Primary care prescriptions: April 2023 to March 2024
This release provides statistics on items prescribed by primary care practitioners in Wales and dispensed in the community (usually in community pharmacies) in the UK for April 2023 to March 2024.
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In this page
Introduction
This statistical release provides an annual summary of items prescribed by primary care practitioners in Wales and dispensed in the community, usually through community pharmacies.
The primary measure for items prescribed counts those prescribed through general practices in Wales only, which have been dispensed in the community, anywhere in the UK. Separate statistics are also provided for items prescribed by other primary care practitioners (NHS dental practitioners, pharmacists and optometrists).
For consistent comparisons between UK countries, analysis should be done using a secondary measure, ‘prescriptions dispensed in the community’. This measure counts all prescriptions dispensed in community pharmacies, based on the location of the pharmacy rather than the prescriber. A comparison of general practice prescriptions and prescriptions dispensed in the community is provided in Table 1 and further details are provided in the Which data should I use? section.
'Items’ refer to each different medicine or appliance listed on a prescription regardless of quantity or volume. Only items which are dispensed are counted.
Items prescribed and dispensed within hospitals are not counted in either measure, but if a prescription was issued by a hospital doctor and later dispensed at a community pharmacy, it would be counted in the secondary measure of prescriptions dispensed in the community.
Main points
- Almost 85 million items were prescribed by all primary care practitioners in Wales and dispensed in the community in the UK, in 2023-24.
- Of these, 84.6 million items were prescribed through general practices, an increase of 430,000 items (or 0.5%) since 2022-23 and the highest number on record.
- 224,000 items were prescribed by dental practitioners, a decrease of 12.3% from the previous year.
- 80,000 items by pharmacists working in community pharmacies, an increase of 93.4% from the previous year.
- 20,000 items by optometrists, an increase of 30.7% from the previous year.
- The number of items prescribed through general practices in Wales and dispensed in the community in the UK has increased steadily over the longer-term with 7.8% more items prescribed in 2023-24 than ten years ago.
- The number of items prescribed through general practices per patient registered with a GP was 25.7 in 2023-24, unchanged from the previous year, but 1.0 items per patient higher than ten years ago.
- Almost 60% of items prescribed through general practices in Wales were to treat conditions affecting either the cardiovascular system, central nervous system, or endocrine system.
- Total net ingredient cost of items prescribed through general practices increased by 4.6% compared with the previous year and increased by 21.1% compared with ten years ago.
- The net ingredient cost per patient registered with a GP in Wales was £214.10, £8.35 higher than the previous year and £30.86 higher than ten years ago.
- There are variations between the number of items prescribed and dispensed between Welsh health board areas. The number of items prescribed and dispensed per prescribing unit in the health board with the lowest number of items (Cardiff and Vale) was 27.8% fewer than in the health board with the most amount of items (Cwm Taf Morgannwg).
- More items were prescribed and dispensed to patients living in more deprived areas than in less deprived areas; 1.5 (or 5.9%) more items were prescribed per patient registered with a GP in the two most deprived quintiles compared to the least two deprived quintiles.
- More prescription items per population were dispensed in Wales than any of the other UK countries. However, a greater proportion of items dispensed in Wales were of relatively low cost, as items dispensed in Wales had the lowest net ingredient cost per prescription item dispensed of all four countries.
General practice prescriptions
Statistics in this section are based on items prescribed by practitioners working in general practices in Wales. This includes all items prescribed by GPs as well as nurses, pharmacists and other qualified prescribers that are employed directly in general practices.
It also includes a relatively small number of items dispensed in the community which had been prescribed in non-hospital or general practice settings which have been allocated a prescribing code (W code) by the local health board. These include settings such as specialist continence services, prisons, police stations and public health services. In 2023-24, items from these settings accounted for less than 0.5% of all items prescribed.
It does not include items prescribed by practitioners working in NHS dental practices, pharmacies or optometry practices (which are shown separately in Figure 9) or prescriptions through any non-NHS service.
