (GBP) | 2,068,737,380.63 |
| 2024/2025 | 06 | Endocrine System | Total (GBP) | 2,328,877,004.88 |
| 2024/2025 | 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | Hospital prescribing issued within hospitals (GBP) | 61,772,027.90 |
| 2024/2025 | 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | Hospital prescribing dispensed in the community (GBP) | 1,358,608.88 |
| 2024/2025 | 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | Primary care prescribing dispensed in the community (GBP) | 275,109,347.94 |
| 2024/2025 | 07 | Obstetrics, Gynaecology and Urinary-Tract Disorders | Total (GBP) | 338,239,984.72 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | Hospital prescribing issued within hospitals (GBP) | 3,654,158,988.93 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | Hospital prescribing dispensed in the community (GBP) | 6,809,636.84 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | Primary care prescribing dispensed in the community (GBP) | 170,710,074.96 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | Total (GBP) | 3,831,678,700.73 |
| 2024/2025 | 09 | Nutrition and Blood | Hospital prescribing issued within hospitals (GBP) | 811,874,736.59 |
| 2024/2025 | 09 | Nutrition and Blood | Dental prescribing dispensed in the community (GBP) | 29,683,313.52 |
| 2024/2025 | 09 | Nutrition and Blood | Hospital prescribing dispensed in the community (GBP) | 4,784,669.43 |
| 2024/2025 | 09 | Nutrition and Blood | Primary care prescribing dispensed in the community (GBP) | 844,944,583.79 |
| 2024/2025 | 09 | Nutrition and Blood | Total (GBP) | 1,691,287,303.33 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | Hospital prescribing issued within hospitals (GBP) | 1,020,859,148.98 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | Dental prescribing dispensed in the community (GBP) | 19,460.13 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | Hospital prescribing dispensed in the community (GBP) | 2,319,240.44 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | Primary care prescribing dispensed in the community (GBP) | 136,490,018.16 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | Total (GBP) | 1,159,687,867.71 |
| 2024/2025 | 11 | Eye | Hospital prescribing issued within hospitals (GBP) | 598,363,625.73 |
| 2024/2025 | 11 | Eye | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 11 | Eye | Hospital prescribing dispensed in the community (GBP) | 6,768,571.96 |
| 2024/2025 | 11 | Eye | Primary care prescribing dispensed in the community (GBP) | 164,989,349.52 |
| 2024/2025 | 11 | Eye | Total (GBP) | 770,121,547.21 |
| 2024/2025 | 12 | Ear, Nose and Oropharynx | Hospital prescribing issued within hospitals (GBP) | 10,510,591.61 |
| 2024/2025 | 12 | Ear, Nose and Oropharynx | Dental prescribing dispensed in the community (GBP) | 734,167.07 |
| 2024/2025 | 12 | Ear, Nose and Oropharynx | Hospital prescribing dispensed in the community (GBP) | 1,510,613.59 |
| 2024/2025 | 12 | Ear, Nose and Oropharynx | Primary care prescribing dispensed in the community (GBP) | 98,061,534.88 |
| 2024/2025 | 12 | Ear, Nose and Oropharynx | Total (GBP) | 110,816,907.15 |
| 2024/2025 | 13 | Skin | Hospital prescribing issued within hospitals (GBP) | 495,610,910.52 |
| 2024/2025 | 13 | Skin | Dental prescribing dispensed in the community (GBP) | 14,031.54 |
| 2024/2025 | 13 | Skin | Hospital prescribing dispensed in the community (GBP) | 6,769,699.34 |
| 2024/2025 | 13 | Skin | Primary care prescribing dispensed in the community (GBP) | 311,297,055.99 |
| 2024/2025 | 13 | Skin | Total (GBP) | 813,691,697.39 |
| 2024/2025 | 14 | Immunological Products and Vaccines | Hospital prescribing issued within hospitals (GBP) | 418,091,023.35 |
| 2024/2025 | 14 | Immunological Products and Vaccines | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 14 | Immunological Products and Vaccines | Hospital prescribing dispensed in the community (GBP) | 1,760.98 |
| 2024/2025 | 14 | Immunological Products and Vaccines | Primary care prescribing dispensed in the community (GBP) | 144,349,415.41 |
| 2024/2025 | 14 | Immunological Products and Vaccines | Total (GBP) | 562,442,199.74 |
| 2024/2025 | 15 | Anaesthesia | Hospital prescribing issued within hospitals (GBP) | 117,452,729.50 |
| 2024/2025 | 15 | Anaesthesia | Dental prescribing dispensed in the community (GBP) | 14,638.94 |
| 2024/2025 | 15 | Anaesthesia | Hospital prescribing dispensed in the community (GBP) | 411,599.05 |
| 2024/2025 | 15 | Anaesthesia | Primary care prescribing dispensed in the community (GBP) | 24,589,317.94 |
| 2024/2025 | 15 | Anaesthesia | Total (GBP) | 142,468,285.43 |
| 2024/2025 | 18 | Preparations used in Diagnosis | Hospital prescribing issued within hospitals (GBP) | 114,717,816.02 |
| 2024/2025 | 18 | Preparations used in Diagnosis | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 18 | Preparations used in Diagnosis | Hospital prescribing dispensed in the community (GBP) | 280.00 |
| 2024/2025 | 18 | Preparations used in Diagnosis | Primary care prescribing dispensed in the community (GBP) | 17,482.50 |
| 2024/2025 | 18 | Preparations used in Diagnosis | Total (GBP) | 114,735,578.52 |
| 2024/2025 | 19 | Other Drugs and Preparations | Hospital prescribing issued within hospitals (GBP) | 9,887,209.63 |
| 2024/2025 | 19 | Other Drugs and Preparations | Dental prescribing dispensed in the community (GBP) | 10,063.81 |
| 2024/2025 | 19 | Other Drugs and Preparations | Hospital prescribing dispensed in the community (GBP) | 973,123.53 |
| 2024/2025 | 19 | Other Drugs and Preparations | Primary care prescribing dispensed in the community (GBP) | 9,283,157.56 |
| 2024/2025 | 19 | Other Drugs and Preparations | Total (GBP) | 20,153,554.53 |
| 2024/2025 | 20 | Dressings | Hospital prescribing issued within hospitals (GBP) | 16,865,136.04 |
| 2024/2025 | 20 | Dressings | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 20 | Dressings | Hospital prescribing dispensed in the community (GBP) | 448,443.52 |
| 2024/2025 | 20 | Dressings | Primary care prescribing dispensed in the community (GBP) | 167,314,787.04 |
