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Dramatic drop in prescriptions spend in 2018, report shows

The number of prescription items dispensed in the community grew modestly in 2018 while overall costs to the NHS may have fallen by almost 10 times the amount seen in the previous year, an annual report from NHS Digital shows.

The 2018 Prescription Cost Analysis (PCA) for England looks at both the number of items dispensed in each BNF category and the Net Ingredient Cost (NIC) as listed in the Drug Tariff ["not necessarily the price the NHS paid", NHS Digital says, as it does not take into account factors such as discounts and dispensing costs].

The report collates data published each month by the NHS Business Services Authority on drugs dispensed in the community – not items dispensed in hospital or private prescriptions.

The PCA shows that while items rose by 2.9 million to 1.108 billion in 2018 – an increase of just 0.3 per cent – the total NIC fell by £336.6m to £8.8bn, representing a 3.7 per cent drop.

Between 2016 and 2017 the cost of prescriptions dispensed in the community fell by £37.6m – just 11 per cent of the decrease seen in 2018.

The biggest year-on-year cost discrepancy was seen in the month of April (the most expensive month in NIC terms in both years). April 2017 saw a NIC of around £1.8bn compared to £1.5bn in April 2018.

The BNF therapeutic classifications with the highest spend continue to be cardiovascular drugs (£324m spend in 2018), central nervous system drugs (£210m), endocrine system medicines (£111m) and gastro-intestinal drugs (£100m).

The 2018 data has a “higher level of accuracy” than previous years due to a new ‘data warehouse’ being used, NHS Digital said, though new methodologies mean the data “will differ in some respects to that previously reported”. NHS Digital says that "currently the prescription processing activity is internally audited to 99 per cent accuracy".

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