Thank you for your request for information about the following: 

Request 

I am writing to make a request under the Freedom of Information Act 2000. 

I am researching NHS prescribing patterns for PCSK9 inhibitors in England, in the context of cardiovascular disease prevention policy. I would be grateful if you could provide the following information. 

1 — Community prescribing (primary care and outpatient) 

For the most recent full financial year available, and for each of the two preceding financial years (i.e. three years in total), please provide: 

(a) The total number of prescription items dispensed in the community in England for each of the following chemical substances / branded medicines: 

    — Evolocumab (brand name: Repatha) 

    — Alirocumab (brand name: Praluent) 

    — Inclisiran (brand name: Leqvio) 

(b) The Net Ingredient Cost (NIC) associated with each of the above for each year. 

(c) Where possible, an estimate of the number of individual patients receiving each medicine (noting that one patient may generate multiple prescription items per year). 

2 — Secondary care / homecare supply 

I understand that evolocumab in particular is classified as a 'red drug' on the NHS formulary and is typically supplied via hospital homecare companies rather than community pharmacies. To the extent that the NHSBSA holds or has access to secondary care medicines data (including via the Rx-Info/Prescribing Costs in Hospitals and the Community dataset): 

(a) Please provide the equivalent volume and cost data for evolocumab, alirocumab, and inclisiran dispensed via hospital pharmacy or homecare routes in England for the same three financial years. 

(b) If the NHSBSA does not hold this data directly, please advise which NHS body does hold it and confirm whether an FOI request to that body would be the appropriate route. 

3 — Private prescriptions 

(a) To the extent that the NHSBSA captures data on private prescriptions dispensed in England, please provide the number of private prescription items for evolocumab, alirocumab, and inclisiran for the same three financial years, with a note on the completeness and limitations of this data. 

(b) If private prescription data for these medicines is not held, please confirm this explicitly. 

4 — NICE expected uptake versus actual uptake 

(a) At the time NICE Technology Appraisal 394 (evolocumab) and Technology Appraisal 393 (alirocumab) were published in June 2016, NICE produced Resource Impact Reports estimating the expected number of patients who would be eligible for and receive these treatments. Please provide any data held by the NHSBSA on actual versus projected uptake of these medicines since 2016. 

(b) Please provide any data held in connection with the NHS England Pathway Transformation Fund for PCSK9 inhibitors, including the number of additional patients initiated on treatment as a result of that programme and in which Integrated Care Board areas. 

PURPOSE OF THE REQUEST 

This information is being sought for policy research purposes, specifically to document the scale of NHS prescribing of PCSK9 inhibitors relative to the estimated eligible population, as part of a submission to NICE and NHS England on cardiovascular disease prevention policy regarding Lipoprotein(a). 

I am happy to receive the data in any standard electronic format (Excel, CSV, or PDF). If any part of this request would exceed the appropriate cost limit under Section 12 of the FOI Act, I would be grateful if you could advise which elements fall within the limit and provide those, advising me on how to refine the remainder. 

The NHS Business Services Authority (NHSBSA) received your request on 15 April 2026. 

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

Our response 

I can confirm that the NHSBSA holds some of the information you have requested and a copy of the information is attached. 

Please read the below notes to ensure correct understanding of the data. 

Data Source:  

NHSBSA Information Services Data Warehouse 

Time Period:  

Data covers financial years 2022/2023, 2023/2024 and 2024/2025.  The data is presented by financial year. 

Contents:   

The data in this FOI release relates to prescribing of the following PCSK9 inhibitors (BNF Chemical Substance code in brackets): 

Inclisiran (0212000AM) 

Evolocumab (0212000AH) 

Alirocumab (0212000AI) 

The data provided is based on prescribing by GP practices in England only. 

In the UNIQUE_IDENTIFIED_PATIENTS totals in the question 1 data, patients who could not be identified by means of a valid NHS number on the prescription form are excluded. The figures for the number of identifiable patients should not be combined and reported at any other level than provided as this may result in the double-counting of patients. 

Exclusions: 

The data excludes: 

• Items not dispensed, disallowed and those returned to the contractor for further clarification.  

• Prescriptions prescribed and dispensed in Prisons, Hospitals and Private prescriptions. 

• Items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser. 

Please note we are unable to categorically state what medication was physically dispensed by the contactor; the data shows the medication for which payment was claimed. 

NHSBSA Prescription Services process prescriptions and information is then used to make payments to pharmacists and appliance contractors (in England) for prescriptions dispensed in primary care settings. This involves processing approximately 1 billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health users. 

Question 1: Community prescribing (primary care and outpatient) 

I can confirm that the NHSBSA holds the information you have requested and a copy of the information is attached. 

Question 2: Secondary care / homecare supply 

Under Section 21 of the FOIA we are not required to provide information in response to a request if it is already reasonably accessible to you.  

The information you requested on hospital activity data is available on the NHSBSA Open Data Portal at: 

https://opendata.nhsbsa.net/dataset/secondary-care-medicines-data-indicative-price   

Please note this data relates to information on hospital pharmacy stock control, and is provided by RxInfo, a third-party organisation that collates the data and provides a copy to NHSBSA for release.  Any queries relating to the sourcing or collation of the data should be directed to RxInfo.  The data may contain activity which is supplied by Homecare organisations, but this is not made explicit in the data provided. 

Please see the following link to view the section 21 in full - https://www.legislation.gov.uk/ukpga/2000/36/section/21 

Question 3: Private prescriptions 

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. No private prescriptions for the chemical substances in question were submitted to NHSBSA for payment in the time period specified.  

Additionally, the NHSBSA do not hold information on treatments which have been provided as a private service by pharmacies, or other healthcare providers. 

Question 4: NICE expected uptake versus actual uptake 

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. 

Data Queries 

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data. 

Reusing the data and copyright 

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented. 

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: 

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/  

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2026”. Failure to do so is a breach of the terms of the licence. 

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.