| 2024/2025 | 20 | Dressings | Total (GBP) | 184,628,366.60 |
| 2024/2025 | 21 | Appliances | Hospital prescribing issued within hospitals (GBP) | 36,521,077.25 |
| 2024/2025 | 21 | Appliances | Dental prescribing dispensed in the community (GBP) | 73,395.70 |
| 2024/2025 | 21 | Appliances | Hospital prescribing dispensed in the community (GBP) | 2,753,286.52 |
| 2024/2025 | 21 | Appliances | Primary care prescribing dispensed in the community (GBP) | 804,731,731.94 |
| 2024/2025 | 21 | Appliances | Total (GBP) | 844,079,491.41 |
| 2024/2025 | 22 | Incontinence Appliances | Hospital prescribing issued within hospitals (GBP) | 468,894.75 |
| 2024/2025 | 22 | Incontinence Appliances | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 22 | Incontinence Appliances | Hospital prescribing dispensed in the community (GBP) | 10,246.83 |
| 2024/2025 | 22 | Incontinence Appliances | Primary care prescribing dispensed in the community (GBP) | 63,714,957.18 |
| 2024/2025 | 22 | Incontinence Appliances | Total (GBP) | 64,194,098.76 |
| 2024/2025 | 23 | Stoma Appliances | Hospital prescribing issued within hospitals (GBP) | 3,376,264.08 |
| 2024/2025 | 23 | Stoma Appliances | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 23 | Stoma Appliances | Hospital prescribing dispensed in the community (GBP) | 39,117.81 |
| 2024/2025 | 23 | Stoma Appliances | Primary care prescribing dispensed in the community (GBP) | 406,844,306.93 |
| 2024/2025 | 23 | Stoma Appliances | Total (GBP) | 410,259,688.82 |
| 2024/2025 | Undefined | Undefined | Hospital prescribing issued within hospitals (GBP) | 474,642,061.27 |
| 2024/2025 | Undefined | Undefined | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | Undefined | Undefined | Hospital prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | Undefined | Undefined | Primary care prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | Undefined | Undefined | Total (GBP) | 474,642,061.27 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 5
In 2024/25, the highest Actual Cost within hospitals for any one BNF Chapter was £3.65 billion. This was for Chapter 8: Malignant Disease and Immunosuppression.
In 2024/25, the highest NIC within primary care for any one BNF Chapter was £2.07 billion. This was for Chapter 6: Endocrine System.
In 2024/25, £475 million of the Actual Cost of items issued in hospitals was not accounted for under a BNF Chapter.
In 2024/25, 32.8% of the Actual Cost of items issued in hospitals in England was for BNF Chapter 8: Malignant Disease and Immunosuppression. Chapter 8 was also the BNF Chapter with the highest overall costs in 2024/25, at £3.83 billion. This was 17.3% of the total costs of £22.2 billion, where total expenditure is the sum of the NIC of items dispensed anywhere in the community and the Actual Cost of items issued within hospitals.
In 2024/25, 19.0% of the NIC of items prescribed in primary care in England was for Chapter 6: Endocrine System. In the same financial year, 2.3% of the Actual Cost of medicines issued in hospitals in England was for this chapter.
Within hospitals, the medicines not accounted for under any BNF Chapters are drugs manufactured as specials, dressings, appliances and medical devices which are not listed in the Dictionary of Medicines and Devices.
Top 10 BNF Sections by costs across all settings in the 2024/2025 financial year
Cost measures and care settings included in Figure 4
These figures use Net Ingredient Costs (NIC) for items dispensed in the community and Actual Costs for those issued in hospitals. These figures do not include data on costs of prescribing in the Adult Secure Estate as this data is not available for BNF Chapter breakdowns.
Chart
Figure 4: In 2024/25, BNF Section 0801 Cytotoxic Drugs had the highest total costs
Table
Table 4: In 2024/25, BNF Section 0801 Cytotoxic Drugs had the highest total costs
| Financial year | BNF Chapter code | BNF Chapter name | BNF Section code | BNF Section name | Area | Cost (GBP) |
|---|---|---|---|---|---|---|
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0801 | Cytotoxic drugs | Hospital prescribing issued within hospitals (GBP) | 2,820,154,904.77 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0801 | Cytotoxic drugs | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0801 | Cytotoxic drugs | Hospital prescribing dispensed in the community (GBP) | 402,540.53 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0801 | Cytotoxic drugs | Primary care prescribing dispensed in the community (GBP) | 5,499,358.88 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0801 | Cytotoxic drugs | Total (GBP) | 2,826,056,804.18 |
| 2024/2025 | 06 | Endocrine System | 0601 | Drugs used in diabetes | Hospital prescribing issued within hospitals (GBP) | 79,249,951.17 |
| 2024/2025 | 06 | Endocrine System | 0601 | Drugs used in diabetes | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 06 | Endocrine System | 0601 | Drugs used in diabetes | Hospital prescribing dispensed in the community (GBP) | 2,338,914.74 |
| 2024/2025 | 06 | Endocrine System | 0601 | Drugs used in diabetes | Primary care prescribing dispensed in the community (GBP) | 1,629,159,777.75 |
| 2024/2025 | 06 | Endocrine System | 0601 | Drugs used in diabetes | Total (GBP) | 1,710,748,643.66 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | 1001 | Drugs used in rheumatic diseases and gout | Hospital prescribing issued within hospitals (GBP) | 935,071,711.55 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | 1001 | Drugs used in rheumatic diseases and gout | Dental prescribing dispensed in the community (GBP) | 19,460.13 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | 1001 | Drugs used in rheumatic diseases and gout | Hospital prescribing dispensed in the community (GBP) | 2,059,393.16 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | 1001 | Drugs used in rheumatic diseases and gout | Primary care prescribing dispensed in the community (GBP) | 82,981,461.54 |
| 2024/2025 | 10 | Musculoskeletal and Joint Diseases | 1001 | Drugs used in rheumatic diseases and gout | Total (GBP) | 1,020,132,026.38 |
