Thank you for your request for information about the following:

Please can I request how much in total the NHS spends on licensed and unlicensed medicines respectively each year. If used off-label, or it is unknown as to whether it was used on or off-label, that can be categorised as a licensed medicine. If possible could I have the data for the past five years, but if not then the most recent year will do. This was then clarified on 19th June with the following:

For 'NHS spend' read 'net ingredient cost for spend in the community' as you suggest. To clarify, by 'licensed' I meant MHRA-licensed drugs, and 'unlicensed' means unlicensed specials. Please provide data for calendar years. Please provide the net ingredient cost data for items prescribed in England and dispensed in the community in England.

Your request was received on 19th April and has been dealt with under the terms of the Freedom of Information Act 2000.

Response

A copy of the information is attached.

Data Source The data source was the NHSBSA Information Services Data Warehouse.

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.

Time Period 2018 - 2022 prescribing provided with a monthly breakdown

Organisation Limited to prescribing and dispensing in England

Licensing authority The Licensing Authority is recorded in the NHS Dictionary of Medicines and Devices (dm+d) against Actual Medicinal Products (AMPs).

These are medicines or devices that have been made available by a manufacturer or supplier but does not describe the pack size or the quantity.

However, the majority of prescribing is done generically, using Virtual Medicinal Products (VMPs) which describes the abstract or generic medicinal product.

One VMP may have many real-world AMPs which could have been actually dispensed to the patient, and therefore potentially multiple different licensing authorities attached to different AMPs under a single VMP.

The Licencing authority has been assigned in this data set using the following logic:

If the drug was prescribed as an AMP or AMPP (AMP with pack size) then the licensing authority associated with that AMP has been listed. If the drug was prescribed as a VMP or VMPP (VMP with pack size), and the VMP or VMPP has only a single AMP or AMPP then the licencing authority for that AMP or AMPP was listed.

If the drug was prescribed as a VMP or VMPP and there are multiple AMP or AMPPs under that VMP or VMPP, but all AMPs or AMPPs have the same licensing authority, then that licensing authority was recorded.

If the drug was prescribed as a VMP or VMPP and there are multiple AMP or AMPPs under that VMP or VMPP, and the AMPs or AMPPs have multiple licensing authorities, then the licensing authority was recorded as "Mixed" The possible Licensing Authority attributes in the data are:

• None

• Medicines - MHRA/EMA

• Devices

• Unknown

• Traditional Herbal Medicines

Note that some prescribing appears in our system as "Dummy AMP", which was not possible to attribute a licensing authority so has been left in the data as "Dummy AMP" dm+d online can be found here: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/dictionary-medicines-and-devices-dmd

Mixed Description Where there is more than one listed licencing authority attribute for a product, then the Licensing Authority is listed as "Mixed". The Mixed Description details the different licensing authority attributes associated with the relevant Net Ingredient Cost

Net Ingredient Cost (GBP) Net Ingredient cost (NIC) is the basic price of a drug as stated in Part II Clause 8 of the Drug Tariff but please note that where a price concession for items listed in Part VIIIA of the Drug Tariff has been agreed between the Department of Health and Social Care (DHSC) and the Pharmaceutical Services Negotiating Committee the NIC will reflect the concession price rather than the Drug Tariff price. Shown in Pound sterling (GBP) Please note that this request and our response is published on our Freedom of Information disclosure log at:

https://opendata.nhsbsa.net/dataset/foi-01117

If you have any queries regarding the data provided, or if you plan on publishing the data, please contact foidata@nhsbsa.nhs.uk ensuring you quote the above reference. This is important to ensure that the figures are not misunderstood or misrepresented.

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