Variation in prescribing in different medicine categories

Map of prescription variation across England – click to enlarge

Trends in prescribing

In 2015, an average of 18.6 items were prescribed in primary care for each patient registered with a GP practice in England. A total of just over 1 billion items were prescribed. The total list price of these items was £9.3 billion – around £157 per head, up from £152 in 2014. The average cost per item was £8.55.

As the charts below show, the number of items prescribed each year has increased by 50% over the past decade. Over this period, the population has increased by only 8%. Over the same period, however, the total cost of prescriptions has increased by only 16%. This means that on average, individual items prescribed have become cheaper.

Trends in prescription rates, England, 2005-2015

Variation Across England

Prescription rates vary substantially across England. Four parliamentary constituency areas had prescription rates above 30 items per head (Louth & Horncastle; Easington; Clacton; Houghton & Sunderland South) while four had rates below 10 items per head (Hackney North & Stoke Newington; Hampstead & Kilburn; Cities of London & Westminster; Kensington).

The average total cost of prescriptions per head varied from £267 in Clacton to £86 in Cities of London & Westminster.

Total cost of prescriptions per head, constituency, 2015

Constituency prescription rates

Which medicines are prescribed the most?

29% of all items prescribed were for the cardiovascular system, with the most common categories being drugs for high blood pressure/heart failure and statins. 19% of all prescriptions were for the central nervous system, encompassing painkillers and antidepressants amongst other treatments. In terms of net ingredient cost, the leading category was drugs used for diabetes, totalling £936m.

Number & cost of items prescribed in each BNF chapter, 2015

Prescription rates by BNF Chapter

Antibiotic prescribing

The challenge of antimicrobial resistance means that the NHS has been aiming to reduce prescribing in antibiotics. In 2015, around 2 million fewer antibacterial drugs were prescribed than in 2014– a reduction of 5%. However, the scale of this reduction varied across the country. Looking at rates relative to population size, 515 constituencies saw reductions in antibacterial prescribing.

Antibiotic prescribingChart showing reductions in antibiotic prescribing – click to enlarge

Detailed analysis of variation between constituencies for each drug and treatment category, including charts and maps, is contained in this note. The data is aggregated from Presentation-Level GP Prescribing Data published by NHS Digital.

Prescription rates provide only a partial picture of disease burden and cost across England, and should be considered in conjunction with other data – for example, disease prevalence statistics from the Quality and Outcomes Framework, or public health outcomes indicators.

Full data on prescription rates for parliamentary constituencies in English parliamentary constituencies is provided in the downloadable tables (Excel & CSV) below.

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