| 2024/2025 | 03 | Respiratory System | 0302 | Corticosteroids (respiratory) | Hospital prescribing issued within hospitals (GBP) | 23,336,794.14 |
| 2024/2025 | 03 | Respiratory System | 0302 | Corticosteroids (respiratory) | Dental prescribing dispensed in the community (GBP) | 370.00 |
| 2024/2025 | 03 | Respiratory System | 0302 | Corticosteroids (respiratory) | Hospital prescribing dispensed in the community (GBP) | 963,637.98 |
| 2024/2025 | 03 | Respiratory System | 0302 | Corticosteroids (respiratory) | Primary care prescribing dispensed in the community (GBP) | 816,496,865.38 |
| 2024/2025 | 03 | Respiratory System | 0302 | Corticosteroids (respiratory) | Total (GBP) | 840,797,667.50 |
| 2024/2025 | 03 | Respiratory System | 0307 | Mucolytics | Hospital prescribing issued within hospitals (GBP) | 706,830,570.95 |
| 2024/2025 | 03 | Respiratory System | 0307 | Mucolytics | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 03 | Respiratory System | 0307 | Mucolytics | Hospital prescribing dispensed in the community (GBP) | 206,275.47 |
| 2024/2025 | 03 | Respiratory System | 0307 | Mucolytics | Primary care prescribing dispensed in the community (GBP) | 24,895,819.86 |
| 2024/2025 | 03 | Respiratory System | 0307 | Mucolytics | Total (GBP) | 731,932,666.28 |
| 2024/2025 | 02 | Cardiovascular System | 0208 | Anticoagulants and protamine | Hospital prescribing issued within hospitals (GBP) | 178,489,949.54 |
| 2024/2025 | 02 | Cardiovascular System | 0208 | Anticoagulants and protamine | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 02 | Cardiovascular System | 0208 | Anticoagulants and protamine | Hospital prescribing dispensed in the community (GBP) | 3,248,547.54 |
| 2024/2025 | 02 | Cardiovascular System | 0208 | Anticoagulants and protamine | Primary care prescribing dispensed in the community (GBP) | 457,671,200.85 |
| 2024/2025 | 02 | Cardiovascular System | 0208 | Anticoagulants and protamine | Total (GBP) | 639,409,697.93 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0802 | Drugs affecting the immune response | Hospital prescribing issued within hospitals (GBP) | 579,574,419.62 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0802 | Drugs affecting the immune response | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0802 | Drugs affecting the immune response | Hospital prescribing dispensed in the community (GBP) | 5,098,788.13 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0802 | Drugs affecting the immune response | Primary care prescribing dispensed in the community (GBP) | 23,197,341.85 |
| 2024/2025 | 08 | Malignant Disease and Immunosuppression | 0802 | Drugs affecting the immune response | Total (GBP) | 607,870,549.60 |
| 2024/2025 | 04 | Central Nervous System | 0407 | Analgesics | Hospital prescribing issued within hospitals (GBP) | 114,010,131.69 |
| 2024/2025 | 04 | Central Nervous System | 0407 | Analgesics | Dental prescribing dispensed in the community (GBP) | 46,001.88 |
| 2024/2025 | 04 | Central Nervous System | 0407 | Analgesics | Hospital prescribing dispensed in the community (GBP) | 2,405,935.23 |
| 2024/2025 | 04 | Central Nervous System | 0407 | Analgesics | Primary care prescribing dispensed in the community (GBP) | 435,856,893.10 |
| 2024/2025 | 04 | Central Nervous System | 0407 | Analgesics | Total (GBP) | 552,318,961.90 |
| 2024/2025 | 13 | Skin | 1305 | Preparations for eczema and psoriasis | Hospital prescribing issued within hospitals (GBP) | 451,663,817.65 |
| 2024/2025 | 13 | Skin | 1305 | Preparations for eczema and psoriasis | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 13 | Skin | 1305 | Preparations for eczema and psoriasis | Hospital prescribing dispensed in the community (GBP) | 2,578,330.15 |
| 2024/2025 | 13 | Skin | 1305 | Preparations for eczema and psoriasis | Primary care prescribing dispensed in the community (GBP) | 78,562,048.97 |
| 2024/2025 | 13 | Skin | 1305 | Preparations for eczema and psoriasis | Total (GBP) | 532,804,196.77 |
| 2024/2025 | 09 | Nutrition and Blood | 0913 | Oral nutrition | Hospital prescribing issued within hospitals (GBP) | 0.00 |
| 2024/2025 | 09 | Nutrition and Blood | 0913 | Oral nutrition | Dental prescribing dispensed in the community (GBP) | 0.00 |
| 2024/2025 | 09 | Nutrition and Blood | 0913 | Oral nutrition | Hospital prescribing dispensed in the community (GBP) | 852,403.18 |
| 2024/2025 | 09 | Nutrition and Blood | 0913 | Oral nutrition | Primary care prescribing dispensed in the community (GBP) | 478,067,895.36 |
| 2024/2025 | 09 | Nutrition and Blood | 0913 | Oral nutrition | Total (GBP) | 478,920,298.54 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 6
BNF Section 0801 - Cytotoxic Drugs had the highest overall costs in 2024/25, at £2.83 billion.
BNF Section 0601 - Drugs Used in Diabetes had the second highest overall costs, at £1.71 billion.
In 2024/25, 99.8% of the total costs of BNF Section 0801 - Cytotoxic Drugs came from medicines issued in hospitals. In the same year, cytotoxic drugs issued in hospitals also had the largest spend of any BNF Section within a single care setting, at £2.82 billion. This accounted for 25.3% of the total spend within hospitals.
For BNF Section 0601 - Drugs Used in Diabetes, 95.2% of the total costs in 2024/25 came from primary care prescribing dispensed in the community. Drugs used in diabetes had the highest NIC within primary care, at £1.63 billion. This accounted for 15.0% of the total NIC for primary care prescribing dispensed in the community in 2024/25.
2.3 Costs by ICB
Costs by ICB in the 2024/2025 financial year
Cost measures and care settings used in Figure 5
These figures are Net Ingredient Costs (NIC) for items dispensed in the community and Actual Costs for those issued in hospitals. Data for prescriptions issued by dentists and dispensed in the community is not included in Figure 5, because dental data is captured under a national code and cannot be linked to individual ICBs. These figures also do not include data on costs of prescribing in the Adult Secure Estate as this data is not available for ICB breakdowns.
