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 or feedback@openprescribing.net. 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 NamePrescription ItemsActual CostCommonly Used For
Corticosteroids (Respiratory)21,099,043£548,653,646Inhalers for lung conditions
Antidiabetic Drugs41,654,329£545,347,171Diabetes
Oral Anticoagulants18,486,373£541,626,860Blood thinners - to prevent clots/strokes
Insulin7,538,314£332,531,643Diabetes
Control of Epilepsy28,704,569£278,841,283Epilepsy
Enteral Nutrition3,725,985£236,304,624Malnutrition
Opioid Analgesics23,196,389£213,975,882Pain relief
Renin-Angiotensin System Drugs65,424,446£188,452,348High blood pressure - heartdisease
Diabetic Diagnostic and Monitoring Agents7,145,514£155,910,265Blood sugar test for diabetes

Table 2: Top Medicines Class by volume in 2019 in NHS Primary Care

BNF Paragraph NamePrescription ItemsActual CostCommonly Used For
Lipid-Regulating Drugs77,997,663£116,000,000Statins-high cholesterol
Renin-Angiotensin System Drugs65,424,446£188,000,000High blood pressure - heart disease
Proton Pump Inhibitors62,236,186£98,727,913Indigestion or stomach ulcers
Calcium-Channel Blockers42,419,537£105,000,000High blood pressure - heat disease
Antidiabetic Drugs41,654,329£545,000,000Diabetes
Selective Serotonin Re-Uptake Inhibitors40,254,277£66,154,129Depression
Beta-Adrenoceptor Blocking Drugs39,505,912£67,928,111High blood pressure - heart disease
Non-Opioid Analgesics and Compound Preparations34,487,135£128,000,000Pain Relief
Antiplatelet Drugs33,308,350£66,684,077Reduce the risk of heart attacks and stroke

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 NamePrescription ItemsActual CostCommonly Used For
Apixaban5,862,145£268,932,709Blood thinner - stroke prevention
Enteral Nutrition3,725,985£236,304,624Malnutrition
Beclometasone Dipropionate11,293,617£201,973,695Inhalers for lung conditions
Rivaroxaban4,310,724£201,973,695Blood thinner - stroke prevention
Glucose Blood Testing Reagents6,806,704£147,620,355Blood sugar tests for diabetes
Fluticasone Propionate (Inh)4,523,933£138,481,006Inhalers for lung conditions
Budesonide3,585,322£118,720,380Inhalers for lung conditions
Tiotropium Bromide3,704,740£109,306,933Inhalers for lung conditions
Other Food for Special Diet Preps888,137£89,162,778Conditions requiring special diets

Table 4: Top 10 Medicines chemical by volume in 2019 in NHS Primary Care

BNF Paragraph NamePrescription ItemsActual CostCommonly Used For
Atorvastatin45,792,988£55,759,286Statins-high cholesterol
Levothyroxine Sodium32,934,807£62,757,734Low thyroid levels
Omeprazole31,791,795£50,092.650Indigestion or stomach ulcers
Amlodipine30,541,931£29,329,631High blood pressure - heart disease
Ramipril29,318,773£41,931,828High blood pressure - hear disease
Lansoprazole27,723,751£33,480,232Indigestion or stomach ulcers
Bisoprolol Fumarate24,905,410£21,124,240High blood pressure - heart disease
Colecalciferol24,004,981£86,331,206Vitamin D deficiency
Metformin Hydrochloride22,375,503£84,576,576Diabetes