Changes in recent prescribing volumes – Nationally, items and costs have changed

  • The number of prescription items increased sharply in March and decreased in April but remained relatively high compared to recent years
  • By May, the number of items was as low as it has been in the last 5 years
  • Costs followed a similar pattern but increased proportionately more and remained at average levels in May even though items were relatively low
  • The average cost of each item remained in excess of £8.40
  • The number of patients receiving prescriptions increased sharply in March, but fell back to low levels in both April and May

The number of prescribed items was over 7 million (7%) higher in March 2020 than the average March from 2016-2019. This pattern was also mirrored by costs measured by the Net Ingredient Cost (NIC) 1 . By May however, items had decreased significantly and while costs have decreased they have remained higher than previously seen in May of years prior.

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Why have costs increased faster than volumes?

Part of the reason that costs have increased by more than items is likely to be the price concessions granted for Sertraline from March 2020 as shown in the table below.

For example the total Net Ingredient Cost 2 in March was £100m higher than the average for March in 2016-2019. Around 60% of that could be explained by the unusually high number of items in March 2020. A large part of the remaining increase can be explained by the cost of the two Sertraline products receiving a concession that together increased costs by over £11m from February to March 2020 and a further £6m in April.

Table 1: Reimbursement Prices and Net Ingredient Cost for Sertraline 100mg and 50mg tablets from January to May 2020

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Taken together with other changes in prices and the mix of items being prescribed, the average cost per item has remained above £8.40 in May 2020.

The year so far

While figures have been at record high for March and April, the number of items dispensed in May is the lowest seen in the previous 4 years. While this is a sizeable drop, it still doesn’t offset the rise seen in March and April. So far in 2020 we have dispensed 13.3 million more items than we usually see in the first 5 months of the year and spent £230.8m more. It remains to be seen whether figures remain low in the following months and whether the demand in March is balanced out across the rest of the year.

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There are several dashboards within ePACT2 which allow you to see data for your area in more detail. For example, the Volumes and Costs dashboard allows you to view trends and comparators for different medicines.

1 This represents the basic price of a pharmaceutical product as set out in the Drug Tariff multiplied by the quantity dispensed and includes any price concessions in place.

2  For English prescriptions dispensed in England.

3  For English prescriptions dispensed in England including equivalent proprietary presentations.