Chart
Figure 5: In 2024/25, the costs of primary and secondary care prescribing varied by ICB
Table
Table 5: In 2024/25, the costs of primary and secondary care prescribing varied by ICB
| Financial year | ICB code | ICB name | ICB population | Area | Cost (GBP) |
|---|---|---|---|---|---|
| 2024/2025 | QOP | NHS Greater Manchester | 3,009,664 | Hospital prescribing issued within hospitals (GBP) | 751,077,938.32 |
| 2024/2025 | QOP | NHS Greater Manchester | 3,009,664 | Hospital prescribing dispensed in the community (GBP) | 3,947,134.82 |
| 2024/2025 | QOP | NHS Greater Manchester | 3,009,664 | Primary care prescribing dispensed in the community (GBP) | 606,586,674.83 |
| 2024/2025 | QHM | NHS North East and North Cumbria | 3,088,985 | Hospital prescribing issued within hospitals (GBP) | 664,914,813.98 |
| 2024/2025 | QHM | NHS North East and North Cumbria | 3,088,985 | Hospital prescribing dispensed in the community (GBP) | 9,218,031.65 |
| 2024/2025 | QHM | NHS North East and North Cumbria | 3,088,985 | Primary care prescribing dispensed in the community (GBP) | 651,877,248.79 |
| 2024/2025 | QYG | NHS Cheshire and Merseyside | 2,615,425 | Hospital prescribing issued within hospitals (GBP) | 518,166,627.99 |
| 2024/2025 | QYG | NHS Cheshire and Merseyside | 2,615,425 | Hospital prescribing dispensed in the community (GBP) | 4,519,406.58 |
| 2024/2025 | QYG | NHS Cheshire and Merseyside | 2,615,425 | Primary care prescribing dispensed in the community (GBP) | 571,171,548.67 |
| 2024/2025 | QWO | NHS West Yorkshire | 2,487,154 | Hospital prescribing issued within hospitals (GBP) | 516,105,648.09 |
| 2024/2025 | QWO | NHS West Yorkshire | 2,487,154 | Hospital prescribing dispensed in the community (GBP) | 1,540,350.48 |
| 2024/2025 | QWO | NHS West Yorkshire | 2,487,154 | Primary care prescribing dispensed in the community (GBP) | 492,315,472.69 |
| 2024/2025 | QMJ | NHS North Central London | 1,436,301 | Hospital prescribing issued within hospitals (GBP) | 727,452,422.98 |
| 2024/2025 | QMJ | NHS North Central London | 1,436,301 | Hospital prescribing dispensed in the community (GBP) | 3,018,687.57 |
| 2024/2025 | QMJ | NHS North Central London | 1,436,301 | Primary care prescribing dispensed in the community (GBP) | 223,332,888.39 |
| 2024/2025 | QKK | NHS South East London | 1,824,242 | Hospital prescribing issued within hospitals (GBP) | 686,401,680.67 |
| 2024/2025 | QKK | NHS South East London | 1,824,242 | Hospital prescribing dispensed in the community (GBP) | 2,527,459.41 |
| 2024/2025 | QKK | NHS South East London | 1,824,242 | Primary care prescribing dispensed in the community (GBP) | 261,362,251.15 |
| 2024/2025 | QRL | NHS Hampshire and Isle of Wight | 1,879,207 | Hospital prescribing issued within hospitals (GBP) | 406,026,054.55 |
| 2024/2025 | QRL | NHS Hampshire and Isle of Wight | 1,879,207 | Hospital prescribing dispensed in the community (GBP) | 2,911,373.36 |
| 2024/2025 | QRL | NHS Hampshire and Isle of Wight | 1,879,207 | Primary care prescribing dispensed in the community (GBP) | 364,394,569.62 |
| 2024/2025 | QRV | NHS North West London | 2,181,495 | Hospital prescribing issued within hospitals (GBP) | 386,761,298.54 |
| 2024/2025 | QRV | NHS North West London | 2,181,495 | Hospital prescribing dispensed in the community (GBP) | 1,847,923.95 |
| 2024/2025 | QRV | NHS North West London | 2,181,495 | Primary care prescribing dispensed in the community (GBP) | 315,848,916.23 |
| 2024/2025 | QF7 | NHS South Yorkshire | 1,430,623 | Hospital prescribing issued within hospitals (GBP) | 382,227,534.21 |
| 2024/2025 | QF7 | NHS South Yorkshire | 1,430,623 | Hospital prescribing dispensed in the community (GBP) | 2,494,280.56 |
| 2024/2025 | QF7 | NHS South Yorkshire | 1,430,623 | Primary care prescribing dispensed in the community (GBP) | 289,169,627.65 |
| 2024/2025 | QMF | NHS North East London | 2,098,267 | Hospital prescribing issued within hospitals (GBP) | 336,852,252.38 |
| 2024/2025 | QMF | NHS North East London | 2,098,267 | Hospital prescribing dispensed in the community (GBP) | 4,944,912.08 |
| 2024/2025 | QMF | NHS North East London | 2,098,267 | Primary care prescribing dispensed in the community (GBP) | 312,737,609.44 |
| 2024/2025 | QOQ | NHS Humber and North Yorkshire | 1,748,885 | Hospital prescribing issued within hospitals (GBP) | 278,284,548.60 |
| 2024/2025 | QOQ | NHS Humber and North Yorkshire | 1,748,885 | Hospital prescribing dispensed in the community (GBP) | 1,616,350.74 |
| 2024/2025 | QOQ | NHS Humber and North Yorkshire | 1,748,885 | Primary care prescribing dispensed in the community (GBP) | 371,830,951.32 |
| 2024/2025 | QU9 | NHS Buckinghamshire, Oxfordshire and Berkshire West | 1,862,474 | Hospital prescribing issued within hospitals (GBP) | 337,405,535.70 |
| 2024/2025 | QU9 | NHS Buckinghamshire, Oxfordshire and Berkshire West | 1,862,474 | Hospital prescribing dispensed in the community (GBP) | 3,599,210.74 |
| 2024/2025 | QU9 | NHS Buckinghamshire, Oxfordshire and Berkshire West | 1,862,474 | Primary care prescribing dispensed in the community (GBP) | 294,704,930.83 |
| 2024/2025 | QE1 | NHS Lancashire and South Cumbria | 1,790,318 | Hospital prescribing issued within hospitals (GBP) | 252,151,674.62 |
| 2024/2025 | QE1 | NHS Lancashire and South Cumbria | 1,790,318 | Hospital prescribing dispensed in the community (GBP) | 2,245,829.08 |
| 2024/2025 | QE1 | NHS Lancashire and South Cumbria | 1,790,318 | Primary care prescribing dispensed in the community (GBP) | 361,780,643.64 |
| 2024/2025 | QKS | NHS Kent and Medway | 1,931,684 | Hospital prescribing issued within hospitals (GBP) | 248,848,182.54 |
| 2024/2025 | QKS | NHS Kent and Medway | 1,931,684 | Hospital prescribing dispensed in the community (GBP) | 5,981,753.92 |
| 2024/2025 | QKS | NHS Kent and Medway | 1,931,684 | Primary care prescribing dispensed in the community (GBP) | 357,568,010.77 |
