Medicines prescribed in primary care and dispensed in the community make up half of the total expenditure on medicines in England, figures show.

The NHS Businesses Service Authority data published today revealed that medicines were prescribed in this way made up 50% of total expenditure, at £8.09bn.

Meanwhile, medicines issued in hospitals represented 49.3% of total expenditure, at £8.77bn, while medicines prescribed in hospitals and dispensed in the community cost £85.1m and those prescribed by dentists and dispensed in the community cost £29.3m.

The total cost to NHS commissioners of medicines, appliances, and medical devices in England in 2021/22 is estimated to be £17.2bn.

This includes a deduction of £619m for central rebates, including those agreed by NHS England and Improvement with pharmaceutical companies, such as within the cancer drugs fund (CDF) and in routine commissioning covering both rare diseases and more common conditions.

The total cost without central rebates was £17.8bn, an increase of 8.32% from £16.4bn in 2020/21.

Highest community dispensing cost in Northern England

The highest cost to the NHS on medicines prescribed in primary care and dispensed in the community took place in within the North East and North Cumbria ICB, at £572m. This was closely followed by the Greater Manchester ICB at £385m, which also had the highest overall prescribing costs when hospital prescribing was included.

The ICB with the largest average per capita costs was Birmingham and Solihull, at £516, while Hertfordshire and West Essex was the lowest at £224.

The average cost per capita for medicines issued in all settings in England in 2021/22 was £324. This is an increase from £301 in 2020/21 and an increase from £274 in 2017/18.

Highest spend in community on diabetes drugs

Diabetes drugs make up the highest proportion (13.2%) of spending on medicines prescribed in primary care and dispensed in the community at £1.25bn, closely followed by anticoagulants and protamine (£804m), then corticosteroids (respiratory) (£623m) and analgesics (435m).

Cytotoxic drugs came at the highest cost to hospitals at £1.98bn or 22.6% of other total spend within hospitals. This was followed by drugs affecting immune response (£753m), and drugs used in rheumatic diseases and gout (£712m).

Dental-prescribed drugs increased from last year

The NHSBSA figures showed that medicines prescribed by dentists and dispensed in the community has risen by 28.2% since last year.

A report published by the Care Quality Commission in March said that the pandemic compounded resulted in reduced capacity within dental services and made it harder for people to see a dentist – routine NHS dental services were paused at the start of the pandemic, followed by the introduction of enhanced infection prevention and control measures.