Figure 1: Items prescribed through general practices in Wales and dispensed in the community in the UK, 2014-15 to 2023-24
Description of Figure 1: Chart showing the number of items prescribed and dispensed has increased steadily over the last ten years. The number of items prescribed per head has also increased marginally.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescriptions summary data by year on StatsWales
In 2023-24, there were 84.6 million items prescribed through general practices in Wales and dispensed in community pharmacies, the highest on record. This is equivalent to 25.7 items per patient registered with a GP in Wales.
Just over 430,000 more items were prescribed and dispensed in the community in 2023-24 compared to 2022-23, an increase of 0.5%.
The longer-term trend shows a broadly steady increase in the number of items prescribed and dispensed; the number of items increased by 3.0% in the last five years and by 7.8% in the last ten years. Similarly, the number of items prescribed and dispensed per patient registered with a GP increased by 0.4 in the last five years and by 1.0 in the last ten years.
Figure 2: Net ingredient cost of items prescribed by GPs in Wales and dispensed in the community in the UK, 2014-15 to 2023-24 [Note1]
Description of Figure 2: Chart showing that the net ingredient cost of all items prescribed through general practices and dispensed in the community has been on an upward trend over the last five years and the net ingredient cost per head has increased at a similar rate.
[Note 1] Net ingredient costs for all years are not adjusted for inflation. Standard adjustments for inflation are not considered appropriate as drug prices are subject to controls under the Pharmaceutical Price Regulation Scheme and to other central controls.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescriptions summary data by year on StatsWales
In 2023-24, the total net ingredient cost of all items prescribed through general practices in Wales and dispensed in the community in the UK was just over £704 million, equivalent to £214.10 per patient registered with a GP in Wales.
Total net ingredient costs increased by £31.2 million (or 4.6%) compared with the previous year. The cost per patient increased by £8.35.
In the three years before 2018-19, the total net ingredient cost had been on a slight downward trend, but it has increased in every year since. The net ingredient cost has increased by 18.6% in the last five years and by 21.1% in the last ten years.
The cost of items prescribed and dispensed per patient increased by £30.57 over the last five years and by £30.86 over the last ten years.
Figure 3: Average net ingredient costs per item prescribed through general practices in Wales and dispensed in the community, 2014-15 to 2023-24
Description of Figure 3: Chart showing the mean cost per item prescribed through general practices in Wales and dispensed in the community in the UK has increased slightly every year since 2018-19. The median cost per item has varied from year-to-year but has remained close to £1.90 over the last 10 years.
[Note 1] Mean cost per item is calculated by dividing the net ingredient cost for all items prescribed in the financial year by the number of items prescribed in the financial year.
[Note 2] Median cost per item, refers to middle value of the cost per item prescribed in the March of each year only. Data for a single month is used for practical purposes given the volume of prescription items issued. The median may vary for other months during the year.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Mean and median cost per item prescribed on StatsWales
In 2023-24, the mean net ingredient cost per item was £8.32. This was £0.33 higher than in 2022-23 and £0.92 higher than ten years ago.
The median cost per item in March 2024 was £1.88. This was £0.29 lower than in March 2023 but £0.22 higher than ten years ago.
The median cost per item is much lower than the mean cost per item as there were a relatively low number of items prescribed and dispensed with a very high net ingredient cost. These high-cost items will have a greater impact on the mean than the median. The median is the more appropriate measure to use to understand the cost of more ‘common’ prescription items.
British National Formulary (BNF) chapters
The British National Formulary (BNF) is a pharmaceutical reference book containing information and advice on prescribing. Every item prescribed is categorised by its BNF chapter (for example, central nervous system), section (for example, analgesics); sub-paragraph (for example, non-opioid analgesics and compound preparations) and chemical name (for example, paracetamol).
Data for all of these categories are provided on the prescriptions dashboard and spreadsheets linked on the ‘Data’ tab of the latest release page.
