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 @openprescribing or [email protected]. 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
Antimuscarinic Bronchodilators 5,444,178 £153,085,158 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
Thyroid Hormones 32,992,875 £66,684,077 Blood sugar test for diabetes

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
Influenza 10,193,903 £87,512,930 Vaccine for Flu

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 Sodiu, 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
Aspirin 22,205,029 £817,,516,108 Reduce the risk of heart attacks and stroke