Publication, Part of Statistics on Public Health
Statistics on Public Health, England 2021
Official statistics, National statistics, Accredited official statistics
Part 3: Lifestyle-related prescriptions
Prescription items and cost used to treat alcohol dependence
This section presents information on the number of prescriptions for drugs used to treat alcohol dependence and the Net Ingredient Cost (NIC) of these prescriptions. The data is extracted from ePACT2, a data warehouse hosted by NHS Prescription Services. NHS Prescription Services process prescriptions in order to reimburse dispensers.
The number of prescriptions is not the same as the volume of drugs prescribed. Each single item prescribed is counted as a prescription item and volume is not available within the prescribing data. There will be different practices locally on the duration of supply for a prescription.
The NIC is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, dispensing costs, prescription charges or fees.
The two main drugs prescribed for the treatment of alcohol dependence are Acamprosate Calcium (Campral) and Disulfiram (Antabuse). In May 2013 a new drug Nalmefene (Selincro) was launched.
Naltrexone is also prescribed for alcohol dependence. It is not included here however, as it can also be used to treat drug dependence and the condition that Naltrexone is prescribed to treat is not available within the prescribing data.
Note: National-level and time series data in this section are taken from Table A.1 and include data for non-CCGs (cost centres not linked to Clinical Commissioning Groups (CCG) such as trusts, councils and private company providers) and unidentified doctors and trusts. Regional breakdowns are taken from Table A.2 and exclude these data since they cannot be allocated to a CCG. In 2020/21 data for non-CCGs and unidentified doctors and trusts accounted for 13% of prescriptions dispensed.
Total prescription items dispensed – time series
The number of prescription items dispensed in England in 2020/21 was 167 thousand which is 1% higher than 2019/20 (164 thousand) but 15% lower than 2014/15 (196 thousand).
The general trend is a decreasing number of prescription items dispensed since 2014/15.
Note: this time series has been revised to present data by financial year. Data is only available from 2014/15 due to changes in how the prescription data is processed and held by the NHS Prescription Services. Users should always use data from the latest publication where available.
Type of prescription items dispensed
137 thousand items of Acamprosate Calcium were dispensed in 2020/21 which is 6% higher than in 2019/20 but 1% lower than the number dispensed in 2014/15.
28 thousand items of Disulfiram were dispensed in 2020/21 which is 15% lower than in 2019/20 and 48% lower than in 2014/15.
1,000 items of Nalmefene (introduced in 2013) were dispensed in 2020/21 which is 21% lower than in 2019/20 and 56% lower than in 2014/15.
Prescription items dispensed by region
The regions that dispensed the highest number of items were the North West and North East and Yorkshire. Both regions dispensed 33 thousand items and account for 47% of items dispensed across all CCGs.
London dispensed the lowest number of items (12 thousand).
Prescription items dispensed to treat alcohol dependence by CCG, per 100,000 population
NHS Salford dispensed the highest number of items (1,341 per 100,000).
NHS Milton Keynes dispensed the lowest number of items (15 per 100,000).
Total cost of prescription items dispensed
The total Net Ingredient Cost (NIC) for items prescribed for alcohol dependence in 2020/21 was £4.63 million. The Net Ingredient Cost NIC is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, prescription charges or fees.
This is 2% higher than in 2019/20 and 33% higher than in 2014/15.
Average NIC per item
The average NIC per item for all pharmacotherapy items was £28. This is 1% higher than in 2019/20 and 57% higher than in 2014/15.
The average per item was £23 for Acamprosate Calcium, £52 for Disulfiram and £64 for Nalmefene. The cost for Disulfiram has increased by the most since 2014/15, with a 240% increase.
Prescription items and cost used to help people stop smoking
This section presents information on the number of prescription items used to help people stop smoking, using prescription data held by NHS Prescription Services.
The Net Ingredient Cost (NIC) is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, dispensing costs, prescription charges or fees.
There are three main pharmacotherapies prescribed for the treatment of smoking dependence in England: Nicotine Replacement Therapy (NRT), Bupropion (Zyban) and Varenicline (Champix).
Please note that the charts are based on rounded data. Unrounded data are available in the corresponding data tables.
Prescription items dispensed, by year
The number of prescription items dispensed in England in 2019/20 was 710 thousand, compared to 2.48 million ten years ago.
