Doctor and patient

NHS Business Services Authority (NHSBSA) publishes ‘Prescribing Costs in Hospital and the Community 2021-22’ report

The report covers data in England from April 2021 to March 2022. It compares expenditure on medicines between primary care, secondary care and prescriptions written in secondary care but dispensed in the community.

Key findings of the report show that the total cost to NHS commissioners in England, for the issue of medicines, appliances, and medical devices in 2021/22 is estimated to be £17.2 billion. This includes a deduction of £619 million for central rebates. The total cost without central rebates was £17.8 billion, an increase of 8.32% from £16.4 billion in 2020/21.

In 2021/22, the cost to NHS commissioners in England for medicines:

  • prescribed in primary care and dispensed in the community was £8.90 billion, 50.0% of total expenditure
  • issued in hospitals was £8.77 billion, 49.3% of total expenditure
  • prescribed in hospitals and dispensed in the community was £85.1 million
  • prescribed by dentists and dispensed in the community was £29.3 million

In 2021/22, medicines that come under Malignant Disease and Immunosuppression (BNF Chapter 8) had the highest spend across all settings of £3.11 billion when using Net Ingredient Cost (NIC) for items dispensed in the community, 16.9% of the total spend. Of this spend, £2.95 billion was for medicines issued and dispensed in hospitals.

The average costs per capita when using NIC for items dispensed in the community for medicines, appliances, and medical devices prescribed in England in 2021/22 across all settings was £324. This is an increase from £301 in 2020/21.

To read the full report visit:

Contact Information

Sahdia Hassen


Notes to editors

The total cost to NHS commissioners is known as ‘actual cost’ in primary care data.

Per capita national health expenditures indicate the average cost per person to different payers for various health care services.

Net ingredient cost (NIC) is the basic cost of a drug as used in primary care. This is the cost at list price excluding VAT, i.e. the price listed in the national Drug Tariff or in standard price lists and is not necessarily the price the NHS paid.

Prescription ‘items’ refer to individual drugs or inhalers etc on a prescription form, however a ‘prescription’ can include multiple medicines on it.

These statistics are based on the financial year and not on the calendar year as some other sources of data may be.

The British National Formulary (BNF) is a reference book containing the standard list of medicines used in UK prescribing. It aims to provide prescribers, pharmacists, and other healthcare professionals with sound up-to-date information about the use of medicines. For more information about BNF go to

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