Figure 4: Number of items and percentage of total items prescribed through general practices in Wales and dispensed in the community in the UK, by British National Formulary (BNF) chapter, 2023-24
Description of Figure 4: Bar chart showing wide variation in the number and percentage of items prescribed between the 21 BNF chapters. Three quarters of all items prescribed were in five chapters: cardiovascular system; central nervous system; endocrine system; gastro-intestinal system; and respiratory system.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescription items and cost by area and BNF chapter (time series on StatsWales)
The BNF chapter with the most items prescribed was the cardiovascular system. In 2023-24, 23.5 million items (27.8% of all items) were prescribed and dispensed for treatment of the cardiovascular system, equal to 7.2 items per patient registered with a GP in Wales.
17.5 million items (20.6% of all items) were prescribed and dispensed for the treatment of the central nervous system, equal to 5.3 items per patient registered with a GP in Wales.
Other BNF chapters with more than 5% of all items prescribed included endocrine system (10.8%); gastro-intestinal system (9.3%); respiratory system (7.2%); and nutrition and blood (5.7%).
Figure 5: Net ingredient costs and percentage of total cost of items prescribed through general practices in Wales and dispensed in the community in the UK, by British National Formulary (BNF) chapter, 2023-24
Description of Figure 5: Bar chart showing wide variation in the net ingredient costs of items prescribed between the 21 BNF chapters. Two thirds of the total net ingredient cost were for items prescribed in five chapters: endocrine system; cardiovascular system; central nervous system; respiratory system; and nutrition and blood.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescription items and cost by area and BNF chapter (time series on StatsWales)
While nearly half of all items prescribed were for treatments of the cardiovascular and central nervous systems, their combined net ingredient cost was less than a third (29.1%) of the total cost.
The highest net ingredient costs (£123 million) were for endocrine system treatments, which accounted for a sixth (17.5%) of the total cost of all items prescribed.
The BNF chapters with the highest cost per item were preparations used in diagnosis (£87.50, but with only 3 items prescribed in the year); stoma appliances (£75.81); malignant diseases and immunosuppression (£28.45); and incontinence appliances (£27.06).
The chapters with the lowest cost per item were cardiovascular system (£4.37); musculoskeletal and joint diseases (£4.87); central nervous system (£5.83); and gastro-intestinal system (£5.84).
Most common items prescribed
This section focusses on the most common items (chemical names) prescribed through general practices in the latest financial year.
Figure 6: The 10 items most commonly prescribed through general practices in Wales and dispensed in the community in the UK, 2023-24
Description of Figure 6: Bar chart showing the ten most common items varied from Atorvastatin (3.6 million items) to Salbutamol (1.6 million items).
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Atorvastatin (a lipid-regulating medicine) was prescribed just more than 3.6 million times and was the most prescribed item in 2023-24. This is equivalent to one in every 23 (or 4.3%) of all items prescribed.
The ten most common items accounted for just more than a quarter (27.0%) of all items prescribed in 2023-24 and all ten were also the ten most prescribed items in 2022-23.
Prescriptions for five of the items increased from the previous year, with the largest increases for Atorvastatin (6.2%) and Sertraline Hydrochloride (2.2%).
Prescriptions decreased from the previous year for the five other items, with the largest decreases for Salbutamol (7.4%) and Levothyroxine Sodium (2.0%).
Prescriptions by staff in general practices
While most items are prescribed by general practitioners (GPs), some other staff roles employed in general practices are also qualified to prescribe items.
Figure 7: Items prescribed by GPs in Wales and dispensed in the community in the UK, 2019-20 to 2023-24
Description of Figure 7: Line chart showing that the number of items prescribed by GPs has increased slightly in every year since 2020-21, with nearly 81.8 million items prescribed by GPs in the latest year.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Items prescribed by practitioner type on StatsWales
Figure 8: Items prescribed by wider staff in general practices in Wales and dispensed in the community in the UK, 2019-20 to 2023-24 [Note 1]
[Note 1] Each year there are a small number of items prescribed which were not coded to a practitioner type. In 2023-24, there were 75 items prescribed without an associated practitioner type.
