The Pharmaceutical Journal
Vol 279 No 7476 p491
3 November 2007

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Rise in hospital drug costs revealed

Medicines issued in NHS hospitals in England in 2006 represent nearly 24 per cent of the total cost of medicines, which was £10.3bn, new data reveal.

Statistics published in a bulletin from The Information Centre show that the estimated cost of drugs used in hospitals rose by 7.7 per cent last year, compared with a 3.2 per cent increase in the cost of prescribing in primary care. The estimated cost of medicines per person in England in 2006 is £210.92.

This is the third year that these data have been published, and the latest figures focus on four drug groups: statins, proton pump inhibitors, drugs affecting the renin angiotensin system and antidiabetics.

Use of statins has risen over the past few years and the bulletin states that this is likely to continue following National Institute for Health and Clinical Excellence advice. The proportion of low-cost statins (simvastatin and pravastatin) used in hospitals was found to be higher than in primary care in every strategic health authority area.

A similar pattern of prescribing was seen for low-cost proton pump inhibitors (omeprazole and lansoprazole). This may be because more patients are initiated on these drugs in hospital, whereas patients in primary care may have been started on these drugs when prices were significantly different.

The statistics show that use of angiotensin-converting enzyme inhibitors compared with more expensive angiotensin-II receptor antagonsists was also higher in hospitals than in the majority of SHA areas.

Hospital use of insulins represented a small proportion of the total use of insulins in the NHS (primary care use ranges from 83 to 97 per cent) and hospital use of oral antidiabetics represented an even smaller proportion of the total use of oral antidiabetics.

Of drugs that have been appraised by NICE, trastuzumab (Herceptin) had the highest estimated cost in hospitals in 2006 (£54.7m), followed by etanercept (Enbrel; £50.7m), infliximab (Remicade; £50.4m) and imatinib (Glivec; £47.5m).