Hospital medicines spending

Secondary Care Medicines Data (SCMD) · indicative cost · May 2025 – April 2026

Data updated April 2026

What NHS hospitals in England actually use, by indicative cost. Over the 12 months to April 2026, the highest was Adalimumab 40mg/0.4ml solution for injection pre-filled disposable devices (£718,928,770). 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 April 2026

Highest indicative cost, May 2025 – April 2026

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NHS hospital medicines by indicative cost, May 2025 – April 2026
#	Medicine	Indicative cost (12 months)
1	Adalimumab 40mg/0.4ml solution for injection pre-filled disposable devices	£718,928,770
2	Pembrolizumab 100mg/4ml solution for infusion vials	£551,797,078
3	Daratumumab 1.8g/15ml solution for injection vials	£519,857,712
4	Generic Kaftrio 75mg/50mg/100mg tablets	£519,411,711
5	Ivacaftor 150mg tablets	£447,556,500
6	Enzalutamide 40mg tablets	£393,553,936
7	Infliximab 100mg powder for solution for infusion vials	£380,573,832
8	Faricimab 21mg/0.175ml solution for injection pre-filled syringes	£348,488,229
9	Adalimumab 40mg/0.8ml solution for injection pre-filled disposable devices	£339,886,764
10	Aflibercept 3.6mg/90microlitres solution for injection pre-filled syringes	£321,575,568
11	Pertuzumab 600mg/10ml / Trastuzumab 600mg/10ml solution for injection vials	£252,399,324
12	Tafamidis 61mg capsules	£248,234,632
13	Ustekinumab 90mg/1ml solution for injection pre-filled syringes	£247,195,919
14	Emtricitabine 200mg / Tenofovir disoproxil 245mg tablets	£241,311,354
15	Lenalidomide 10mg capsules	£229,727,025
16	Tebentafusp 100micrograms/0.5ml solution for infusion vials	£218,053,390
17	Bictegravir 50mg / Emtricitabine 200mg / Tenofovir alafenamide 25mg tablets	£207,983,828
18	Etanercept 50mg/1ml solution for injection pre-filled disposable devices	£200,458,616
19	Acalabrutinib 100mg tablets	£199,676,857
20	Darolutamide 300mg tablets	£197,080,792
21	Ofatumumab 20mg/0.4ml solution for injection pre-filled disposable devices	£191,431,035
22	Dupilumab 300mg/2ml solution for injection pre-filled disposable devices	£182,174,202
23	Ocrelizumab 300mg/10ml solution for infusion vials	£174,078,180
24	Dolutegravir 50mg / Lamivudine 300mg tablets	£173,732,663
25	Nivolumab 240mg/24ml solution for infusion vials	£167,894,906
26	Vedolizumab 300mg powder for solution for infusion vials	£153,013,681
27	Generic Alyftrek 125mg/50mg/10mg tablets	£149,902,112
28	Emicizumab 60mg/0.4ml solution for injection vials	£138,681,695
29	Emicizumab 150mg/1ml solution for injection vials	£136,995,816
30	Zanubrutinib 80mg capsules	£134,370,752
31	Osimertinib 80mg tablets	£132,326,740
32	Sofosbuvir 400mg / Velpatasvir 100mg tablets	£130,514,224
33	Nintedanib 150mg capsules	£129,001,287
34	Emicizumab 105mg/0.7ml solution for injection vials	£128,542,266
35	Chorionic gonadotrophin 5,000unit powder and solvent for solution for injection pre-filled syringes	£126,005,220
36	Secukinumab 300mg/2ml solution for injection pre-filled disposable devices	£125,268,646
37	Risdiplam 750micrograms/ml oral solution sugar free	£125,061,641
38	Durvalumab 500mg/10ml solution for infusion vials	£120,927,215
39	Rituximab 500mg/50ml solution for infusion vials	£119,129,954
40	Apalutamide 60mg tablets	£117,839,632
41	Abiraterone 500mg tablets	£116,972,778
42	Polatuzumab vedotin 140mg powder for solution for infusion vials	£115,501,571
43	Ribociclib 200mg tablets	£114,187,017
44	Normal immunoglobulin human 20g/200ml solution for infusion bottles	£113,980,962
45	Infliximab 120mg/1ml solution for injection pre-filled disposable devices	£109,848,454
