Thank you for your request for information about the following:

Request

‘Under the Freedom of Information Act 2000, please provide the following data regarding prescription costs for patients holding a Medical Exemption (MedEx) certificate for type 1 diabetes for the most recent financial year (2024/25):

Total Gross Expenditure: The total annual cost of all prescriptions (of any type) issued to patients with a diabetes medical exemption.

Core Clinical Management: The portion of the total spend allocated to Insulin and Glucagon (BNF section 6.1.1).

Clinical Equipment: The portion of the total spend allocated to delivery and testing equipment (pumps, syringes, needles, CGMs, Flash sensors, and test strips).

Non-Clinical Hypo Treatments: The portion of the total spend allocated to specialist glucose/dextrose products (e.g., GlucoGel, Dextro Energy tablets, Lift Juice) excluding Glucagon.

Non-Diabetes Related Spend: The total spend on all other medications not listed above (e.g., antibiotics, statins, etc.) issued for free under these exemptions. For this category I would also like to see how much is lost to the NHS due to no prescription charge being applied.

Please provide these figures as Gross Ingredient Cost (GIC) to ensure the data reflects the actual cost of the items before any discounts or charges.’

The NHS Business Services Authority (NHSBSA) received your request on 29 January 2026.

We have handled your request under the Freedom of Information Act 2000 (FOIA).

Our response

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. We cannot provide the information as we do not hold the condition for which a drug was prescribed and a MEDEX certificate covers patients with a range of conditions.

We also only hold one exemption reason per exempt prescription, but patients can be exempt for multiple reasons e.g. both MEDEX and low income, or if they are age exempt, we might just capture that. Therefore, we can't calculate the total spend where MEDEX was applicable, only where MEDEX was captured as the exemption.

Advice and assistance

You may find the following link useful:

https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england/prescription-cost-analysis-england-202425

This provides cost summaries by BNF or by exemption category in the management information.

You should refer to the background information and methodology note to see the definitions used. Specifically, there is an explanatory note about the term 'Gross Ingredient cost' that is used in Scotland but not in Prescription Cost Analysis (PCA).

We could provide a breakdown by drug grouping where MEDEX is recorded as the exemption, subject to you specifying the relevant BNF codes. However, this would not be diabetes-specific and would not capture all diabetes-related exemptions, as patients may be exempt for multiple reasons.