This site is intended for health professionals only

NHSE: ‘4-5%’ surge in GP prescribing costs driven by demand, DOACs and HRT

NHSE: ‘4-5%’ surge in GP prescribing costs driven by demand, DOACs and HRT

The increasing number of GP appointments, alongside increased prescribing of DOACs and HRT, has driven up the cost of prescribing in primary care, NHS England has said.

Chief financial officer Julian Kelly told a board meeting yesterday that the 4-5% increase in the cost of prescribing is due to inflation and to GPs ‘seeing a lot more people than they were.’

He also explained that there has been a growth in the prescription of direct oral anticoagulants (DOACs) and hormone replacement therapy (HRT).

Mr Kelly said: ‘We have seen quite a significant increase in the cost of prescribing in primary care. Now, that is influenced by three things: one, global inflation has started to feed through prices in the back end of last year and that has continued through into this year.

‘GPs are seeing a lot more people than they were, it’s a thing that is worth repeating but as a result they are seeing people who need care and therefore are being prescribed medicines.’

But he added: ‘On the plus side it is also partly because we have seen quite a growth in the prescription of DOACs, which we would actually anticipate having substantial benefits for those who would otherwise have cardiovascular disease or stroke. And indeed we have seen quite a surge in the prescription of HRT.’

Mr Kelly said that this is creating financial pressure but it is also ‘good news’ because of ‘changes in prescribing that that we had been striving for’.  

He added: ‘To give a sense of it, we are probably seeing prescribing spend grow by 4-5% annually rather than for the past 10 or so years it has been growing by about 1% annually, so that is the scale of change.’

According to the latest NHS Digital data on GP appointments, 28.3 million appointments were estimated to have been delivered by practices and PCNs in August, up from 27.8 million in July.

new Investment and Impact Fund (IIF) indicator this year specified that GPs should consider switching all patients on DOACs onto edoxaban for cost-saving purposes, although PCNs warned this would cause an unnecessary and unmanageable workload.

Meanwhile, efforts have been made to reduce prescription costs for HRT via pharmacy prescribing, however negotiators warned this had gone ahead without the IT in place to support it.

During the same board meeting yesterday, NHS England bosses said that ‘serious discussions’ must resume between the Government and doctors to end strike action ahead of winter.


Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.


Please note, only GPs are permitted to add comments to articles

Dave Haddock 6 October, 2023 6:49 pm

Time to sort out ludicrous prescription charging system?