[Note 2] Includes paramedics, physiotherapists, and other qualified prescribers providing direct patient care.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Items prescribed by practitioner type on StatsWales
Between 2019-20 and 2023-24, the large majority of items prescribed in general practice were from GPs and the number of items prescribed by GPs has steadily increased over the time period increased. However, the proportion of all items prescribed by GPs has decreased slightly from 97.4% in 2019-20 to 96.7% in 2023-24.
In 2023-24, more than 1.5 million items were prescribed by nurses, an increase of 2.1% from the previous year. In total, 1.8% of all items prescribed in general practices in Wales and dispensed in the UK were issued by nurses.
Almost 1.2 million items were prescribed by pharmacists working in general practices, an increase of 9.9% from the previous year. In total, 1.4% of all items prescribed through general practices in Wales and dispensed in the UK were issued by pharmacists.
Just over 76,000 items were prescribed by other staff in general practice which includes direct patient care practitioners such as paramedics and physiotherapists.
Items prescribed by primary care practitioners outside general practice
Items can be prescribed by other primary care practitioners who work in NHS dental practices, community pharmacies and optometry practices. This does not include items prescribed in hospitals or items prescribed through non-NHS providers.
Figure 9: Items prescribed by other primary care practitioners in Wales and dispensed in the community in the UK, 2020-21 to 2023-24
Description of Figure 9: Line chart showing that the majority of items prescribed outside of general practices were from NHS dental practitioners. However, the number of items prescribed by dentists has decreased every year since 2020-21. A smaller number of items have been prescribed in pharmacies and optometry practices, but this number has increased in every year since 2020-21.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Items prescribed by practitioner type on StatsWales
In 2023-24, just fewer than 225,000 items were prescribed through NHS dental practices, a 12.3% decrease from the previous year.
Just more than 80,000 items were prescribed through community pharmacies, almost twice (93.4% increase) the number provided in the previous year.
Just more than 20,000 items were prescribed through optometrists, almost a third more (30.7%) than the previous year.
In addition, while not a primary care service, 250 items were prescribed directly through the Welsh Ambulance Services NHS Trust in 2023-24. While this was a very small number of items compared to other practitioners, it was an increase of 44.5% from the previous year.
Emergency medicine supply
In certain emergency circumstances, such as patients losing medication or patients unexpectedly running out of medication, community pharmacists can provide a limited quantity of medicines without a prescription. These are counted separately to items prescribed directly by community pharmacists and are therefore not included in the data for Figure 9.
Figure 10: The 10 most common medicines provided through emergency medicine supply, 2023-24
Description of Figure 10: Bar chart showing the 10 items that were most commonly items prescribed through the emergency medicine supply scheme in 2023-24 ranged from Ramipril (7,581 items) to Metformin Hydrochloride (3,846 items).
Source: Choose Pharmacy System, Digital Health and Care Wales
In total, nearly 158,000 items were dispensed by pharmacists through the emergency medicine supply, an increase of 20.2% from the previous year.
681 different items were prescribed, but the most common 10 items accounted for 38.4% of the total.
In 2023-24, the medication most commonly dispensed through the emergency medicine supply was Ramipril, a drug used to treat high blood pressure. This was followed by Sertraline hydrochloride (primarily used to treat depression or anxiety) and Atorvastatin (primarily used to treat high blood cholesterol).
Prescription volumes
In October 2022, the All Wales Medicines Strategy Group recommended that patients, general practices and community pharmacies would all benefit from longer prescribing intervals, where clinically appropriate. In practice, if a two-months supply of medication was provided, instead of a one-month supply, patients would still get the same amount of medication but need fewer visits to GPs and pharmacies.
Over time this policy change would result in fewer items being prescribed to some patients to treat certain conditions, but the volume of the item per prescription would increase.
