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Antidepressants show greatest increase in number of prescription items dispensed

5 July 2016: 3.9 million more items of antidepressant drugs dispensed in 2015 than in 2014

*HSCIC must be quoted as the source of these figures

A report published today by the Health and Social Care Information Centre (HSCIC)1 shows that, of all BNF drug categories2, prescription items3 for antidepressants saw the greatest numeric rise in 2015.

The report Prescriptions Dispensed in the Community 2005-20154 shows that the number of antidepressant5 items prescribed and dispensed in England has more than doubled in the last decade. In 2015, there were 61.0 million antidepressant items prescribed - 31.6 million (107.6 per cent) more than in 2005 and 3.9 million (6.8 per cent) more than in 2014.

The Net Ingredient Cost (NIC)6 of antidepressants has also increased in the past year, rising by £19.7 million (7.4 per cent) to £284.7 million, however this is £53.8 million (15.9 per cent) lower than in 2005.

This means that in 2015, antidepressants cost the NHS £780,000 per day.

The report also finds that:

  •  More than 1.08 billion prescription items were dispensed overall in 2015. This is a 1.8 per cent increase on the previous year, and a 50.4 per cent increase on the same figure a decade ago.
  •  The NIC for all prescriptions dispensed in 2015 was £9.27 billion. This is a 4.7 per cent increase on the previous year, and a 16.8 per cent increase on the same figure a decade ago.
  •  For the ninth year running, drugs used to treat diabetes7 continued to cost the NHS the most. Costs for this category, from 2014 to 2015, increased by £87.6 million to £936.7 million. In 2015, the NHS spent more than £2.6 million per day on drugs to treat diabetes. The number of items dispensed for 2015 was 49.1 million, which was an increase of 2.4 million (5.1 per cent) from 2014.
  •  Categories with large cost increases between 2014 and 2015 included anticoagulants and protamine9 (blood thinning drugs), for which costs rose by £83.5 million (a 60.3 per cent increase) to £222.2 million, and antiepileptics10, for which costs rose by £37.9 million (a 7.8 per cent increase) to £524.4 million.
  •  Following antidepressants, the therapeutic area with the second greatest increase from 2014 to 2015 for number of items prescribed and dispensed was antisecretory drugs and mucosal protectants11, used to prevent and treat gastro-intestinal ulcerations, of which 3.1 million more items were dispensed. Prescription items for this category have also more than doubled in the last decade, from 26.9 million to 60.8 million (a 125.4 per cent increase).
  •  There were also categories of medicine where the number of items dispensed decreased. Most noticeably, antibacterial drugs12 (the main category of antibiotics), saw a 5.6 per cent fall in the number of prescription items dispensed, with 39.4 million items provided in 2015 - down from 41.7 million the previous year.
  •  In 2015, 89.7 per cent of all prescription items were dispensed free of charge8. In more detail, of all prescription items:

    o 60.4 per cent were dispensed free of charge to those aged 60 and over.

    o 4.5 per cent were dispensed free of charge to all children aged under 16, and to those aged 16-18 and in full-time education.

    o 24.8 per cent were dispensed free of charge for the remaining exemption categories, including medical conditions (see Notes to editors).

The full report is at:

http://www.hscic.gov.uk/pubs/presdisp0515

ENDS


Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1, 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 260 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. The British National Formulary (BNF) is a joint publication of the British Medical Association and the Royal Pharmaceutical Society, which aims to provide prescribers, pharmacists and other healthcare professionals with information on the use of medicines. It includes information on how to select, prescribe, dispense, and administer medicines. Medicines are listed within the BNF by therapeutic groupings. The Prescription Cost Analysis system uses the therapeutic classifications defined in the BNF September 2014 (edition 68).

3. Prescription Item: Prescribers write prescriptions on a prescription form. Each single item written on the form is counted as a prescription item.

4. The Prescriptions Dispensed in the Community 2005-2015 bulletin covers all prescriptions that were dispensed in England by community pharmacists, appliance contractors and dispensing doctors. The majority of prescriptions dispensed are written by GPs, but prescriptions written by dentists, nurses, pharmacists and prescriptions written in hospital or a Community Health Trust are also included, provided they were dispensed by a community pharmacist.

5. BNF Section 4.3 Antidepressant drugs. This includes medicines for depressive illness, generalised anxiety disorder, obsessive-compulsive disorder, and panic attacks. The five most commonly prescribed medicines in this category for 2015, were citalopram hydrobromide, amitriptyline hydrochloride, sertraline hydrochloride, mirtazapine, and fluoxetine hydrochloride.

6. The Prescriptions Dispensed in the Community 2005-2015 bulletin shows the headline cost (net ingredient cost) of medicines before the deduction of discount or charges paid and therefore does not represent the actual cost to the NHS. Net ingredient cost figures given here are not adjusted for inflation. Standard adjustments for inflation are not considered appropriate as drug prices are subject to controls under the Pharmaceutical Price Regulation Scheme and to other central controls.

7. BNF chapter 6.1 Drugs used in Diabetes. This includes insulins, oral antidiabetic drugs and monitoring devices. This does not include hypodermic equipment, which is recorded in the BNF section "Other appliances". The most commonly prescribed medicine in this category was metformin Hydrochloride.

8. Items dispensed free of charge: Prescriptions are subject to a prescription charge, but many people are eligible for free prescriptions, if they meet certain exemption criteria. Exempt groups include those aged 60 years and over, those aged under 16, or aged 16-18 in full-time education, those in receipt of certain benefits, and those with certain medical conditions. All items personally administered and all contraceptives are free.

9. BNF section 2.8 anticoagulants and protamine, the increase in cost has largely been driven by rivaroxaban, apixiban and dabigatran etexilate. These medicines are recommended by the National Institute of Health and Clinical Excellence (NICE) as options for the prevention of stroke and systemic embolism in patients with atrial fibrillation.

10. BNF section 4.8 Antiepileptics.

11. BNF section 1.3 Antisecretory drugs and mucosal protectants.

12. BNF section 5.1 Antibacterial drugs.

13. Figures over 1 billion have been rounded to the nearest 10 million, those over 1 million have been rounded to the nearest 100,000. Other figures (including percentages) have been rounded to one decimal place.

14. For media enquiries, please contact the press office on 0300 303 3888 or media@hscic.gov.uk

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