| 2024/2025 | QHL | NHS Birmingham and Solihull | 1,404,860 | Hospital prescribing issued within hospitals (GBP) | 325,314,193.07 |
| 2024/2025 | QHL | NHS Birmingham and Solihull | 1,404,860 | Hospital prescribing dispensed in the community (GBP) | 3,185,807.46 |
| 2024/2025 | QHL | NHS Birmingham and Solihull | 1,404,860 | Primary care prescribing dispensed in the community (GBP) | 281,262,222.04 |
| 2024/2025 | QNX | NHS Sussex | 1,759,789 | Hospital prescribing issued within hospitals (GBP) | 224,209,615.65 |
| 2024/2025 | QNX | NHS Sussex | 1,759,789 | Hospital prescribing dispensed in the community (GBP) | 5,657,750.32 |
| 2024/2025 | QNX | NHS Sussex | 1,759,789 | Primary care prescribing dispensed in the community (GBP) | 358,208,899.57 |
| 2024/2025 | QWE | NHS South West London | 1,549,431 | Hospital prescribing issued within hospitals (GBP) | 326,888,705.14 |
| 2024/2025 | QWE | NHS South West London | 1,549,431 | Hospital prescribing dispensed in the community (GBP) | 1,063,232.30 |
| 2024/2025 | QWE | NHS South West London | 1,549,431 | Primary care prescribing dispensed in the community (GBP) | 216,058,254.95 |
| 2024/2025 | QJK | NHS Devon | 1,254,506 | Hospital prescribing issued within hospitals (GBP) | 280,342,557.73 |
| 2024/2025 | QJK | NHS Devon | 1,254,506 | Hospital prescribing dispensed in the community (GBP) | 1,916,681.48 |
| 2024/2025 | QJK | NHS Devon | 1,254,506 | Primary care prescribing dispensed in the community (GBP) | 246,411,146.86 |
| 2024/2025 | QUE | NHS Cambridgeshire and Peterborough | 955,401 | Hospital prescribing issued within hospitals (GBP) | 335,211,974.53 |
| 2024/2025 | QUE | NHS Cambridgeshire and Peterborough | 955,401 | Hospital prescribing dispensed in the community (GBP) | 954,931.67 |
| 2024/2025 | QUE | NHS Cambridgeshire and Peterborough | 955,401 | Primary care prescribing dispensed in the community (GBP) | 168,910,786.24 |
| 2024/2025 | QUA | NHS Black Country | 1,262,719 | Hospital prescribing issued within hospitals (GBP) | 206,959,873.84 |
| 2024/2025 | QUA | NHS Black Country | 1,262,719 | Hospital prescribing dispensed in the community (GBP) | 6,116,255.77 |
| 2024/2025 | QUA | NHS Black Country | 1,262,719 | Primary care prescribing dispensed in the community (GBP) | 267,494,482.95 |
| 2024/2025 | QT1 | NHS Nottingham and Nottinghamshire | 1,188,090 | Hospital prescribing issued within hospitals (GBP) | 253,323,627.06 |
| 2024/2025 | QT1 | NHS Nottingham and Nottinghamshire | 1,188,090 | Hospital prescribing dispensed in the community (GBP) | 2,820,789.71 |
| 2024/2025 | QT1 | NHS Nottingham and Nottinghamshire | 1,188,090 | Primary care prescribing dispensed in the community (GBP) | 213,837,003.17 |
| 2024/2025 | QUY | NHS Bristol, North Somerset and South Gloucestershire | 1,025,309 | Hospital prescribing issued within hospitals (GBP) | 252,057,190.84 |
| 2024/2025 | QUY | NHS Bristol, North Somerset and South Gloucestershire | 1,025,309 | Hospital prescribing dispensed in the community (GBP) | 2,933,153.94 |
| 2024/2025 | QUY | NHS Bristol, North Somerset and South Gloucestershire | 1,025,309 | Primary care prescribing dispensed in the community (GBP) | 159,545,768.83 |
| 2024/2025 | QK1 | NHS Leicester, Leicestershire and Rutland | 1,175,364 | Hospital prescribing issued within hospitals (GBP) | 177,935,707.22 |
| 2024/2025 | QK1 | NHS Leicester, Leicestershire and Rutland | 1,175,364 | Hospital prescribing dispensed in the community (GBP) | 1,499,696.79 |
| 2024/2025 | QK1 | NHS Leicester, Leicestershire and Rutland | 1,175,364 | Primary care prescribing dispensed in the community (GBP) | 222,031,700.04 |
| 2024/2025 | QMM | NHS Norfolk and Waveney | 1,058,014 | Hospital prescribing issued within hospitals (GBP) | 171,353,215.71 |
| 2024/2025 | QMM | NHS Norfolk and Waveney | 1,058,014 | Hospital prescribing dispensed in the community (GBP) | 1,488,335.78 |
| 2024/2025 | QMM | NHS Norfolk and Waveney | 1,058,014 | Primary care prescribing dispensed in the community (GBP) | 224,950,251.99 |
| 2024/2025 | QNC | NHS Staffordshire and Stoke-on-Trent | 1,177,578 | Hospital prescribing issued within hospitals (GBP) | 141,423,928.48 |
| 2024/2025 | QNC | NHS Staffordshire and Stoke-on-Trent | 1,177,578 | Hospital prescribing dispensed in the community (GBP) | 4,450,413.11 |
| 2024/2025 | QNC | NHS Staffordshire and Stoke-on-Trent | 1,177,578 | Primary care prescribing dispensed in the community (GBP) | 249,289,511.96 |
| 2024/2025 | QM7 | NHS Hertfordshire and West Essex | 1,545,554 | Hospital prescribing issued within hospitals (GBP) | 133,982,193.20 |
| 2024/2025 | QM7 | NHS Hertfordshire and West Essex | 1,545,554 | Hospital prescribing dispensed in the community (GBP) | 4,288,191.76 |
| 2024/2025 | QM7 | NHS Hertfordshire and West Essex | 1,545,554 | Primary care prescribing dispensed in the community (GBP) | 252,273,683.74 |
| 2024/2025 | QJG | NHS Suffolk and North East Essex | 1,025,557 | Hospital prescribing issued within hospitals (GBP) | 151,276,438.90 |
| 2024/2025 | QJG | NHS Suffolk and North East Essex | 1,025,557 | Hospital prescribing dispensed in the community (GBP) | 648,862.46 |
| 2024/2025 | QJG | NHS Suffolk and North East Essex | 1,025,557 | Primary care prescribing dispensed in the community (GBP) | 212,306,448.31 |
| 2024/2025 | QH8 | NHS Mid and South Essex | 1,241,837 | Hospital prescribing issued within hospitals (GBP) | 133,487,886.02 |
| 2024/2025 | QH8 | NHS Mid and South Essex | 1,241,837 | Hospital prescribing dispensed in the community (GBP) | 1,412,970.66 |
| 2024/2025 | QH8 | NHS Mid and South Essex | 1,241,837 | Primary care prescribing dispensed in the community (GBP) | 225,950,636.96 |
| 2024/2025 | QJ2 | NHS Derby and Derbyshire | 1,096,526 | Hospital prescribing issued within hospitals (GBP) | 138,928,895.72 |
