NHSBSA report shows significant decline in cost of dependency-forming medicines prescribed in England

12 September 2025

NHS Business Services Authority (NHSBSA) data published yesterday shows there has been a significant reduction in the cost of dependency-forming medicines prescribed in the community, falling by 57% from Q1 (April to June) 2015/16 to Q1 in 2025/26. 

The latest 'Dependency-Forming Medicines - England 2015/16 to 2025/26' quarterly report reveals that in Q1 2025/26, 16.5 million items for dependency-forming medicines were prescribed to an estimated 4.37 million identified patients, at a total cost of £83.7 million. 

The substantial decrease in overall costs has been driven primarily by an 84% decline in the total cost of gabapentinoid prescribing since Q1 2015/16. This is largely attributed to pregabalin coming off patent in August 2017 which allowed for cheaper generic alternatives to be prescribed. Additionally, opioid drug costs decreased by 39% over the same period. 

Other key findings show that between April and June 2025: 

• opioid drugs accounted for the largest proportion of dependency-forming medicine prescriptions, with 9.67 million items prescribed at a cost of £64.5 million. 

• significant demographic and geographical variations in prescribing patterns. Female patients aged 60 to 64 years represented the largest group receiving these medications, with 291,000 identified patients.  

• notable health inequality. The most deprived areas had 78% more identified patients receiving dependency-forming medications compared to the least deprived areas.

The statistics cover five categories of medicines: Opioid pain medicines, Gabapentinoids, Benzodiazepines, Z-drugs and antidepressants. 

The data encompasses prescriptions prescribed in the community across England, but excludes medicines prescribed and dispensed in secondary care, prisons, or issued by private prescribers. Medications used specifically to treat existing drug dependence or substance misuse disorders have also been excluded from this report. 

To read the full report, visit: www.nhsbsa.nhs.uk/statistical-collections/dependency-forming-medicines-england/dependency-forming-medicines-england-quarterly-summary-statistics

Notes to editors

• The statistics detail prescription items issued, costs, identified patient numbers, co-prescribing patterns, and demographic breakdowns by age, gender, and deprivation measures. 

• Classifications follow the British National Formulary (BNF) therapeutic classifications system prior to BNF edition 70, with annual updates each January potentially affecting drug classifications between publication years. 

• The data includes patients using opioids for cancer-related pain management and end-of-life care, representing a broader scope than the original prescribed medicines review analysis. 

• A breakdown of the data by ICB area is available.  

• When a drug "comes off patent," it means the exclusive patent protection that the original pharmaceutical company held on that medication has expired. Once the patent protection ends, other pharmaceutical companies can legally manufacture and sell their own versions of the same medication.  

The NHSBSA is an arm's length body of the Department of Health and Social Care and provides a range of critical central services to NHS organisations, NHS contractors, patients and the public. Its purpose is deliver business service excellence to the NHS to help people live longer, healthier lives and its vision is to be the provider of national at scale business services for the health and social care system. For more information, visit: www.nhsbsa.nhs.uk.

​

Unsubscribe