Presentation (CTI)

OBJECTIVES: Pharmaceutical value assessment in the NHS has been constrained by data fragmentation — prescribing records sit separately from hospital activity, cost and patient phenotype, preventing a unified view of where medicines spend creates clinical and economic value. CF built an integrated view and tested whether allocating medicines spend to population segments provides a more actionable basis for payer conversations and outcomes-based agreements than therapy-area or BNF-chapter views.
METHODS: CF integrated national datasets covering 57.3m patients in England (Hospital Episode Statistics, National Cost Collection 2024/25, English Prescribing Dataset, Hospital Prescribing Data Collection, Secondary Care Medicines Data). Active medicinal products were classified by BNF chapter, linked to ICD-10 diagnosis groups, and attributed to eight population segments. Total measured branded medicines spend for FY2024 (£21.3bn, ABPI VPAG full year) was rolled up by product, BNF chapter and population segment.
RESULTS: Total acute and primary care HCRU was £106.5bn/year, of which medicines accounted for £21.3bn (20%). Multi-morbidity alone drove £40.5bn of healthcare resource utilisation and £6.0bn of medicines spend across an 8.6m population; end-stage/end-of-life patients (0.26m) consumed £8.2bn at £31,974 per capita vs £308 for generally healthy. Distributions varied by chapter: malignant disease (£3.6bn) was 82% cancer; CNS therapies (£2.5bn) spanned mental illness (22%), multi-morbidity (28%) and single long-term condition (LTC) (18%); cardiovascular spend (£1.8bn) was 45% multi-morbidity and 38% single LTC; immunological and vaccines (£655m) were 70% generally healthy. Multi-morbidity was the single largest segment of medicines spend across most chronic-disease chapters (~28-46%).
CONCLUSIONS: Linking national prescribing and activity data through a common segmentation framework enables consistent, per-segment value assessment of medicines across the full care pathway. It supports outcomes-based contracting anchored on the segments where a product's impact concentrates, real-world evidence generation, and population-level value cases for branded therapies. The methodology is scalable and applicable to manufacturer- and payer-requested therapy-area deep-dives.