Publication, Part of Statistics on Public Health
Statistics on Public Health, England 2023
Official statistics, National statistics, Accredited official statistics
Part 3: Lifestyle-related prescriptions
- This section has been backdated and updated as part of the August 2024 release.
Introduction
This part presents information on the number of prescriptions for drugs used to:
- Treat alcohol dependence
- Help people stop smoking
- Treat obesity
It also includes the Net Ingredient Cost (NIC) of these prescriptions.
The data is extracted from ePACT2, a data warehouse hosted by NHS Business Services Authority that 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.
Prescription items and cost used to treat alcohol dependence
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.1.1 and include data for non-ICBs (i.e. where cost centres are not linked to Integrated Care Boards (ICB) such as trusts, councils and private company providers) and unidentified doctors and trusts. Regional breakdowns are taken from Table A.1.2 and exclude these data since they cannot be allocated to an ICB. In 2022/23 data for non-ICBs and unidentified doctors and trusts accounted for 2% of prescriptions dispensed.
Total prescription items dispensed – time series
The number of prescription items dispensed in England in 2022/23 was 167 thousand which is 2% higher than 2021/22 (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
142 thousand items of Acamprosate Calcium were dispensed in 2022/23 which is 4% higher than in 2021/22 and 2% higher than the number dispensed in 2014/15.
24 thousand items of Disulfiram were dispensed in 2022/23 which is 9% lower than in 21/22 and 57% lower than in 2014/15.
1,092 items of Nalmefene (introduced in 2013) were dispensed in 2022/23 which is 4% higher than in 2021/22, but 54% lower than in 2014/15.
Prescription items dispensed by region
The regions that dispensed the highest number of items were North East and Yorkshire (39 thousand items) and the North West (37 thousand items). This accounts for 46% of items dispensed across all ICBs.
East of England dispensed the lowest number of items (12 thousand).
Prescription items dispensed to treat alcohol dependence by ICB, per 1,000 population
NHS Sussex Integrated Care Board dispensed the highest number of items (6.9 per 1,000).
NHS Northamptonshire Integrated Care Board dispensed the lowest number of items (0.4 per 1,000).
Total cost of prescription items dispensed
The total Net Ingredient Cost (NIC) for items prescribed for alcohol dependence in 2022/23 was £4.19 million. This is 12% lower than in 2021/22, but 21% higher than in 2014/15.
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.
Average NIC per item
The average NIC per item for all pharmacotherapy items was £25. This is 13% lower than in 2021/22, but 42% higher than in 2014/15.
The average per item was £15 for Acamprosate Calcium, £82 for Disulfiram and £64 for Nalmefene. The cost for Disulfiram has increased by the most since 2014/15, with a 440% increase.
Prescription items and cost used to help people stop smoking
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 Champix (Varenicline) was withdrawn under precautionary safety grounds in 2021.
Prescription items dispensed, by year
The number of prescription items dispensed in England in 2022/23 was 413 thousand, compared to 2.2 million in 2012/13.
Prescription items dispensed has decreased considerable during the time series.
In 2022/23, 361 thousand items of NRT were dispensed, down from 374 thousand in 2021/22, and almost a quarter of the total of ten years ago in 2012/13 (1.32 million).
Following the withdrawal of Champix in October 2021, only 1,208 items of Varenicline were dispensed in 2022/23, compared with a peak of 859 thousand items in 2012/13.
Use of Bupropion, although well below NRT, is increasing through time, with 51 thousand dispensed in 2022/23, over a 95% increase from 2012/13 (26 thousand), and up 143% from the lowest levels of dispensation in 2020/21 (20 thousand).
Prescription items dispensed to help people stop smoking by Integrated Care Board, per 1,000 population
The rate of items dispensed per 1,000 population in 2022/23 was 7.2 for England.
NHS Cornwall and the Isles of Scilly Integrated Care Board had the highest rate of items dispensed, with 22.7 per 1,000 population. NHS North Central London Integrated Care Board (17.8), NHS Devon Integrated Care Board (17.0) and NHS Greater Manchester Integrated Care Board (16.8) had the next highest rates.
NHS Northamptonshire Integrated Care Board, NHS Herefordshire and Worcestershire Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board all recorded rates of below 1 item per 1,000 population.
Number of Prescription items dispensed by Integrated Care Board, per 1,000 population.
Total cost of prescription items dispensed
The Net Ingredient Cost (NIC) of all prescription items used to help people quit smoking in 2022/23 was £12.7 million.
This is a fall of 78% compared to 2012/13 when the NIC of all prescription items was £58.1 million.
Average NIC per item
In 2022/23, the average NIC per item for all pharmacotherapy items was £31.
The average per item was £39 for Varenicline, £36 for Bupropion and £30 for NRT.
Prescription items and cost for the treatment of obesity
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 start from this point in time.
Items prescribed, by year
370 thousand items (Orlistat) were prescribed for the treatment of obesity in primary care in 2022/23. That is 27% fewer than in 2012/13 when 508 thousand items were prescribed, but 12% higher than in 2021/22 (330 thousand items).
Net Ingredient Cost (NIC) of items, by year
The NIC of items (Orlistat) was £10.8 million in 2022/23. This is an increase of 27% from £8.5 million in 2021/22, but 26% lower than in 2012/23, when the NIC of items (Orlistat) was £14.6 million.
As such the NIC per item (Orlistat) in 2022/23 was £29, which is an increase from 2021/22 (£26).
Prescription items per head of population
Prescription items for the treatment of obesity per 1,000 population, by Integrated Care Board (ICB)
NHS South Yorkshire Integrated Care Board had the highest prescription rate with 12.2 items per 1,000 population. NHS Black Country Integrated Care Board (9.9), NHS Lancashire and South Cumbria Integrated Care Board (9.4) and NHS Cheshire and Merseyside Integrated Care Board (9.3) had the next highest prescription rates per 1,000 population.
NHS Northamptonshire Integrated Care Board had the lowest prescription rate with 0.4 per 1,000 population. NNHS Nottingham and Nottinghamshire Integrated Care Board (3.1), NHS Cambridgeshire and Peterborough Integrated Care Board (3.2) and the NHS Buckinghamshire, Oxfordshire and Berkshire West and the NHS Frimley Integrated Care Boards (3.3) had the next lowest rates of prescribed items per 1,000 population.
Prescription items per 1,000 population, by Integrated Care Board (ICB).
Prescription items per 1,000 population, by NHS Commissioning Region
In 2022/23, the North West had the highest prescription rate with 9 items per 1,000 population, whilst the South East had the lowest rate with 4.
For more data/information on this section see:
Last edited: 12 November 2024 2:51 pm