As the same items can be prescribed in various forms (liquid/tablets/powder) and in different volumes, it is not possible to measure the volume of items prescribed fairly, across the whole range of items prescribed. However, a sample of 44 medications, known as the ‘28-day basket’ of medications can be used as an approximation of prescription volume. These 44 medications are usually taken as once-daily doses, therefore the total quantity of tablets or capsules divided by the number of times the item is prescribed can give an indication of the average number of days of treatment prescribed.
Figure 11: Average prescription volume for medications in the ’28-day basket’ medications per month, March 2020 to March 2024
Description of Figure 11: Line chart showing that prescription volumes have increased marginally in most months since March 2022.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
In March 2024, there was an average of 29.9 doses per prescription in the ’28-day basket’ of medications. This was 0.7 doses per prescription (or 2.4%) higher than in March 2023 and 1.8 doses (or 6.2%) higher than in March 2022.
Analysis by local health board
The demographics of local health board areas in Wales are different and therefore their clinical needs are different. For example, patients registered at GP practices in Wales data (StatsWales) for October 2023 shows that 21.2% of the patients in Wales were aged 65 or over but this ranged between 27.6% in Powys to 16.2% in Cardiff and Vale.
To account for the different age profiles of each health board, health board analysis is provided by prescribing unit (PU), rather than simply by health board population. Prescribing units are calculated by giving a greater weight (by a factor of three) to the population aged 65 or over. This adjustment is made because older patients typically require more medications. By making this adjustment for age profiles, the differences between health boards when analysed on a prescribing unit basis are more likely to reflect differences in the health of the populations and differences in local prescribing culture.
Figures 12 to 14 provide analysis based on items prescribed through general practices only, based on the number of patients registered at GP practices mid-way through the financial year, in October 2023.
The number and cost of items prescribed by cluster and health board, categorised by BNF chapter is published separately on StatsWales.
Figure 12: Number of items prescribed through general practice in Wales and dispensed in the community in the UK, per prescribing unit, 2023-24
Description of Figure 12: Bar chart showing that the number of items prescribed in general practices in Wales and dispensed in the community in the UK, per prescribing unit ranged from 14.8 in Cardiff and Vale to 20.5 in Cwm Taf Morgannwg, in 2023-24.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescription items and costs by local health board prescribing unit on StatsWales
Figure 13: Net ingredient cost (£) of items prescribed through general practices in Wales and dispensed in the community in the UK, per prescribing unit, 2023-24
Description of Figure 13: Bar chart showing that the total net ingredient cost of items prescribed through general practices per prescribing unit ranged from £137.00 in Cardiff and Vale to £167.23 in Cwm Taf Morgannwg.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescription items and costs by local health board prescribing unit on StatsWales
Figure 14: Net ingredient cost per item prescribed through general practices in Wales and dispensed in the community in the UK, per prescribing unit, 2023-24
Description of Figure 14: Bar chart showing the average cost of items issued per prescribing unit ranged from £8.07 in Betsi Cadwaladr to £9.24 in Cardiff and Vale.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
Prescription items and costs by local health board prescribing unit on StatsWales
In 2023-24, there were large variations in the number of items prescribed and dispensed between each health board, with 27.8% fewer items prescribed per prescribing unit in Cardiff and Vale than in Cwm Taf Morgannwg.
Similarly, there were variations between the net ingredient costs for items prescribed in each health board with the cost per prescribing unit £30.23 (or 18.1%) lower in Cardiff in Vale than in Cwm Taf Morgannwg.
However, there was less variation in the cost per items prescribed, per prescribing unit, with six of the seven health boards within £0.26 of the Wales average. The highest cost per item, per prescribing unit was in Cardiff and Vale, 9.9% higher than the Wales average.
The statistics suggest fewer items per prescribing unit were required in Cardiff and Vale health board, but a higher proportion of the items prescribed were more expensive items than in other health boards. Conversely, more items per prescribing unit were required in both Cwm Taf Morgannwg, but a higher proportion of the items prescribed were relatively less expensive items than in other health boards.
