The total cost of prescription items dispensed in the community in England has increased for the fourth year in a row and has risen by 8% in a year.

New data published by the NHS Business Services Authority (NHSBSA) revealed that in 2022/23, some 1.18 billion prescription items were dispensed in the community at a cost of £10.4bn.

While the total cost is up by 8% (from £9.69bn) in 2021/22, the number of items dispensed increased by 3%.

Analysis from the NHSBSA suggests that compared to 2014/15, the number of items dispensed has increased by 10% and the cost has jumped by a significant 17% – equal to £1.48bn.

While there was a decrease in costs between 2015/16 to 2018/19, the latest data marks the fourth year in a row where the cost of items dispensed has increased, the NHSBSA said.

The average number of items dispensed per head was 21 in 2022/23, while the mean cost of items dispensed per head was £184, the data showed.

The most dispensed drug in the country in 2022/23 was high blood cholesterol medication atorvastatin, totalling almost 59 million items. This was followed by omeprazole (35.6 million) and amlodipine (35 million).

Meanwhile, anticoagulant drug apixaban saw the highest costs at £430m. Apixaban 5mg tablets also had the largest increase in cost between 2021/22 and 2022/23, equalling a rise of £280 million.

Three anticoagulants and two respiratory medications, were among the top 10 drugs, based on costs.

In addition, the data showed that for 2022/23, generic items made up 85% of the total items prescribed, which was ‘slightly higher’ than the previous year, said the NHSBSA. Generic prescribing also accounted for 62% of the total cost – up 1% on the previous year.

Responding to the new data, director of corporate affairs at the National Pharmacy Association (NPA), Gareth Jones, said: ‘Community pharmacies are working harder than ever, delivering new services while also dispensing a higher volume of medicines.

‘They should be commissioned to do more to optimise the use of medicines, so that the NHS’s £10 billion-plus expenditure achieves maximum benefits for patients.’

He added: ‘A relatively small investment in community pharmacy-based medicines advice services could deliver a considerable return on investment for the NHS.’

Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) said the data ‘demonstrates the increased level of work our sector is putting in to deliver patient care’, but warned it was ‘not compensated with a fair funding’.

‘The rising prescription volume and rising costs are the key drivers of the burn of our members’ cash balances pushing them into negative cash flow at various points in the year which is perilous,’ she told The Pharmacist.

The data also highlighted challenges around the availability of medicines, noted Dr Hannbeck, who noted that Atorvastatin was currently on the shortages list.

Meanwhile, Mike Dent, director of pharmacy funding at Community Pharmacy England (formerly PSNC), flagged how an additional 40 million items had been dispensed in 2022/23, while ‘core pharmacy funding has dropped in real terms’.

‘It is unsustainable for pharmacies to continue to absorb this additional workload without a funding increase, especially when it’s set against a backdrop of capacity and workforce pressures,’ he added.

Mr Dent stressed the NHS has ‘used the pharmacy sector to squeeze the medicines market to breaking point’.

He added that Community Pharmacy England had ‘made it clear to government that our members cannot continue to subsidise the NHS medicines bill and remain in constant discussion with DHSC about improvements to the medicines supply chain and reimbursement systems’.