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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