| 2024/2025 | QJ2 | NHS Derby and Derbyshire | 1,096,526 | Hospital prescribing dispensed in the community (GBP) | 916,150.83 |
| 2024/2025 | QJ2 | NHS Derby and Derbyshire | 1,096,526 | Primary care prescribing dispensed in the community (GBP) | 199,750,479.16 |
| 2024/2025 | QWU | NHS Coventry and Warwickshire | 1,001,233 | Hospital prescribing issued within hospitals (GBP) | 144,246,679.71 |
| 2024/2025 | QWU | NHS Coventry and Warwickshire | 1,001,233 | Hospital prescribing dispensed in the community (GBP) | 468,407.70 |
| 2024/2025 | QWU | NHS Coventry and Warwickshire | 1,001,233 | Primary care prescribing dispensed in the community (GBP) | 185,840,081.50 |
| 2024/2025 | QXU | NHS Surrey Heartlands | 1,085,554 | Hospital prescribing issued within hospitals (GBP) | 145,981,490.09 |
| 2024/2025 | QXU | NHS Surrey Heartlands | 1,085,554 | Hospital prescribing dispensed in the community (GBP) | 4,700,891.05 |
| 2024/2025 | QXU | NHS Surrey Heartlands | 1,085,554 | Primary care prescribing dispensed in the community (GBP) | 173,067,371.45 |
| 2024/2025 | QOX | NHS Bath and North East Somerset, Swindon and Wiltshire | 974,918 | Hospital prescribing issued within hospitals (GBP) | 149,781,513.21 |
| 2024/2025 | QOX | NHS Bath and North East Somerset, Swindon and Wiltshire | 974,918 | Hospital prescribing dispensed in the community (GBP) | 596,246.57 |
| 2024/2025 | QOX | NHS Bath and North East Somerset, Swindon and Wiltshire | 974,918 | Primary care prescribing dispensed in the community (GBP) | 167,398,713.69 |
| 2024/2025 | QHG | NHS Bedfordshire, Luton and Milton Keynes | 1,063,247 | Hospital prescribing issued within hospitals (GBP) | 110,870,930.46 |
| 2024/2025 | QHG | NHS Bedfordshire, Luton and Milton Keynes | 1,063,247 | Hospital prescribing dispensed in the community (GBP) | 3,808,093.27 |
| 2024/2025 | QHG | NHS Bedfordshire, Luton and Milton Keynes | 1,063,247 | Primary care prescribing dispensed in the community (GBP) | 169,527,179.95 |
| 2024/2025 | QJM | NHS Lincolnshire | 789,502 | Hospital prescribing issued within hospitals (GBP) | 96,241,616.67 |
| 2024/2025 | QJM | NHS Lincolnshire | 789,502 | Hospital prescribing dispensed in the community (GBP) | 407,975.20 |
| 2024/2025 | QJM | NHS Lincolnshire | 789,502 | Primary care prescribing dispensed in the community (GBP) | 187,242,676.76 |
| 2024/2025 | QVV | NHS Dorset | 798,914 | Hospital prescribing issued within hospitals (GBP) | 119,654,964.59 |
| 2024/2025 | QVV | NHS Dorset | 798,914 | Hospital prescribing dispensed in the community (GBP) | 1,756,295.13 |
| 2024/2025 | QVV | NHS Dorset | 798,914 | Primary care prescribing dispensed in the community (GBP) | 156,755,769.57 |
| 2024/2025 | QGH | NHS Herefordshire and Worcestershire | 812,407 | Hospital prescribing issued within hospitals (GBP) | 107,348,730.93 |
| 2024/2025 | QGH | NHS Herefordshire and Worcestershire | 812,407 | Hospital prescribing dispensed in the community (GBP) | 1,762,696.89 |
| 2024/2025 | QGH | NHS Herefordshire and Worcestershire | 812,407 | Primary care prescribing dispensed in the community (GBP) | 164,462,224.56 |
| 2024/2025 | QNQ | NHS Frimley | 803,615 | Hospital prescribing issued within hospitals (GBP) | 95,927,035.92 |
| 2024/2025 | QNQ | NHS Frimley | 803,615 | Hospital prescribing dispensed in the community (GBP) | 2,454,133.69 |
| 2024/2025 | QNQ | NHS Frimley | 803,615 | Primary care prescribing dispensed in the community (GBP) | 123,306,544.27 |
| 2024/2025 | QPM | NHS Northamptonshire | 813,682 | Hospital prescribing issued within hospitals (GBP) | 87,219,059.76 |
| 2024/2025 | QPM | NHS Northamptonshire | 813,682 | Hospital prescribing dispensed in the community (GBP) | 1,315,960.27 |
| 2024/2025 | QPM | NHS Northamptonshire | 813,682 | Primary care prescribing dispensed in the community (GBP) | 133,049,036.90 |
| 2024/2025 | QR1 | NHS Gloucestershire | 669,380 | Hospital prescribing issued within hospitals (GBP) | 96,547,866.08 |
| 2024/2025 | QR1 | NHS Gloucestershire | 669,380 | Hospital prescribing dispensed in the community (GBP) | 2,346,488.24 |
| 2024/2025 | QR1 | NHS Gloucestershire | 669,380 | Primary care prescribing dispensed in the community (GBP) | 118,747,543.11 |
| 2024/2025 | QT6 | NHS Cornwall and the Isles of Scilly | 585,655 | Hospital prescribing issued within hospitals (GBP) | 84,723,532.33 |
| 2024/2025 | QT6 | NHS Cornwall and the Isles of Scilly | 585,655 | Hospital prescribing dispensed in the community (GBP) | 995,730.42 |
| 2024/2025 | QT6 | NHS Cornwall and the Isles of Scilly | 585,655 | Primary care prescribing dispensed in the community (GBP) | 126,414,485.62 |
| 2024/2025 | QSL | NHS Somerset | 588,328 | Hospital prescribing issued within hospitals (GBP) | 81,787,325.04 |
| 2024/2025 | QSL | NHS Somerset | 588,328 | Hospital prescribing dispensed in the community (GBP) | 1,847,926.38 |
| 2024/2025 | QSL | NHS Somerset | 588,328 | Primary care prescribing dispensed in the community (GBP) | 107,442,432.90 |
| 2024/2025 | QOC | NHS Shropshire, Telford and Wrekin | 528,407 | Hospital prescribing issued within hospitals (GBP) | 68,958,742.42 |
| 2024/2025 | QOC | NHS Shropshire, Telford and Wrekin | 528,407 | Hospital prescribing dispensed in the community (GBP) | 1,212,732.34 |
| 2024/2025 | QOC | NHS Shropshire, Telford and Wrekin | 528,407 | Primary care prescribing dispensed in the community (GBP) | 101,796,469.24 |
| 2024/2025 | UNKNOWN | Unknown ICB | NA | Hospital prescribing issued within hospitals (GBP) | 0.00 |
| 2024/2025 | UNKNOWN | Unknown ICB | NA | Hospital prescribing dispensed in the community (GBP) | 127,024.20 |
| 2024/2025 | UNKNOWN | Unknown ICB | NA | Primary care prescribing dispensed in the community (GBP) | 4,178,464.00 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 7
In 2024/25, Greater Manchester ICB had the largest total spend across primary and secondary care, at £1.36 billion.
