2. Main findings
Total number of items and costs
There were 1.12 billion prescriptions items dispensed in England in 2019. These items had a total cost of 9.08 billion. Both the number of items dispensed and the costs of those items increased when compared to 2018. The number of items increased 0.98% from 2018 whilst costs increased by 2.81%.
The number of items dispensed in the community in England has increased each year since 2014.
Costs have fluctuated, with 2019’s total cost being lower than the cost in 3 of the previous 5 years.
Source: PCA 2019 - Presentation Data 2014 to 2019
- There were 1,120 million prescription items dispensed in England in 2019.
- There was a 0.98% increase in items dispensed in England between 2018 and 2019.
- There was a 5.16% increase in items dispensed in England between 2014 and 2019.
Source: PCA 2019 - Presentation Data 2014 to 2019
- The cost of prescription items dispensed in England for 2019 was £9,079 million.
- This was an increase of 2.81% (£248 million) from 2018.
- There was also an increase of 2.55% (£226 million) from 2014.
Prescribing by British National Formulary (BNF) chapter
These statistics use the therapeutic classifications defined in the British National Formulary (BNF) using the classification system prior to edition 70. Information on why a drug is prescribed is not available in this dataset. Since drugs can be prescribed to treat more than one condition, it may not be possible to separate the different conditions for which a drug may have been prescribed. NHS Prescription Services have created pseudo BNF chapters for items not included in BNF chapters 1 to 15. The majority of such items are dressings and appliances, which have been classified into six pseudo BNF chapters (18 to 23).
The BNF is a standard classification of medicines into conditions of primary therapeutic use. The broadest grouping of this classification is a BNF chapter. Figures 3 and 4 show the distribution of items and costs across these chapters. To find out what these chapters are you can go to the ‘England totals by BNF chapter’ table in the summary tables of this publication.
Source: PCA 2019 Additional Analysis - Table A8
There was and increase in the number of items prescribed between 2018 and 2019 in 13 of the 23 BNF chapters, with the largest increase of 4.1 million items in chapter 02 - ‘Cardiovascular system’. This increased by 1.24% compared to 2018.
The largest decrease in items was in chapter 13 - ‘Skin’, which fell by 1.9 million items, or 6.07% compared to 2018.
Source: PCA 2019 Additional Analysis - Table A8
Chapter 02 - ‘Cardiovascular system’ saw the largest increase in cost between 2018 and 2019 of £119.6 million. This increased by 9.59%. Chapter 02 - ‘Cardiovascular system’ has also seen the greatest increase in cost from 2014 and 2019 of £362.9 million, an increase of 36.17%.
The cost of some chapters has also decreased between 2018 and 2019. The cost of items in chapter 04 - ‘Central Nervous System’ decreased the most, by 3.66% (£55.4 million). Chapter 04 - ‘Central Nervous System’ saw the greatest decline in cost between 2014 and 2019 of 22.21% (£417 million).
Generic prescribing
Prescribers are encouraged to prescribe generic or unbranded products where possible and where it is clinically appropriate to do so. Generic prescribing can save money for the NHS as generic drugs are often cheaper than their proprietary, or ‘branded’ equivalents, especially those listed in the Drug Tariff for England and Wales.
Figure 5 shows the generic prescribing rates of items dispensed in the community in England between 2014 and 2019.
Source: PCA 2019 Additional Analysis - Table A5
Generic prescribing rates have remained consistent between 2014 and 2019. Generically prescribed items made up a smaller proportion of costs in 2019 than in 2014, having fallen by 2.2%.
The 10 most prescribed drugs
Figures 6 and 7 show the ten most prescribed products based on the total number of items dispensed and total cost respectively. These charts exclude dressings and appliances and show data aggregated to a chemical substance level.
Source: PCA 2019 Summary tables - England 2019 total by chemical substance.
Atorvastatin was the most prescribed product in England in 2019 with 45.8 million items dispensed. Atorvastatin is a type of statin that is used to lower cholesterol and to prevent heart disease.
Source: PCA Summary tables - England 2019 total by chemical substance.
Apixaban had the highest total cost for items dispensed in the community in England in 2019 of £290 million. Apixaban is an anticoagulant, used to treat people who have had a health problem caused by a blood clot or to prevent future blood clots. Drugs used to treat respiratory illnesses feature heavily in the top 10, making up 4 of the top 10 (Beclometasone dipropionate, Fluticasone propionate (Inhalation), Budesonide, Tiotropium bromide).