Thank you for your request for information about the following:

Request

You asked us:

Please provide the following information for the most recent 12‑month period available, broken down by Integrated Care Board (ICB):

The number of patients prescribed levothyroxine

The number of new patients prescribed liothyronine (I already have the total number)

The number of patients prescribed levothyroxine AND five or more other distinct medicines.

The number of patients prescribed liothyronine AND five or more other distinct medicines.

The number of patients prescribed five or more other distinct medicines.

If possible, please also provide the total number of registered patients in each ICB for context.

Please provide anonymised patient counts only.

The NHS Business Services Authority (NHSBSA) received your request on 14 March 2026.

Clarifications

We asked you for clarification of the information requested on 26 March 2026:

I am writing to ask you to clarify your request. This is because we need further details from you in order to identify and locate the information.

Therefore I would be grateful if you would help with the below questions.

Question 1

What do you consider a ‘new patient’?

Question 2

Is ‘no prescription in our data for liothyronine in the previous 12 months’ acceptable? Given that we do not know for sure if it is a patients’ first prescription but we can narrow this down to patients that haven’t had this in the last 12 months.

Question 3

What do you consider a distince medicine, would this be a different BNF chemical substance or different BNF presentation?

Question 4

For Levothyroxine, we will use Levothyroxine sodium (BNf Chemical Substance 0602010V0), and for Liothyronine we will use Liothyronine sodium (BNF 0602010M0).

There is another BNF chemical substance, Levothyroxine sodium and liothyronine (BNF 0602010Z0) - if patients are prescribed this, do you want us to count them as both on levothyroxine and liothyronine?

And please can you confirm if it would count as one of the 5 distinct medicines for your fifth question?

You responded on 26 March 2026:

Question 1

My definition would be one that had no prescription for liothyronine in the prior 12 months or the prescription commenced in the 12 month period of data.

Example - patient A has no prescription in period 1 to 4 but there is a prescription in period 5 onwards

Example - patient B has a prescription in period 1 but there was no prescription in period -1,-2, -3 or -4 etc

Question 2

That is acceptable - liothyronine is a chronic condition medication and would be prescribed continuously. Prescribing is usually at 2 or 3 month intervals and therefore if they had been prescribed previously it would show up.

Question 3

BNF chemical substance

Question 4

On BNF 0602010Z0 - yes please count as both liothyronine and levothyroxine.

And please can you confirm if it would count as one of the 5 distinct medicines for your fifth question?

confirmed 5 distinct

We requested further clarification on 2 April 2026:

I am writing to ask you to clarify your request. This is because we need further details from you in order to identify and locate the information.

Therefore I would be grateful if you would confirm if you are happy with us using “no prescription in the last 12 months as a definition for a new patient?

Please can you also confirm if levothyroxine from BNF 0602010Z0 count as one of the 5 additional substances?

And finally, please can you confirm if for all the 5 or more distinct medicines questions, do all the prescriptions have to be in the same month to count?

We received your response on 6 April 2026:

Therefore I would be grateful if you would confirm if you are happy with us using “no prescription in the last 12 months as a definition for a new patient?

That would okay.

Please can you also confirm if levothyroxine from BNF 0602010Z0 count as one of the 5 additional substances?

Yes

And finally, please can you confirm if for all the 5 or more distinct medicines questions, do all the prescriptions have to be in the same month to count?

No - its unlikely they will be. I get a 2 month prescription for one medication and a 3 month prescription for another. The prescribing rules are not that logical in the GP systems.

We made a final request for clarification on 16 April 2026:

For the final point, if the 5 medicines don't have to be in one month, please can you confirm for me how far apart they have to be to count? Would 5 distinct medicines in 3 months reasonable? If not please let us know what time period you would like this information for.

You responded on 16 April 2026:

I think a 3 month period is reasonable.

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

Our response

I can confirm that the NHSBSA holds 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.

NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors and Personal Administration with information then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over 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 and Social Care users.

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.

Items supplied as part of a Pharmacy First consultation or service.

Time Period

TOTAL_UNIQUE_PATIENTS_PRESCRIBED_LEVOTHYROXINE - March 2025 - February 2026 processed prescriptions

TOTAL_UNIQUE_NEW_PATIENTS_PRESCRIBED_LIOTHYRONINE - March 2025 - February 2026 processed prescriptions, but also looking at a patient's previous 11 months' prescribing, so potentially as far back as April 2024 processed prescriptions.

TOTAL_UNIQUE_PATIENTS_PRESCRIBED_LEVOTHYROXINE_AND_FIVE_OTHER_MEDS_IN_SAME_OR_PREVIOUS_TWO_MONTHS - March 2025 - February 2026 processed prescriptions, but also looking back at a patient's previous 2 months' prescribing, so potentially as far back as January 2025 processed prescriptions

TOTAL_UNIQUE_PATIENTS_PRESCRIBED_LIOTHYRONINE_AND_FIVE_OTHER_MEDS_IN_SAME_OR_PREVIOUS_TWO_MONTHS - March 2025 - February 2026 processed prescriptions, but also looking back at a patient's previous 2 months' prescribing, so potentially as far back as January 2025 processed prescriptions

TOTAL_UNIQUE_PATIENTS_PRESCRIBED_FIVE_OR_MORE_MEDS_NOT_LIOTHYRONINE_OR_LEVOTHYROXINE_IN_SAME_OR_PREVIOUS_TWO_MONTHS - March 2025 - February 2026 processed prescriptions, but also looking back at a patient's previous 2 months' prescribing, so potentially as far back as January 2025 processed prescriptions

ICB_AVERAGE_LIST_SIZE - March 025 - February 2026

Drugs

Levothyroxine: BNF Chemical Substance 0602010V0 -Levothyroxine sodium or BNF Chemical Substance 0602010Z0 - Levothyroxine sodium and liothyronine

Liothyronine: BNF Chemical Substance 0602010M0 - Liothyronine sodium or BNF Chemical Substance 0602010Z0 - Levothyroxine sodium and liothyronine

All other medications are taken from BNF Chapters 1-4 and 6-10 as per NHSBSA polypharmacy dashboard.

Organisation Data

Only items prescribed within an Integrated Care Board (ICB) in England have been included.

Each of the metrics is specific to the patient in the ICB. If a patient meets the criteria for a metric in multiple ICBs, then they will appear in multiple patient counts.

Therefore it is not possible to add patient counts without the possibility of counting a single patient more than once.

Patient data:

Only items associated with an identified patient have been included in this analysis. For Levothyroxine, liothyronine and Levothyroxine sodium and liothyronine,

99.59% of items were able to be associated with an NHS number between April 2024 and February 2026.

For all medicines in chapters 1-4 and 6-10, 99.10% of items were attributable to an identified NHS number.

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: “Data Warehouse, 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.