What are the most commonly prescribed medicines? Top 10 prescribed medicines in NHS England primary care for 2019

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 Name	Prescription Items	Actual Cost	Commonly Used For
Corticosteroids (Respiratory)	21,099,043	£548,653,646	Inhalers for lung conditions
Antidiabetic Drugs	41,654,329	£545,347,171	Diabetes
Oral Anticoagulants	18,486,373	£541,626,860	Blood thinners - to prevent clots/strokes
Insulin	7,538,314	£332,531,643	Diabetes
Control of Epilepsy	28,704,569	£278,841,283	Epilepsy
Enteral Nutrition	3,725,985	£236,304,624	Malnutrition
Opioid Analgesics	23,196,389	£213,975,882	Pain relief
Renin-Angiotensin System Drugs	65,424,446	£188,452,348	High blood pressure - heartdisease
Diabetic Diagnostic and Monitoring Agents	7,145,514	£155,910,265	Blood sugar test for diabetes

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

BNF Paragraph Name	Prescription Items	Actual Cost	Commonly Used For
Lipid-Regulating Drugs	77,997,663	£116,000,000	Statins-high cholesterol
Renin-Angiotensin System Drugs	65,424,446	£188,000,000	High blood pressure - heart disease
Proton Pump Inhibitors	62,236,186	£98,727,913	Indigestion or stomach ulcers
Calcium-Channel Blockers	42,419,537	£105,000,000	High blood pressure - heat disease
Antidiabetic Drugs	41,654,329	£545,000,000	Diabetes
Selective Serotonin Re-Uptake Inhibitors	40,254,277	£66,154,129	Depression
Beta-Adrenoceptor Blocking Drugs	39,505,912	£67,928,111	High blood pressure - heart disease
Non-Opioid Analgesics and Compound Preparations	34,487,135	£128,000,000	Pain Relief
Antiplatelet Drugs	33,308,350	£66,684,077	Reduce 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 Name	Prescription Items	Actual Cost	Commonly Used For
Apixaban	5,862,145	£268,932,709	Blood thinner - stroke prevention
Enteral Nutrition	3,725,985	£236,304,624	Malnutrition
Beclometasone Dipropionate	11,293,617	£201,973,695	Inhalers for lung conditions
Rivaroxaban	4,310,724	£201,973,695	Blood thinner - stroke prevention
Glucose Blood Testing Reagents	6,806,704	£147,620,355	Blood sugar tests for diabetes
Fluticasone Propionate (Inh)	4,523,933	£138,481,006	Inhalers for lung conditions
Budesonide	3,585,322	£118,720,380	Inhalers for lung conditions
Tiotropium Bromide	3,704,740	£109,306,933	Inhalers for lung conditions
Other Food for Special Diet Preps	888,137	£89,162,778	Conditions requiring special diets

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

BNF Paragraph Name	Prescription Items	Actual Cost	Commonly Used For
Atorvastatin	45,792,988	£55,759,286	Statins-high cholesterol
Levothyroxine Sodium	32,934,807	£62,757,734	Low thyroid levels
Omeprazole	31,791,795	£50,092.650	Indigestion or stomach ulcers
Amlodipine	30,541,931	£29,329,631	High blood pressure - heart disease
Ramipril	29,318,773	£41,931,828	High blood pressure - hear disease
Lansoprazole	27,723,751	£33,480,232	Indigestion or stomach ulcers
Bisoprolol Fumarate	24,905,410	£21,124,240	High blood pressure - heart disease
Colecalciferol	24,004,981	£86,331,206	Vitamin D deficiency
Metformin Hydrochloride	22,375,503	£84,576,576	Diabetes