Hospital medicines spending
Secondary Care Medicines Data (SCMD) · indicative cost · April 2025 – March 2026
What NHS hospitals in England actually use, by indicative cost. Over the 12 months to March 2026, the highest was Adalimumab 40mg/0.4ml solution for injection pre-filled disposable devices (£693,765,000). This is a different dataset from hospital prescribing dispensed in the community: it covers medicines issued within secondary care.
Cost is indicative — actual hospital medicine prices are commercially confidential, so these figures are estimated from list prices and understate true spend on some drugs. See methodology.
Figure 1. National hospital medicines indicative cost by month (£ millions)
Source: NHSBSA Secondary Care Medicines Data, to March 2026
Highest indicative cost, April 2025 – March 2026
Download CSV| # | Medicine | Indicative cost (12 months) |
|---|---|---|
| 1 | Adalimumab 40mg/0.4ml solution for injection pre-filled disposable devices | £693,765,000 |
| 2 | Pembrolizumab 100mg/4ml solution for infusion vials | £550,945,616 |
| 3 | Generic Kaftrio 75mg/50mg/100mg tablets | £531,764,235 |
| 4 | Daratumumab 1.8g/15ml solution for injection vials | £519,546,672 |
| 5 | Ivacaftor 150mg tablets | £458,883,250 |
| 6 | Enzalutamide 40mg tablets | £394,415,053 |
| 7 | Infliximab 100mg powder for solution for infusion vials | £378,290,355 |
| 8 | Adalimumab 40mg/0.8ml solution for injection pre-filled disposable devices | £353,000,303 |
| 9 | Aflibercept 3.6mg/90microlitres solution for injection pre-filled syringes | £346,418,954 |
| 10 | Faricimab 21mg/0.175ml solution for injection pre-filled syringes | £337,915,837 |
| 11 | Pertuzumab 600mg/10ml / Trastuzumab 600mg/10ml solution for injection vials | £250,442,527 |
| 12 | Ustekinumab 90mg/1ml solution for injection pre-filled syringes | £248,054,719 |
| 13 | Emtricitabine 200mg / Tenofovir disoproxil 245mg tablets | £243,996,825 |
| 14 | Tafamidis 61mg capsules | £242,849,392 |
| 15 | Lenalidomide 10mg capsules | £227,267,865 |
| 16 | Tebentafusp 100micrograms/0.5ml solution for infusion vials | £217,820,768 |
| 17 | Bictegravir 50mg / Emtricitabine 200mg / Tenofovir alafenamide 25mg tablets | £209,108,194 |
| 18 | Etanercept 50mg/1ml solution for injection pre-filled disposable devices | £199,549,526 |
| 19 | Acalabrutinib 100mg tablets | £197,787,318 |
| 20 | Ofatumumab 20mg/0.4ml solution for injection pre-filled disposable devices | £188,352,008 |
| 21 | Darolutamide 300mg tablets | £185,540,927 |
| 22 | Dupilumab 300mg/2ml solution for injection pre-filled disposable devices | £177,864,089 |
| 23 | Nivolumab 240mg/24ml solution for infusion vials | £177,636,128 |
| 24 | Ocrelizumab 300mg/10ml solution for infusion vials | £176,089,980 |
| 25 | Dolutegravir 50mg / Lamivudine 300mg tablets | £171,175,135 |
| 26 | Vedolizumab 300mg powder for solution for infusion vials | £154,012,031 |
| 27 | Chorionic gonadotrophin 5,000unit powder and solvent for solution for injection pre-filled syringes | £149,158,395 |
| 28 | Emicizumab 60mg/0.4ml solution for injection vials | £139,464,253 |
| 29 | Emicizumab 150mg/1ml solution for injection vials | £134,363,139 |
| 30 | Osimertinib 80mg tablets | £131,955,344 |
| 31 | Sofosbuvir 400mg / Velpatasvir 100mg tablets | £130,110,967 |
| 32 | Nintedanib 150mg capsules | £129,331,945 |
| 33 | Zanubrutinib 80mg capsules | £129,135,803 |
| 34 | Emicizumab 105mg/0.7ml solution for injection vials | £128,415,463 |
| 35 | Risdiplam 750micrograms/ml oral solution sugar free | £127,637,338 |
| 36 | Secukinumab 300mg/2ml solution for injection pre-filled disposable devices | £123,996,240 |
| 37 | Apalutamide 60mg tablets | £120,693,580 |
| 38 | Rituximab 500mg/50ml solution for infusion vials | £118,814,291 |
| 39 | Durvalumab 500mg/10ml solution for infusion vials | £116,530,337 |
| 40 | Polatuzumab vedotin 140mg powder for solution for infusion vials | £116,421,652 |
| 41 | Generic Alyftrek 125mg/50mg/10mg tablets | £113,004,170 |
| 42 | Ribociclib 200mg tablets | £109,280,718 |
| 43 | Infliximab 120mg/1ml solution for injection pre-filled disposable devices | £107,542,462 |