Prescribing by cluster deprivation
Using Welsh Index of Multiple Deprivation (WIMD) and GP practice population data (StatsWales) it is possible to calculate an approximate measure of deprivation at general practice and GP collaborative/cluster level (Primary Care One, NHS Wales).
This section summarises items prescribed through general practices by cluster deprivation, using the deprivation measure for percentage of patients registered to practices who live in the most deprived 20% of areas in WIMD 2019. The 63 clusters are ranked from most deprived to least deprived and separated into broadly evenly sized quintiles. The most deprived quintile (quintile 1) contains the 13 clusters with the highest percentage of their population living in deprived areas. The least deprived quintile contains the 13 clusters with the lowest percentage of their population living in deprived areas.
Full details of the methodology used are available in the statistical article General practice and primary care cluster population and workforce by deprivation: at 31 December 2021.
Prescriptions data in this analysis only includes general practices operating under a General Medical Services (GMS) contract as these are part of clusters. In practice this includes all NHS GP practices and excludes non-general practice settings such as specialist continence services, prisons and police stations.
Figure 15: Number of items prescribed per patients registered with a GP by cluster deprivation quintile, 2023-24
Description of Figure 15: Bar chart showing the number of items prescribed by deprivation quintile ranged from 27.1 items per patient in the second most deprived quintile to 24.4 items per patient in the least deprived quintile.
Sources: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership; Welsh Index of Multiple Deprivation (WIMD), Welsh Government
Prescription items and costs by cluster deprivation quintiles on StatsWales
Figure 16: Net ingredient cost per item prescribed by cluster deprivation quintile, 2023-24
Description of Figure 16: Bar chart showing there was little variation in the net ingredient costs per item prescribed by deprivation quintile, which ranged from £8.16 per item in the most deprived quintile to £8.35 per item in the least deprived quintile.
Sources: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership; Welsh Index of Multiple Deprivation (WIMD), Welsh Government
Prescription items and costs by cluster deprivation quintiles on StatsWales
In 2023-24, there were small differences in the number of items prescribed and their cost across most cluster deprivation quintiles.
While the statistics do not show a totally linear relationship between the number of items prescribed and deprivation, 1.5 more items were prescribed per person in the two most deprived quintiles combined than in the two least deprived quintiles combined.
The largest number of items prescribed per person registered with a GP was in the second most deprived quintile, where 2.7 (or 10.0%) more items were prescribed than in the least deprived quintile.
The net ingredient cost per item prescribed only differed slightly between deprivation quintiles and the cost per item in the most deprived quintile was 20p lower than in the least deprived quintile, the largest difference between all quintiles.
This suggests while more items are prescribed to people living in more deprived areas, the items are of broadly similar costs to those prescribed to people in less deprived areas.
UK comparisons
This section compares the number of prescription items dispensed per head of population, the net ingredient cost (NIC) per population, and the cost per prescription item across the four UK countries.
The prescription data in this section is based on the location of the community pharmacy where items were dispensed, rather than by the location of the general practice which issued the prescription. Therefore, statistics for Wales in this section will differ from those presented in the other sections in the release. Prescriptions dispensed in the community is a consistent measure available across all four countries.
For consistency between countries, the latest available Office for National Statistics (ONS) mid-year population estimates (2023) are used in this section, rather than the number of people registered to a GP practice.
Note that the latest data for Wales and England refers to the financial year 2023-24, for Scotland the financial year 2022-23, and for Northern Ireland the calendar year 2023.
Figure 17: Prescription items dispensed in community pharmacies per population, UK countries, latest available year
Description of Figure 17: Bar chart showing that the number of items dispensed in the community, per population, ranged from 20.3 in Scotland to 27.0 in Wales in the latest available year for each country.
