NHS hospital prescribing costs remain high

New and expensive treatments are continuing to drive up NHS prescribing costs in England’s hospitals.

This is according to a new IMS Health report, commissioned by the NHS, which found that hospital prescribing costs in England increased by 6.9% in 2011, far outstripping the 1.9% growth seen in primary care.

The rate of increase is down on last year, however, when hospital prescribing costs grew by 7.7 per cent.

The report, which is released annually each autumn by the NHS Prescribing Centre, says that the greater rate of growth in medicines used in hospitals is likely to be related to the introduction of new and innovative medicines, many of which have a relatively high cost.

Topping the hospital spending table were two arthritis drugs, led by Abbott’s Humira (adalimumab), spending on which was up 18.3% to £214.3 million in 2011.

Humira took the 2009 top spot from Pfizer and Amgen’s arthritis drug Enbrel (etanercept), which came in a close second at £207.1 million, up 15.2% on 2010.

Novartis’ eye disease drug Lucentis (ranibizumab) rounded off the top three with spending growing by 20.5% to £155.1 million, apparently remaining unaffected by off-label competition from Roche’s cancer drug Avastin (bevacizumab).

The biggest drops came from Janssen’s atypical antipsychotic drug Risperdal (risperidone), spending on which fell by 19.8% to £17.8 million.

The top 10 drugs were mainly biologics used to treat either autoimmune diseases, such as arthritis, or certain cancers.

The difficulty in copying biologics means most will not succumb to the same generic pressures as many primary care drugs, and consequently the cost for the NHS in England will continue to grow. Meanwhile, manufacturers are likely to make more innovative forms of their existing drugs, which could further push costs up.

Hospital prescribing costs now account for 33.3% of all prescribing costs in England, up 1.6% from 2010.

In contrast the primary care drugs bill, which takes up the majority (65.3%) of the £13.1 billion spent on medicines in the English NHS, is expected to shrink by around £1 billion over the next four years due to a raft of patent expiries, with costs for GP prescribing falling by 0.4% in 2011.

Post script: The report’s authors note that hospital prescribing data is notoriously difficult to pin down as there is no central collation of information, and some hospitals may have been given price cuts for certain drugs that has not been shown in the data.


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