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Prescribing Costs in Hospitals and the Community - England 2018/19 to 2022/23

Published 9 November 2023

Summary 

This publication aims to explore the costs of medicines prescribed within both primary and secondary care in England.

This publication is an experimental Official Statistic release. it's produced in line with the standards set out in the Code of Practice for statistics. Later consideration of this release for National Statistic designation by the Office of Statistical Regulation (OSR) is planned.

The statistics in this publication detail:

  • cost breakdowns by financial year and month within each setting
  • cost breakdowns by BNF Chapter and BNF Section level by financial year and setting
  • financial year cost breakdowns in each setting by Integrated Care Board (ICB)
  • a view of the data down to financial year, BNF Chapter, BNF Section and ICB combined

We’ve included the Actual Cost for prescription items dispensed in the community at national level. This has been done to provide a more accurate measure of the total cost to NHS commissioners for the provision of medicines, appliances, and medical devices in England. Definitions of the different cost measures presented in these statistics can be found in the statistical summary narrative and the background and methodology note.

In July 2022, ICBs replaced Sustainability and Transformation Plans (STPs) as legal entities within the NHS. These statistics have been presented with the latest NHS organisational structure, including historical data to allow easier comparisons to be made across the time period. Users should always use the latest statistics available when carrying out any analysis.

Key findings 

The total cost to NHS commissioners (known as actual cost in primary care data) in England, for the issue of medicines, appliances, and medical devices in 2022/23 is estimated to be £18.5 billion. This includes a deduction of £674 million for central rebates. The total cost without central rebates was £19.2 billion, an increase of 7.99% from £17.8 billion in 2021/22. This publication is an experimental Official Statistic release. it's produced in line with the standards set out in the Code of Practice for statistics. Later consideration of this release for National Statistic designation by the Office of Statistical Regulation (OSR) is planned.

In 2022/23, the cost to NHS commissioners in England for medicines:

  • prescribed in primary care and dispensed in the community was £9.59 billion, 50.0% of total expenditure
  • issued in hospitals was £9.45 billion, 49.2% of total expenditure
  • prescribed in hospitals and dispensed in the community was £93.6 million
  • prescribed by dentists and dispensed in the community was £32.4 million
  • prescribed and dispensed in the Adult Secure Estate was £24.9 million

In 2022/23, the BNF Chapter 8 – Malignant Disease and Immunosuppression had the highest spend across all settings of £3.26 billion when using Net Ingredient Cost (NIC) for items dispensed in the community, 16.4% of the total spend. Of this spend, £3.09 billion was for medicines issued and dispensed in hospitals.

The average costs per capita when using NIC for items dispensed in the community for medicines, appliances, and medical devices prescribed in England in 2022/23 across all settings was £349. This is an increase from £324 in 2021/22.

We’re interested in any feedback about the publication or these changes, which you can send by using our official statistics feedback survey.

Resource list

Prescribing Costs in Hospitals and the Community England 2022/23 - Statistical Summary Narrative (HTML)

Supporting summary tables (Excel: 2620KB)

Background information and methodology note (HTML)

Pre-release access list (HTML)

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Contact us

If you have any questions, comments, or would like more information you can email statistics@nhsbsa.nhs.uk.

Responsible statistician: Lucy Sherwin-Robson