Sources: NHS Wales Shared Services Partnership (Wales), NHS Business Services Authority (England); Public Health Scotland (Scotland) and Business Services Organisation (Northern Ireland).
Figure 18: Net ingredient cost (£) per population of items dispensed, UK countries, latest available year
Description of Figure 18: Bar chart showing the net ingredient cost of items dispensed per head of population ranged from £189.39 in England to £263.80 in Northern Ireland.
Sources: NHS Wales Shared Services Partnership (Wales), NHS Business Services Authority (England); Public Health Scotland (Scotland) and Business Services Organisation (Northern Ireland).
Figure 19: Net ingredient cost (£) per prescription item dispensed, UK countries, latest available year
Description of Figure 19: Bar chart showing the net ingredient cost per prescription item varied from £8.15 in Wales to £11.20 in Scotland.
Sources: NHS Wales Shared Services Partnership (Wales), NHS Business Services Authority (England); Public Health Scotland (Scotland) and Business Services Organisation (Northern Ireland).
There is variation in prescribing between countries, which is likely to be explained by different prescribing policies, different population health needs, and different prescribing cultures in each location.
6.7 more items per population were dispensed in Welsh community pharmacies compared to Scottish community pharmacies. However, the total net ingredient costs of those items per population was £7.09 lower in Wales than in Scotland.
The net ingredient cost per prescription item was £8.15 in Wales, the lowest of all UK countries. This was £3.05 cheaper than in Scotland, £3.01 cheaper than Northern Ireland and £0.86 cheaper than in England.
This means that while more items are dispensed in Wales, the items cost less than those dispensed in other countries. This may be explained by a number of factors including: lower volumes of items prescribed in Wales compared to other countries; differences in types of items prescribed in each country; and the availability of certain items in each country. This is particularly a factor in for Wales as certain more expensive stoma appliances are only available for dispensing is specialist settings located in England.
Quality and methodology information
Detailed quality and methodology information is published in the accompanying quality report.
NHS Shared Service Partnership also publish data on items prescribed through general practices every month, based on the same data which is presented in this publication.
An interactive data tool that allows users to search data on BNF chapters, sections, and sub paragraphs, based on general practice prescriptions is published alongside this release. Data for 2023-24 will be updated in this tool as soon as practicable after the publication date.
Data for England (Prescription Cost Analysis - England (NHS Business Service Authority)), Scotland (Dispenser payments and prescription cost analysis (Public Health Scotland)) and Northern Ireland (Prescription Cost Analysis (Business Services Organisation)) is published on each country’s respective website.
Complementary data on general practice workforce, general practice populations (StatsWales), deprivation at general practice level and community pharmacies are also published by Welsh Government.
Average cost calculations
The mean net ingredient cost is calculated by taking the total net ingredient cost for all prescription items and dividing by the total number of items prescribed during the whole financial year.
The median net ingredient cost is calculated by taking the middle amount when all costs per item are ranked in order from cheapest to most expensive; half of all costs are less than or equal to this amount, and the other half are more than or equal to this amount. This calculation is done on items dispensed in March of each year only, for practical calculation purposes given the large number of items dispensed in a year.
Which data should I use?
