OBJECTIVES: In Financial Year (FY) 2018/19, NHS England (NHSE) spent £7.9 billion on prescription drugs prescribed by GPs to their patients. This is 2.7% less than FY 2017/18. This study investigated drivers of this trend at regional and drug-class levels on a risk-adjusted basis and projected the results over a five year time period.

METHODS: Publicly available data was used. Prescription drug and population data published by the NHS were used to derive the per person per month costs. The prescription drug risk-adjustment factors were based on those used in the NHS funding allocation formula. Prescription drug cost and activity trends were analysed at a drug-class (BNF chapter) and regional level. Regions were defined by sustainability and transformation plan (STP) area. Risk-adjustment helped determine what cost we would ‘expect’ based on each STP’s risk profile compared to the English average. Costs were projected over a five-year period under various scenarios, using expected changes in population size and structure published by the NHS.

RESULTS: The reduction in expenditure is driven by a combination of lower average costs (3.83% decrease) and lower levels of activity (0.92% decrease). These decreases in total cost are slightly offset by the 1.19% increase in the English population size. The research highlights particular BNF chapters and STP regions that are driving these trends as well as how STP regions’ experience compares to the English average on a risk-adjusted basis. The projection model shows that prescription drug costs can be expected to decrease by 3.6% p.a. over the next five years if historical trends persist.

CONCLUSIONS: The insights provided by this research can help stakeholders with experience analysis and planning by identifying cost and activity drivers on a population risk-adjusted basis as well as having a view of how demand may develop over the projection period.