Greater Manchester ICB also had the largest spend within hospitals in 2024/25, at £751 million.
The ICB with the lowest total spend in 2024/25 was Shropshire, Telford and Wrekin ICB, at £172 million. It should be noted that ICBs may have different population sizes and requirements.
In 2024/25, the ICB with the largest NIC for primary care prescribing dispensed in the community was North East and North Cumbria ICB, at £652 million.
Data under ‘Unknown ICB’ refers to costs in both primary and secondary care that could not be mapped to an ICB. In 2024/25, this totalled £4.3 million. This total does not include dental data.
In secondary care, ICB costs are allocated to the ICB where the hospital is located. However, not all of these costs are for patients living in that ICB. For example, patients may be referred to hospitals outside their usual ICB of residence.
Average costs per person by ICB in the 2024/2025 financial year
Cost measures and care settings used in Figure 6
These figures are Net Ingredient Costs (NIC) for items dispensed in the community and Actual Costs for those issued in hospitals. Data for prescriptions issued by dentists and dispensed in the community is not included in Figure 6, because dental data is captured under a national code and cannot be linked to individual ICBs. These figures also do not include data on costs of prescribing in the Adult Secure Estate as this data is not available for ICB breakdowns.
Chart
Figure 6: In 2024/25, the average cost per person varied by ICB
Table
Table 6: In 2024/25, the average cost per person varied by ICB
| Financial year | ICB code | ICB name | ICB population | Total cost (GBP) | Cost per person (GBP) |
|---|---|---|---|---|---|
| 2024/2025 | QMJ | NHS North Central London | 1,436,301 | 953,803,998.94 | 664.07 |
| 2024/2025 | QUE | NHS Cambridgeshire and Peterborough | 955,401 | 505,077,692.44 | 528.66 |
| 2024/2025 | QKK | NHS South East London | 1,824,242 | 950,291,391.23 | 520.92 |
| 2024/2025 | QF7 | NHS South Yorkshire | 1,430,623 | 673,891,442.42 | 471.05 |
| 2024/2025 | QOP | NHS Greater Manchester | 3,009,664 | 1,361,611,747.97 | 452.41 |
| 2024/2025 | QHL | NHS Birmingham and Solihull | 1,404,860 | 609,762,222.57 | 434.04 |
| 2024/2025 | QHM | NHS North East and North Cumbria | 3,088,985 | 1,326,010,094.42 | 429.27 |
| 2024/2025 | QJK | NHS Devon | 1,254,506 | 528,670,386.07 | 421.42 |
| 2024/2025 | QYG | NHS Cheshire and Merseyside | 2,615,425 | 1,093,857,583.24 | 418.23 |
| 2024/2025 | QRL | NHS Hampshire and Isle of Wight | 1,879,207 | 773,331,997.53 | 411.52 |
| 2024/2025 | QWO | NHS West Yorkshire | 2,487,154 | 1,009,961,471.26 | 406.07 |
| 2024/2025 | QUY | NHS Bristol, North Somerset and South Gloucestershire | 1,025,309 | 414,536,113.61 | 404.30 |
| 2024/2025 | QT1 | NHS Nottingham and Nottinghamshire | 1,188,090 | 469,981,419.94 | 395.58 |
| 2024/2025 | QUA | NHS Black Country | 1,262,719 | 480,570,612.56 | 380.58 |
| 2024/2025 | QMM | NHS Norfolk and Waveney | 1,058,014 | 397,791,803.48 | 375.98 |
| 2024/2025 | QOQ | NHS Humber and North Yorkshire | 1,748,885 | 651,731,850.66 | 372.66 |
| 2024/2025 | QT6 | NHS Cornwall and the Isles of Scilly | 585,655 | 212,133,748.37 | 362.22 |
| 2024/2025 | QJM | NHS Lincolnshire | 789,502 | 283,892,268.63 | 359.58 |
| 2024/2025 | QJG | NHS Suffolk and North East Essex | 1,025,557 | 364,231,749.67 | 355.16 |
| 2024/2025 | QWE | NHS South West London | 1,549,431 | 544,010,192.39 | 351.10 |
| 2024/2025 | QVV | NHS Dorset | 798,914 | 278,167,029.29 | 348.18 |
| 2024/2025 | QE1 | NHS Lancashire and South Cumbria | 1,790,318 | 616,178,147.34 | 344.17 |
| 2024/2025 | QK1 | NHS Leicester, Leicestershire and Rutland | 1,175,364 | 401,467,104.05 | 341.57 |
| 2024/2025 | QU9 | NHS Buckinghamshire, Oxfordshire and Berkshire West | 1,862,474 | 635,709,677.27 | 341.33 |
| 2024/2025 | QGH | NHS Herefordshire and Worcestershire | 812,407 | 273,573,652.38 | 336.74 |
| 2024/2025 | QNC | NHS Staffordshire and Stoke-on-Trent | 1,177,578 | 395,163,853.55 | 335.57 |
| 2024/2025 | QNX | NHS Sussex | 1,759,789 | 588,076,265.54 | 334.17 |
| 2024/2025 | QWU | NHS Coventry and Warwickshire | 1,001,233 | 330,555,168.91 | 330.15 |
| 2024/2025 | QOX | NHS Bath and North East Somerset, Swindon and Wiltshire | 974,918 | 317,776,473.47 | 325.95 |
| 2024/2025 | QOC | NHS Shropshire, Telford and Wrekin | 528,407 | 171,967,944.00 | 325.45 |
| 2024/2025 | QR1 | NHS Gloucestershire | 669,380 | 217,641,897.43 | 325.14 |
| 2024/2025 | QSL | NHS Somerset | 588,328 | 191,077,684.32 | 324.78 |
| 2024/2025 | QRV | NHS North West London | 2,181,495 | 704,458,138.72 | 322.92 |
| 2024/2025 | QKS | NHS Kent and Medway | 1,931,684 | 612,397,947.23 | 317.03 |
| 2024/2025 | QMF | NHS North East London | 2,098,267 | 654,534,773.90 | 311.94 |
| 2024/2025 | QJ2 | NHS Derby and Derbyshire | 1,096,526 | 339,595,525.71 | 309.70 |
| 2024/2025 | QXU | NHS Surrey Heartlands | 1,085,554 | 323,749,752.59 | 298.23 |
| 2024/2025 | QH8 | NHS Mid and South Essex | 1,241,837 | 360,851,493.64 | 290.58 |
| 2024/2025 | QNQ | NHS Frimley | 803,615 | 221,687,713.88 | 275.86 |
| 2024/2025 | QPM | NHS Northamptonshire | 813,682 | 221,584,056.93 | 272.32 |
| 2024/2025 | QHG | NHS Bedfordshire, Luton and Milton Keynes | 1,063,247 | 284,206,203.68 | 267.30 |
| 2024/2025 | QM7 | NHS Hertfordshire and West Essex | 1,545,554 | 390,544,068.70 | 252.69 |
Source: Summary Tables - Prescribing Costs in Hospitals and the Community - Table 7
In 2024/25, the average cost per person of items issued across primary and secondary care in England was £378.