Table 1: Comparison of items prescribed through general practices in Wales and dispensed in the community in the UK; and items prescribed anywhere in the UK and dispensed in the community in Wales, 2023-24
| BNF Chapter Name | GP prescriptions (thousands) | Prescriptions dispensed in the community (thousands) | Difference (thousands) |
|---|---|---|---|
| Gastro-Intestinal System | 7,841.7 | 7,883.9 | -42.2 |
| Cardiovascular System | 23,533.4 | 23,577.5 | -44.1 |
| Respiratory System | 6,123.4 | 6,156.3 | -32.9 |
| Central Nervous System | 17,460.0 | 17,746.3 | -286.3 |
| Infections | 2,504.0 | 2,792.0 | -288.0 |
| Endocrine System | 9,125.5 | 9,184.1 | -58.6 |
| Obstetrics,Gynae+Urinary Tract Disorders | 2,208.4 | 2,226.8 | -18.3 |
| Malignant Disease & Immunosuppression | 411.7 | 442.2 | -30.5 |
| Nutrition And Blood | 4,824.1 | 4,887.0 | -63.0 |
| Musculoskeletal & Joint Diseases | 2,339.7 | 2,371.6 | -31.9 |
| Eye | 1,051.7 | 1,104.4 | -52.7 |
| Ear, Nose And Oropharynx | 1,004.4 | 1,053.5 | -49.1 |
| Skin | 1,848.2 | 1,914.0 | -65.8 |
| Immunological Products & Vaccines | 720.1 | 720.1 | 0.0 |
| Anaesthesia | 106.5 | 108.6 | -2.1 |
| Other Drugs And Preparations | 78.7 | 75.9 | 2.7 |
| Dressings | 333.4 | 244.8 | 88.6 |
| Appliances | 2,597.3 | 2,547.0 | 50.4 |
| Incontinence Appliances | 108.7 | 44.0 | 64.7 |
| Stoma Appliances | 376.7 | 202.1 | 174.6 |
| Total | 84,597.5 | 85,282.0 | -684.5 |
Description of Table 1: Table showing 84.6 million items were prescribed through general practices in Wales and dispensed in the community in the UK, compared to 85.3 million items prescribed by anywhere in the UK and dispensed in Welsh community pharmacies.
Source: Pharmacy and Dispensing Systems, NHS Wales Shared Services Partnership
In general, when analysing prescriptions data for Wales, items prescribed through general practices (labelled ‘GP prescriptions’ in Figure 20) should be used as the primary source. This is because this data shows what is being prescribed to people registered with Welsh GP practices and this activity is monitored and influenced by health boards. This data includes items that are prescribed in by GPs as well as other licensed prescribers who are employed in general practices (mainly nurses and pharmacists). The items prescribed in Welsh general practices can be dispensed in any community dispensary in the UK (usually community pharmacies).
‘Prescriptions dispensed in the community’ should be used for more specific purposes where users are interested only in the items actually dispensed in Wales, and if direct comparisons are being made between different UK countries. While the number of items prescribed by GPs is close to the number of items prescribed and dispensed in Wales it does not exactly match for a number of reasons including:
- Items prescribed in Wales but dispensed elsewhere in the UK (including the Isle of Man) are counted in general practice prescriptions but not ‘prescriptions dispensed in the community’. This is particularly common for specialist items such as stomas and incontinence appliances which are often dispensed by appliance contractors, many of which are not located in Wales.
- Items prescribed in another UK country (including the Isle of Man) but dispensed in Wales are not included in general practice prescriptions, but are included in ‘prescriptions dispensed in the community’
- Items which were prescribed by hospital practitioners, which are subsequently dispensed in a community pharmacy, will not be included in general practice prescriptions, but they would be included in ‘prescriptions dispensed in the community’
Note that both ‘general practice prescriptions’ and ‘prescriptions dispensed in the community’ capture prescriptions which are dispensed by dispensing doctors, appliance contractors and community (high street) pharmacies. Neither source contains data for items prescribed and dispensed in hospitals.
Also note that net ingredient costs (NIC) are not adjusted for inflation.
Statement of compliance with the Code of Practice for Statistics
Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.
These official statistics in development demonstrate the standards expected around trustworthiness, quality and public value in the following ways.
Trustworthiness
The published statistics are compiled by professional analysts using the latest available data and applying methods using their professional judgement and analytical skillset.
These statistics are pre-announced on the Statistics and Research area of the Welsh Government website. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice for Statistics.
Quality
Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs.
Value
The purpose of this statistical release is to provide an annual review of prescribing activity in primary care in Wales, with more specific underlying data published in spreadsheets, on open data StatsWales tables and a dashboard. These products allow all users access to the data and analysis they require, from high level summaries to individual chemical name data.
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.
