What are the most commonly prescribed medicines? Top 10 prescribed medicines in NHS England primary care for 2019
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The following is a rapid analysis of the “top 10” medicines in NHS England primary care in 2019. We prepared this analysis for a user who wanted to use the list in a teaching session with students to prepare them for the medicines they will most commonly see in general practice. We are sure others will find it useful — please get in touch and tell us how you use it via Twitter or feedback@openprescribing.net. As always our analysis with complete analytical code is openly available on our GitHub page. You can also investigate the prescribing of any medicines you like using our tools like our Analyse page, chemical trends and our brand new browser for the NHS Dictionary of Medicines and Devices. Read on below where we describe the “top 10” medicines and class of medicines, in terms of volume and cost.
Top 10 medicines by class
Table 1 describes the top 10 medicines by NHS spend in 2019 and table 2 describes the Top 10 in terms of volume of prescription items. In terms of cost, steroid inhalers are the NHS top spend in 2019 with medicines for diabetes in second closely followed by oral anticoagulants. The most commonly prescribed medicines class in 2019 was “lipid regulating drugs” which are more commonly known as statins. We have a paper coming soon on inhalers, an interesting preprint paper already available on the variation in statin use and you can read our previous work on diabetes agents here.
You can see equivalent data for any selected previous year in our long term trends tool (go to the “Top 20 paragraphs” tab). Data currently covers 1998-2018.
Table 1: Top 10 Medicines Class by spend in 2019 in NHS Primary Care
| BNF Paragraph Name | Prescription Items | Actual Cost | Commonly Used For |
|---|---|---|---|
| Corticosteroids (Respiratory) | 21,099,043 | £548,653,646 | Inhalers for lung conditions |
| Antidiabetic Drugs | 41,654,329 | £545,347,171 | Diabetes |
| Oral Anticoagulants | 18,486,373 | £541,626,860 | Blood thinners - to prevent clots/strokes |
| Insulin | 7,538,314 | £332,531,643 | Diabetes |
| Control of Epilepsy | 28,704,569 | £278,841,283 | Epilepsy |
| Enteral Nutrition | 3,725,985 | £236,304,624 | Malnutrition |
| Opioid Analgesics | 23,196,389 | £213,975,882 | Pain relief |
| Renin-Angiotensin System Drugs | 65,424,446 | £188,452,348 | High blood pressure - heartdisease |
| Diabetic Diagnostic and Monitoring Agents | 7,145,514 | £155,910,265 | Blood sugar test for diabetes |
Table 2: Top Medicines Class by volume in 2019 in NHS Primary Care
| BNF Paragraph Name | Prescription Items | Actual Cost | Commonly Used For |
|---|---|---|---|
| Lipid-Regulating Drugs | 77,997,663 | £116,000,000 | Statins-high cholesterol |
| Renin-Angiotensin System Drugs | 65,424,446 | £188,000,000 | High blood pressure - heart disease |
| Proton Pump Inhibitors | 62,236,186 | £98,727,913 | Indigestion or stomach ulcers |
| Calcium-Channel Blockers | 42,419,537 | £105,000,000 | High blood pressure - heat disease |
| Antidiabetic Drugs | 41,654,329 | £545,000,000 | Diabetes |
| Selective Serotonin Re-Uptake Inhibitors | 40,254,277 | £66,154,129 | Depression |
| Beta-Adrenoceptor Blocking Drugs | 39,505,912 | £67,928,111 | High blood pressure - heart disease |
| Non-Opioid Analgesics and Compound Preparations | 34,487,135 | £128,000,000 | Pain Relief |
| Antiplatelet Drugs | 33,308,350 | £66,684,077 | Reduce the risk of heart attacks and stroke |
Top 10 medicines by chemical substance
Table 3 describes the top 10 medicines by NHS spend in 2019 and many of the chemical substances from the medicines classes above feature heavily. Atorvastatin (table 3), a statin or “lipid-regulating drug” is the most commonly prescribed prescription item with the anticoagulant apixaban, an anticoagulant the medicine that the NHS spent the most on in 2019.
Table 3 Top 10 Medicines chemical by spend in 2019 in NHS Primary Care
| BNF Paragraph Name | Prescription Items | Actual Cost | Commonly Used For |
|---|---|---|---|
| Apixaban | 5,862,145 | £268,932,709 | Blood thinner - stroke prevention |
| Enteral Nutrition | 3,725,985 | £236,304,624 | Malnutrition |
| Beclometasone Dipropionate | 11,293,617 | £201,973,695 | Inhalers for lung conditions |
| Rivaroxaban | 4,310,724 | £201,973,695 | Blood thinner - stroke prevention |
| Glucose Blood Testing Reagents | 6,806,704 | £147,620,355 | Blood sugar tests for diabetes |
| Fluticasone Propionate (Inh) | 4,523,933 | £138,481,006 | Inhalers for lung conditions |
| Budesonide | 3,585,322 | £118,720,380 | Inhalers for lung conditions |
| Tiotropium Bromide | 3,704,740 | £109,306,933 | Inhalers for lung conditions |
| Other Food for Special Diet Preps | 888,137 | £89,162,778 | Conditions requiring special diets |
Table 4: Top 10 Medicines chemical by volume in 2019 in NHS Primary Care
| BNF Paragraph Name | Prescription Items | Actual Cost | Commonly Used For |
|---|---|---|---|
| Atorvastatin | 45,792,988 | £55,759,286 | Statins-high cholesterol |
| Levothyroxine Sodium | 32,934,807 | £62,757,734 | Low thyroid levels |
| Omeprazole | 31,791,795 | £50,092.650 | Indigestion or stomach ulcers |
| Amlodipine | 30,541,931 | £29,329,631 | High blood pressure - heart disease |
| Ramipril | 29,318,773 | £41,931,828 | High blood pressure - hear disease |
| Lansoprazole | 27,723,751 | £33,480,232 | Indigestion or stomach ulcers |
| Bisoprolol Fumarate | 24,905,410 | £21,124,240 | High blood pressure - heart disease |
| Colecalciferol | 24,004,981 | £86,331,206 | Vitamin D deficiency |
| Metformin Hydrochloride | 22,375,503 | £84,576,576 | Diabetes |