North Central London ICB had the highest cost per person in 2024/25, at £664.
Hertfordshire and West Essex ICB had the lowest cost per person in 2024/25, at £253.
In 2024/25, the average cost per person of medicines issued across primary and secondary care in England was £378. This was an increase of 2.4% from £369 in 2023/24, and a 24.9% increase from £302 in 2020/21.
The ‘cost per person’ is the total cost divided by the area population. The national average cost per person used in figure 6 is the total costs for all ICBs divided by the sum of the mid-year population estimates for ICBs in 2024. The cost per person for each ICB will be the ICB’s total costs divided by the mid-year population in that ICB.
3. About these statistics
3.1 Uses of these statistics
These statistics have a variety of uses, including:
obtaining a national view of costs for prescriptions dispensed in hospitals and the community in England across the financial year
analysis of cost trends by BNF Chapter, BNF Section and ICB
public scrutiny of national prescribing habits
3.2 British National Formulary (BNF)
The primary care data used in this publication comes from the NHSBSA Enterprise Data Warehouse (EDW). This includes the breakdown by BNF Sections. The data for secondary care is provided by Rx-Info. Rx-Info use an extract from the Dictionary of Medicines and Devices (dm+d) to obtain BNF classifications.
3.3 Time periods reported on by this publication
This publication presents data from April 2020 to March 2025.
3.4 Geographies used by this publication
Integrated Care Boards (ICB) are health geographies formed by NHS organisations, local councils and others, to set out proposals to improve health and care for the local population.
In primary care data the ICB geographies shown use NHSBSA administrative records, not geographical boundaries, and more closely reflect the operational organisation of prescribing organisations than other geographical data sources. Within the secondary care data, ICB is provided by Rx-Info who use the NHS Digital Organisation Data Service (ODS) as their source.
3.5 Population statistics included in this publication
This publication uses two population datasets. The first of these lists the mid-year total population estimate of England, as sourced from the edition “Mid-2024: 2023 local authority boundaries” of the ONS dataset downloadable from Estimates of the population for England and Wales. For the population of financial year A/B, we use the mid-year population of year A.
The second population dataset used in this publication lists mid-year population estimates of ICBs in England, as sourced from the ONS mid-year health geographies population estimates page. ICB populations for mid-year 2020 and 2021 have been sourced from the “Mid-2011 to mid-2022: Integrated Care Boards, 2024 geography” edition of the dataset. ICB population estimates for mid-year 2022 to 2024 have been sourced from the “Mid-2022 revised (Nov 2025) to mid-2024: Integrated Care Boards, 2024 geography” edition of the dataset. Mid-year population estimates for 2022 were rebased by ONS in November 2025, so the latest 2022 population has been used. Therefore some ICB populations for 2022 will not match the ICB population estimates used in the previous 2023/24 PCHC release.
3.6 Planned changes to this publication
This is an Official Statistics publication. We regularly review the content of our publications to make sure that they remain relevant to our users. More information on how users can give us their feedback can be found in section 5 of this summary.
3.7 Monthly Secondary Care Medicines Data (SCMD)
In addition to this publication, the NHSBSA also release a monthly dataset for Secondary Care Medicines Data, via the Open Data Portal (ODP). The ODP is the platform where we host our open data products. The monthly dataset is produced from data provided by Rx-Info. This dataset lists indicative costs rather than Actual Costs. Indicative costs are derived from current medicines pricing data held in NHSBSA data systems including the Common Drug Reference (CDR) database and Dictionary of Medicines and Devices (dm+d) calculated to a Virtual Medicinal Product (VMP) level.
3.8 Adult Secure Estate data
Cost figures for medicines prescribed and dispensed in the Adult Secure Estate are the aggregate spend on medicines dispensed to patients in adult prisons and detention centres. Health services to patients who are in prison or detention are supplied under contract commissioned by NHS England Specialised Commissioning Directorate. A breakdown of spend by BNF Chapter is not currently available.
In this publication, prescription costs in the Adult Secure Estate are always measured by Actual Cost, not Net Ingredient Cost (NIC). Note that data is only available from 2020/2021 onwards, and that values are to the nearest thousand GBP. This data is provided by NHS England.
3.9 Charts in this publication
The charts in this report are interactive, and allow you to choose which categories are displayed. If the name of a category is greyed-out in the legend, then that category is not displayed in the chart. Clicking on the name of the category, in the legend, will toggle between greyed-out and not greyed-out. So, for example, if you want Figure 1 to show only the category ‘Issued in hospitals’, click on items in the legend until this is the only category that is not greyed-out. To see the full effect of changes you make, move the pointer away from the legend. Notice that when more than one category is displayed, the bars are stacked, showing how the total of those categories is broken down.
3.10 Medicines
In this publication we use ‘medicines’ as a short-hand for ‘medicines, appliances, dressings, and medical devices’.
3.11 Rounding
The high-level figures in this statistical summary have been rounded where appropriate for clarity. In most cases, rounding has been to three significant figures. Percentage changes were calculated prior to rounding and all percentages have been rounded to one decimal place. 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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5. Feedback and contact us
We invited feedback on the changes made to the Prescribing Costs in Hospitals and the Community Official Statistics publication, including the change of data source. The consultation took place between 15 November 2021 and 4 February 2022. You can find details of this consultation on our website.
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