46	Vedolizumab 108mg/0.68ml solution for injection pre-filled disposable devices	£108,676,650
47	Lenalidomide 5mg capsules	£106,170,131
48	Benralizumab 30mg/1ml solution for injection pre-filled disposable devices	£104,969,815
49	Ravulizumab 1.1g/11ml solution for infusion vials	£103,597,182
50	Piperacillin 4g / Tazobactam 500mg powder for solution for infusion vials	£103,350,321
51	Upadacitinib 30mg modified-release tablets	£102,206,026
52	Abemaciclib 100mg tablets	£100,826,417
53	Dimethyl fumarate 240mg gastro-resistant capsules	£99,553,998
54	Risankizumab 360mg/2.4ml solution for injection cartridges	£98,834,764
55	Tezepelumab 210mg/1.91ml solution for injection pre-filled disposable devices	£93,330,839
56	Evolocumab 140mg/1ml solution for injection pre-filled disposable devices	£91,625,896
57	Atezolizumab 1.875g/15ml solution for injection vials	£89,538,957
58	Vutrisiran 25mg/0.5ml solution for injection pre-filled syringes	£83,112,666
59	Aflibercept 6.6mg/165microlitres solution for injection pre-filled syringes	£82,490,746
60	Normal immunoglobulin human 20g/200ml solution for infusion vials	£81,191,363
61	Nintedanib 100mg capsules	£80,924,197
62	Aflibercept 21mg/184microlitres solution for injection pre-filled syringes	£76,969,746
63	Imatinib 400mg tablets	£76,215,973
64	Dolutegravir 50mg tablets	£75,444,022
65	Abemaciclib 150mg tablets	£74,861,096
66	Apalutamide 240mg tablets	£74,758,002
67	Risankizumab 150mg/1ml solution for injection pre-filled disposable devices	£74,614,177
68	Dostarlimab 500mg/10ml solution for infusion vials	£74,192,133
69	Upadacitinib 15mg modified-release tablets	£73,859,614
70	Venetoclax 100mg tablets	£72,987,223
71	Isatuximab 500mg/25ml solution for infusion vials	£72,789,066
72	Nivolumab 600mg/5ml solution for injection vials	£70,748,183
73	Burosumab 30mg/1ml solution for injection vials	£68,307,360
74	Olaparib 150mg tablets	£66,804,861
75	Axicabtagene ciloleucel 40million-200million cells/68ml dispersion for infusion bags	£66,466,887
76	Ocrelizumab 920mg/23ml solution for injection vials	£65,661,299
77	Elbasvir 50mg / Grazoprevir 100mg tablets	£65,564,723
78	Avacopan 10mg capsules	£64,906,072
79	Ibrutinib 420mg tablets	£63,816,339
80	Posaconazole 100mg gastro-resistant tablets	£63,466,522
81	Bevacizumab 400mg/16ml solution for infusion vials	£63,200,938
82	Trastuzumab deruxtecan 100mg powder for solution for infusion vials	£62,968,035
83	Abemaciclib 50mg tablets	£62,861,076
84	Trastuzumab 600mg/5ml solution for injection vials	£62,831,307
85	Ustekinumab 130mg/26ml solution for infusion vials	£62,601,400
86	Avelumab 200mg/10ml solution for infusion vials	£62,580,480
87	Faricimab 28.8mg/0.24ml solution for injection vials	£62,444,448
88	Tocilizumab 162mg/0.9ml solution for injection pre-filled disposable devices	£61,979,846
89	Iohexol 755mg/ml (Iodine 350mg/ml) solution for injection 500ml plastic bottles	£60,963,310
90	Dupilumab 300mg/2ml solution for injection pre-filled syringes	£60,922,163
91	Guselkumab 100mg/1ml solution for injection pre-filled disposable devices	£60,648,750
92	Filgrastim 30million units/0.5ml solution for injection pre-filled syringes	£60,438,152
93	Secukinumab 150mg/1ml solution for injection pre-filled disposable devices	£58,772,009
94	Lenalidomide 15mg capsules	£58,586,373
95	Ipilimumab 50mg/10ml solution for infusion vials	£58,293,300
96	Migalastat 123mg capsules	£58,089,245
97	Sodium chloride 0.9% infusion 100ml bags	£57,961,279
98	Meropenem 1g powder for solution for injection vials	£57,828,778
99	Lanreotide 120mg/0.5ml solution for injection pre-filled syringes	£57,483,076
100	Ipilimumab 200mg/40ml solution for infusion vials	£57,248,625