Use of High-Cost Medicines in Secondary Care Settings in the English National Health Service
Author(s)
Edward Burn, DPhil, Elin Rowlands, BSc, MSc.
Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.
Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom.
OBJECTIVES: To describe the use of high-cost medicines in English NHS secondary care settings and characterise the patients receiving them.
METHODS: Three data partners participated in the study. Barts Health NHS Trust, University College London Hospitals, and Lancashire Teaching Hospitals. The study period was 1st January 2022 to end of data capture. High-cost medicines of interest were identified based on the NHS England high-cost drugs commissioning list and the NHS Payment Scheme workbook. Only single ingredient medications were included in the study, with combination therapies and those given with a specific route of administration excluded. In total, 612 high-cost drugs that satisfied these criteria were included.
RESULTS: Across the data partners, 349 high-cost medicines were identified. A total of 331 high-cost medicines were seen in UCLH, 174 in Barts, and 117 in Lancashire. Vancomycin, an antibiotic medication used to treat certain bacterial infections, was the most commonly seen high-cost medicine in Barts and Lancashire. Meanwhile, immunoglobulin G, used to treat antibody deficiencies related to inflammatory and immune-mediated diseases, was the most common high-cost medicine in UCLH (Table 1). Other medications most common across data partners included immunosuppressants used to prevent rejection in organ transplantation (mycophenolate mofetil, tacrolimus), and a synthetic somatostatin analogue used for various indications (Cyclosporine).
CONCLUSIONS: We have described the use of 331 different high-cost medicines in secondary care settings in the English NHS. Using data mapped to the OMOP CDM from 3 different partners from the HERON-UK network has allowed us to identify high-cost medicines in different secondary care settings and summarise the demographics of those receiving them. This study provides a foundation for additional work to understand the economic burden of high cost-medicines, to characterise the individuals receiving them, and to explore variation in their use between and within secondary care centres.
METHODS: Three data partners participated in the study. Barts Health NHS Trust, University College London Hospitals, and Lancashire Teaching Hospitals. The study period was 1st January 2022 to end of data capture. High-cost medicines of interest were identified based on the NHS England high-cost drugs commissioning list and the NHS Payment Scheme workbook. Only single ingredient medications were included in the study, with combination therapies and those given with a specific route of administration excluded. In total, 612 high-cost drugs that satisfied these criteria were included.
RESULTS: Across the data partners, 349 high-cost medicines were identified. A total of 331 high-cost medicines were seen in UCLH, 174 in Barts, and 117 in Lancashire. Vancomycin, an antibiotic medication used to treat certain bacterial infections, was the most commonly seen high-cost medicine in Barts and Lancashire. Meanwhile, immunoglobulin G, used to treat antibody deficiencies related to inflammatory and immune-mediated diseases, was the most common high-cost medicine in UCLH (Table 1). Other medications most common across data partners included immunosuppressants used to prevent rejection in organ transplantation (mycophenolate mofetil, tacrolimus), and a synthetic somatostatin analogue used for various indications (Cyclosporine).
CONCLUSIONS: We have described the use of 331 different high-cost medicines in secondary care settings in the English NHS. Using data mapped to the OMOP CDM from 3 different partners from the HERON-UK network has allowed us to identify high-cost medicines in different secondary care settings and summarise the demographics of those receiving them. This study provides a foundation for additional work to understand the economic burden of high cost-medicines, to characterise the individuals receiving them, and to explore variation in their use between and within secondary care centres.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR232
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Real World Data & Information Systems
Topic Subcategory
Reimbursement & Access Policy
Disease
Biologics & Biosimilars, No Additional Disease & Conditions/Specialized Treatment Areas, Oncology