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Medicine facts from prescriptions dispensed in the community (England) 2006 to 2016

17 July 2017

Prescriptions for antidepressants have increased by 6 percent since 2015, new data shows. Anne Tyrell, CNWL’s Chief Pharmacist highlights key points on prescription medicines dispensed in the community, from the Prescription Cost Analysis National Statistic.  

General facts

1. Total net ingredient cost (NIC) in 2016 was £9.2bn, no of items was 1.1bn items (2% increase on 2015). Total NHS costs will be more as need to include dispensing costs.

2. 47% increase in total number of items from 2006, average no of items per head of popn is 20 cf 15 in 2006

3. Total  NIC increased by 12% from 2006 (£8.2bn) but NIC per item has decreased to £8.34 per item from £10.90 in 2006

4. Average cost per head of population is £166, 2006 was £160

5. 89.4% of all items were dispensed FOC, 60% claiming over 60 yrs of age, 4.4% under 16

6. Diabetes is the BNF section 6.1 with the greatest net ingredient cost in 2016 (£2.7bn)

7. 77.7% of items are prescribed and dispensed generically; Dispensing by brand, where no generic exists, has fallen to 6.2%. 85% of all dispensed medicines prescribed generically and slight increase from 2006. 

Mental Health related

8. Anti-depressants showed the greatest numeric rise since 2015, increased by 3.7 million items or 6 %. 

9. BNF Section 4.2 medicines used in psychoses and related disorders had the greatest decrease in NIC from 2015 but has increase of 4.4% in items dispensed. 11.4m items in 2016 and 58% increase on 2006. NIC per item was £34 in 2006, £13 in 2015 and now £8 in 2016. This BNF section had 36% (£53m) reduction in overall expenditure from 2015 to £93m.

Reasons: aripiprazole going generic and price reductions in the Category M scheme. Quetiapine most popular -3m items dispensed, then olanzapine (2.3m), then risperidone (1.7m)

10. BNF Section 4.3 – antidepressants saw the greatest increase in number of items from 2015-2016. Increase of 6% to 65m items but a decrease of 6.4 % in cost to £266m.  NIC per item is down to £4.12 from £9.39 in 2006. Unable to identify specific indications.     Sertraline most increase in number of items (19%) to 11.2m, duloxetine had significant increase even though not recommended. Citalopram is most widely used, followed by amitriptyline, sertraline, mirtazapine and fluoxetine.

Primary care has made significant savings from mental health medicines in recent years whilst seeing the greatest increase in items dispensed.

Anne Tyrrell