| 44 | Vedolizumab 108mg/0.68ml solution for injection pre-filled disposable devices | £107,494,825 |
| 45 | Abiraterone 500mg tablets | £107,300,172 |
| 46 | Normal immunoglobulin human 20g/200ml solution for infusion bottles | £106,542,762 |
| 47 | Ravulizumab 1.1g/11ml solution for infusion vials | £104,245,401 |
| 48 | Piperacillin 4g / Tazobactam 500mg powder for solution for infusion vials | £103,886,377 |
| 49 | Lenalidomide 5mg capsules | £103,496,711 |
| 50 | Benralizumab 30mg/1ml solution for injection pre-filled disposable devices | £103,466,420 |
| 51 | Abemaciclib 100mg tablets | £101,202,542 |
| 52 | Dimethyl fumarate 240mg gastro-resistant capsules | £101,198,925 |
| 53 | Upadacitinib 30mg modified-release tablets | £99,137,043 |
| 54 | Risankizumab 360mg/2.4ml solution for injection cartridges | £94,257,787 |
| 55 | Evolocumab 140mg/1ml solution for injection pre-filled disposable devices | £91,113,555 |
| 56 | Tezepelumab 210mg/1.91ml solution for injection pre-filled disposable devices | £88,557,590 |
| 57 | Atezolizumab 1.875g/15ml solution for injection vials | £88,491,447 |
| 58 | Normal immunoglobulin human 20g/200ml solution for infusion vials | £84,043,589 |
| 59 | Vutrisiran 25mg/0.5ml solution for injection pre-filled syringes | £82,249,905 |
| 60 | Nintedanib 100mg capsules | £76,806,245 |
| 61 | Imatinib 400mg tablets | £76,052,852 |
| 62 | Dolutegravir 50mg tablets | £75,762,510 |
| 63 | Abemaciclib 150mg tablets | £75,355,274 |
| 64 | Risankizumab 150mg/1ml solution for injection pre-filled disposable devices | £73,323,654 |
| 65 | Venetoclax 100mg tablets | £73,192,652 |
| 66 | Dostarlimab 500mg/10ml solution for infusion vials | £72,873,371 |
| 67 | Faricimab 28.8mg/0.24ml solution for injection vials | £72,699,596 |
| 68 | Aflibercept 21mg/184microlitres solution for injection pre-filled syringes | £72,509,684 |
| 69 | Upadacitinib 15mg modified-release tablets | £72,243,604 |
| 70 | Burosumab 30mg/1ml solution for injection vials | £70,730,880 |
| 71 | Axicabtagene ciloleucel 40million-200million cells/68ml dispersion for infusion bags | £70,393,201 |
| 72 | Apalutamide 240mg tablets | £69,819,666 |
| 73 | Elbasvir 50mg / Grazoprevir 100mg tablets | £69,326,797 |
| 74 | Isatuximab 500mg/25ml solution for infusion vials | £68,477,599 |
| 75 | Olaparib 150mg tablets | £66,599,301 |
| 76 | Ibrutinib 420mg tablets | £64,016,549 |
| 77 | Avacopan 10mg capsules | £63,242,766 |
| 78 | Posaconazole 100mg gastro-resistant tablets | £63,134,086 |
| 79 | Abemaciclib 50mg tablets | £62,754,929 |
| 80 | Trastuzumab deruxtecan 100mg powder for solution for infusion vials | £62,742,917 |
| 81 | Avelumab 200mg/10ml solution for infusion vials | £62,712,576 |
| 82 | Trastuzumab 600mg/5ml solution for injection vials | £62,605,139 |
| 83 | Bevacizumab 400mg/16ml solution for infusion vials | £62,172,709 |
| 84 | Ustekinumab 130mg/26ml solution for infusion vials | £61,830,627 |
| 85 | Tocilizumab 162mg/0.9ml solution for injection pre-filled disposable devices | £61,296,832 |
| 86 | Dupilumab 300mg/2ml solution for injection pre-filled syringes | £61,273,802 |
| 87 | Iohexol 755mg/ml (Iodine 350mg/ml) solution for injection 500ml plastic bottles | £60,716,285 |
| 88 | Ocrelizumab 920mg/23ml solution for injection vials | £60,526,419 |
| 89 | Filgrastim 30million units/0.5ml solution for injection pre-filled syringes | £60,404,596 |
| 90 | Guselkumab 100mg/1ml solution for injection pre-filled disposable devices | £60,160,500 |
| 91 | Aflibercept 6.6mg/165microlitres solution for injection pre-filled syringes | £59,957,885 |
| 92 | Sodium chloride 0.9% infusion 100ml bags | £59,205,384 |
| 93 | Nivolumab 600mg/5ml solution for injection vials | £59,193,000 |
| 94 | Lenalidomide 15mg capsules | £58,394,444 |
| 95 | Secukinumab 150mg/1ml solution for injection pre-filled disposable devices | £58,109,602 |
| 96 | Ipilimumab 50mg/10ml solution for infusion vials | £57,872,400 |
| 97 | Meropenem 1g powder for solution for injection vials | £57,807,826 |
| 98 | Palbociclib 125mg tablets | £57,665,197 |
| 99 | Lanreotide 120mg/0.5ml solution for injection pre-filled syringes | £57,587,083 |
| 100 | Migalastat 123mg capsules | £57,491,552 |