Highest-cost medicines to the NHS in primary care, monthly top 100
The 100 medicines costing English primary care most each month, by net ingredient cost.
In the current release
Coverage
Latest data month
About this dataset
The 100 chemical substances with the highest net ingredient cost to NHS primary care in England in each month, with the items dispensed and the average cost per item. Ranked by cost rather than volume, so it surfaces a different set of medicines from the most-prescribed list. Derived from the NHSBSA Prescription Cost Analysis and updated monthly.
How it is derived
Prescription Cost Analysis records are aggregated to chemical substance level for each published month, summing net ingredient cost and items across all presentations. Substances are ranked by cost within the month and the top 100 kept. Cost per item is the month's cost divided by the month's items.
What this data cannot tell you
- 1 Net ingredient cost is the list price before discounts, clawback and dispensing fees. For branded and specialist medicines the gap between list price and what the NHS pays can be substantial, and confidential commercial arrangements are not reflected here at all.
- 2 Primary care only. The most expensive medicines the NHS buys are largely hospital-issued and appear in the hospital medicines dataset instead.
- 3 A high total cost can come from a very large number of cheap items or a small number of very expensive ones. The cost-per-item column distinguishes the two.
The medicines costing the NHS most in primary care
Net ingredient cost in the latest published month, by chemical substance.
Source: NHSBSA English Prescribing Dataset OGL v3.0
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Preview
The first 20 rows of 6,600.
| month | rank | bnf_chemical_substance_code | bnf_chemical_substance | net_ingredient_cost_gbp | items | cost_per_item_gbp |
|---|---|---|---|---|---|---|
| 2021-01 | 1 | 0208020Z0 | Apixaban | 29933649.82 | 593385 | 50.45 |
| 2021-01 | 2 | 090402000 | Enteral nutrition | 24330491.85 | 327401 | 74.31 |
| 2021-01 | 3 | 0302000C0 | Beclometasone dipropionate | 24125075.7 | 1039204 | 23.21 |
| 2021-01 | 4 | 0208020Y0 | Rivaroxaban | 19402396.2 | 375063 | 51.73 |
| 2021-01 | 5 | 2102 | Catheters | 13990784.79 | 114198 | 122.51 |
| 2021-01 | 6 | 0403030Q0 | Sertraline hydrochloride | 12639289.4 | 1620265 | 7.8 |
| 2021-01 | 7 | 0601060D0 | Glucose blood testing reagents | 11076643.82 | 534488 | 20.72 |
| 2021-01 | 8 | 0302000N0 | Fluticasone propionate (Inhalation) | 10889760.97 | 343659 | 31.69 |
| 2021-01 | 9 | 0302000K0 | Budesonide | 10318044.93 | 290314 | 35.54 |
| 2021-01 | 10 | 2003 | Wound Management & Other Dressings | 9787190.05 | 303371 | 32.26 |
| 2021-01 | 11 | 0601022B0 | Metformin hydrochloride | 9675032.89 | 1891128 | 5.12 |
| 2021-01 | 12 | 2360 | Ileostomy Bags | 8810803.14 | 56645 | 155.54 |
| 2021-01 | 13 | 090401000 | Other food for special diet preparations | 8474336.52 | 69479 | 121.97 |
| 2021-01 | 14 | 0301020Q0 | Tiotropium bromide | 8114603.46 | 263302 | 30.82 |
| 2021-01 | 15 | 2335 | Colostomy Bags | 8005577.99 | 36750 | 217.84 |
| 2021-01 | 16 | 0906040G0 | Colecalciferol | 7771094.35 | 2050357 | 3.79 |
| 2021-01 | 17 | 0103050P0 | Omeprazole | 7718655.36 | 2888531 | 2.67 |
| 2021-01 | 18 | 0407010F0 | Co-codamol (Codeine phosphate/paracetamol) | 7517287.75 | 1231418 | 6.1 |
| 2021-01 | 19 | 0105010B0 | Mesalazine (Systemic) | 7335699.83 | 128482 | 57.1 |
| 2021-01 | 20 | 0601011A0 | Insulin aspart | 7317635.36 | 164151 | 44.58 |
Licence and attribution
The underlying figures are NHS open data published by the NHS Business Services Authority under the Open Government Licence v3.0. Contains public sector information licensed under the Open Government Licence v3.0.
The derived dataset on this page — the aggregation, the columns and the rates — is free to reuse, including commercially. We ask that you credit PharmaInsight with a link when you do, which is what lets other people find their way back to the method and the caveats.
How to cite
Citing a figure in something durable? Use the pinned 2026-06 snapshot rather than the latest file — it will not change when next month's data lands.
Download
-
highest-cost-medicines-nhs-latest.csv
6,600 rows · 412 KB · always current
-
highest-cost-medicines-nhs-2026-06.csv
Pinned snapshot of the June 2026 release — use this in citations
At a glance
- Source NHSBSA Prescription Cost Analysis
- Coverage January 2021 to June 2026
- Latest data June 2026
- Updates Monthly
- Format CSV, UTF-8
- Licence OGL v3.0
- Geography England
Columns
- month
- rank
- bnf_chemical_substance_code
- bnf_chemical_substance
- net_ingredient_cost_gbp
- items
- cost_per_item_gbp
Where we use this data
Refresh
Monthly, within a few days of the NHSBSA publication. Last published 25 August 2026.
More open data
Browse the full dataset catalogue, the sources we import from, and our methodology.