Significant regional differences in NHS prescription spend

The areas in England that spend the most on prescriptions.

Cambridgeshire and Peterborough come in first with £379.82 per person spent on prescriptions.
Herefordshire and Worcestershire rank second with £347.81, while West Yorkshire is third.
North West London spends the least per person on prescriptions, at only £115.74.

A new study reveals that NHS Cambridgeshire and Peterborough Integrated Care Board (ICB) is where the most is spent on prescriptions.
The study, conducted by Cured Pharmacy, analysed the NHS Business Services Authority’s data on prescription costs and compared it to the coinciding population of each ICB to discover which one is spending the most on prescriptions per person.

Integrated Care Boards are NHS organisations responsible for planning health services for their local population.

NHS Cambridgeshire and Peterborough leads the ranking, with £379.82 per person spent on prescriptions, despite sitting mid-table for the number of items prescribed at 23,444,000. This high expenditure results from a total prescription cost of £401,425,034 for a population of 1,056,872, indicating that while the volume of prescriptions is moderate, they are the most expensive in the country, with a cost per item of £17.12.

Following in second place is NHS Herefordshire and Worcestershire, where £347.81 per person is allocated for prescriptions. Despite having one of the lowest volumes of prescribed items at 17,027,399, the total expenditure reaches £291,298,633 for a population of 837,510. This indicates that while the volume of prescriptions is low, their cost is high, averaging £17.11 per item, the second highest on the list.

NHS West Yorkshire is third, with a prescription expenditure of £292.42 per person. The total cost of prescriptions is £791,785,012, the highest on the list, and the population is 2,707,693. West Yorkshire is also the ICB with the highest number of items per person at 35.5, which suggests a correlation between the cost and the volume of prescriptions.

Further down on the list, NHS Nottingham and Nottinghamshire takes fourth place, with £243.79 spent per person. This results from a total cost of prescriptions of £313,075,845 and a population of 1,284,200. This area also dispenses 21.5 items per person, slightly above the national average.

The top five closes with NHS Cheshire and Merseyside, where there is a per person expense of £218.32 on prescriptions. With a total cost of £611,977,870 across a population of 2,803,074 and 23.5 items per person, it is one of only four ICBs to exceed £600 million in total prescription spend.

“Cambridgeshire and Peterborough spends more than three times per person what North West London does, and that gap is largely driven by the cost of individual prescriptions rather than the volume.”

NHS Lincolnshire follows in sixth position, with £210.93 spent per person. The area records the second highest number of items per person at 29.1, yet its cost per item is among the lowest in England at £7.25, producing a total spend of £174,789,367 for a population of 828,658. This points to high demand for medication being met by comparatively inexpensive prescriptions.

NHS Staffordshire and Stoke-on-Trent is seventh, separated from Lincolnshire by just 11 pence per person at £210.82. The ICB’s total prescription cost is £255,039,436 for a population of 1,209,769, with 24.1 items per person, the sixth highest demand for medication on the list.

Eighth place goes to NHS Lancashire and South Cumbria, where £201.80 per person is spent on prescriptions. The total cost reaches £377,549,208 for a population of 1,870,895, with 44,961,722 items dispensed at an average of £8.40 each.

NHS Sussex is ninth, with £201.72 spent per person, only eight pence behind Lancashire and South Cumbria. Its total prescription cost of £376,524,244 is spread across a population of 1,866,614, and at 19.1 items per person it has one of the lowest volumes in the top 10, with a higher than average cost per item of £10.57.

The top 10 closes with NHS Black Country, where £200.21 per person is spent on prescriptions. The area dispenses 28,203,414 items for a population of 1,343,052 at a total cost of £268,893,146, making it the last ICB in England to cross the £200 per person threshold.

At the other end of the ranking, five London ICBs are the ones that spend the least on prescriptions per person.
NHS North West London, NHS South East London, NHS South West London, NHS North Central London, and NHS North East London occupy positions one to five, with an expenditure per person ranging from £115.74 to £126.24.

Tarun Kumar, Co-Founder and Superintendent Pharmacist of Cured Pharmacy, commented on the findings: “What stands out is the enormous variation across England. Cambridgeshire and Peterborough spends more than three times per person what North West London does, and that gap is largely driven by the cost of individual prescriptions rather than the volume. This could reflect differences in the types of medications being prescribed, such as higher proportions of specialist or newer treatments in certain areas.”

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