Prescription items dispensed peaked at 2.56 million in 2010/11.
In 2019/20, 379 thousand items of NRT were dispensed, down from 396 thousand in 2018/19, and around a quarter of the total of ten years ago in 2009/10 (1.56 million).
304 thousand items of Varenicline were dispensed in 2019/20, compared with a peak of 987 thousand items in 2010/11.
Bupropion is the least common item, with 27 thousand dispensed in 2019/20, over a 10% increase from 2018/19 (24 thousand), accelerating the upward trend since 2014/15.
Prescription items dispensed to help people stop smoking by Clinical Commissioning Group, per 1,000 population
The rate of items dispensed per 1,000 population in 2019/20 was 13 for England.
NHS Bradford City CCG had the highest rate of items dispensed, with 45 per 1,000 population. NHS Manchester, NHS Wakefield (both 36), NHS Stockport, NHS Kernow and NHS Bradford Districts (all 32) had the next highest rates.
NHS Wyre Forest, NHS South Worcestershire, NHS Redditch and Bromsgrove, NHS Stafford and Surrounds and NHS Rotherham all recorded rates of below 1 item per 1,000 population.
Number of Prescription items dispensed by Clinical Commissioning Group, per 1,000 population.
Total cost of prescription items dispensed
£22.5 million was the Net Ingredient Cost (NIC) of all prescription items used to help people quit smoking in 2019/20.
This is a fall of 66% compared to 2010/11 when the NIC of all prescription items peaked at £65.9 million.
Average NIC per item
In 2019/20, the average NIC per item for all pharmacotherapy items was £32.
The average per item was £39 for Bupropion, £36 for Varenicline and £28 for NRT.
Prescription items and cost for the treatment of obesity
This part presents information on the number of prescriptions for drugs used to treat obesity and the Net Ingredient Cost (NIC) of these prescriptions. The data source is Prescription Analysis and Cost (PACT) data from NHS Prescription Services. It includes items prescribed in primary care and dispensed in the community. It excludes prescriptions written in hospitals that are dispensed in the community, prescriptions dispensed in hospitals, dental prescribing and private prescriptions.
The NIC is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, dispensing costs, prescription charges or fees.
Since 2010, Orlistat (Xenical®) is the only drug available in the UK that is recommended specifically for the management of obesity. Orlistat acts by reducing the absorption of dietary fat. Clinical guidelines state that pharmacological interventions should only be used in conjunction with other interventions (exercise, diet).
NICE guidance on identifying, assessing and managing obesity
Prescribing data is reported by financial year (previously calendar year). However, as financial year data is only available from 2014/15, time series analysis will continue to be based on calendar years.
Items prescribed, by year
294 thousand items (Orlistat) were prescribed for the treatment of obesity in primary care in 2020. That is 17% fewer than in 2019 when there were 355 thousand items, and continues a long-term downward trend.
Please note that there was a stock shortage of Orlistat in 2012 and this is reflected in the time series charts below. Please see Stock Shortages Update for more details.
Net Ingredient Cost (NIC) of items, by year
The NIC of items (Orlistat) fell to £8.8 million in 2020, an decrease of 16% from £10.4 million in 2019. This is 76% lower than 2010, when the NIC of items (Orlistat) was £36.3 million.
As such the NIC per item (Orlistat) in 2020 was £30, which is similar to 2019 (£29) but £5 lower compared to a peak in 2013 (£35).
Prescription items per head of population
Prescription items for the treatment of obesity per 1,000 population, by Clinical Commissioning Group (CCG)
NHS Barnsley had the highest prescription rate with 17 items per 1,000 population. NHS Stoke on Trent had a prescription rate of 16 items per 1,000 population, and NHS Knowsley had a prescription rate of 15 per 1,000 population.
NHS Bury, NHS Nene and NHS Mansfield and Ashfield all recorded almost zero rates.
Prescription items per 1,000 population, by Clinical Commissioning Group (CCG).
Prescription items per 1,000 population, by NHS Commissioning Region
In 2019/20, North West had the highest prescription rate with 9 items per 1,000 population, and South East had the lowest rate with 4.
For more data/information on this section see:
Tables O.6.1a to O.6.2 of Statistics on Obesity, Physical Activity and Diet - England 2021.
Last edited: 1 December 2023 1:50 pm