How the NHS Prescription Budget Changed Over the Last Decade (2015–2025)

Over the past 10 years, the NHS in England has spent more than ever on prescriptions-and not just because drugs are getting more expensive. The reasons behind this growing budget tell a bigger story about how our nation’s health is changing.

In 2015, the NHS spent £9.27 billion on prescription medicines given out in the community (i.e., outside of hospitals). By 2025, that number has grown to £11.2 billion-a 21% increase in just a decade. But what’s driving this rise? And what does it mean for the future of healthcare?

Let’s explore.

NHS Prescription Spending: Then and Now

In 2015:

• The NHS spent £9.27 billion
• It paid for 1.08 billion prescription items
• The most money was spent on heart and blood pressure medications

By 2025:

• The NHS is spending £11.2 billion
• It’s covering 1.26 billion items
• That’s nearly 200 million more items and £2 billion more in spending than 10 years ago

A Timeline of Key Changes

2016–2018:
Spending actually dropped slightly for a couple of years. This was thanks to smarter buying-more generic (cheaper) versions of medicines and tougher negotiations on drug prices. ²

2020–2021:
The budget rose again to £9.61 billion, a 3.5% increase from the year before. ³ The number of prescriptions remained stable at around 1.11 billion items.

2022–2023:
A bigger jump: £10.4 billion was spent-a whopping 8% increase in just one year. ⁴

2024–2025:
New record: £11.2 billion spent on 1.26 billion prescription items, with a 4% rise in prescriptions from the year before. ⁵

Why Is Prescription Spending Increasing?

There’s no single reason-but several major health trends in the UK help explain the rise.

1. More People Living with Long-Term Conditions

Conditions like diabetes, heart disease, and mental health disorders are more common now than ever. These types of chronic conditions often require people to take multiple medications every day, often for life.

Example: A person with type 2 diabetes might also need drugs for blood pressure, cholesterol, and nerve pain-all increasing the number of prescriptions.

2. Huge Growth in Diabetes Prescriptions

Diabetes is one of the biggest contributors to rising costs.
In 2015–16, prescriptions for diabetes medications cost the NHS £960 million.
By 2023–24, that had soared to £1.67 billion-a 74% increase in spending. ⁶

• The number of prescriptions also rose from 50 million to 71 million, a 42% increase.

Newer diabetes drugs, such as SGLT2 inhibitors, are often more effective-but they also cost more per item.

3. An Aging Population Needs More Medication

As people live longer, they often develop multiple health problems.
It’s common for older adults to be on 5 or more medications at once (a situation called polypharmacy).

This includes:

• Statins (for cholesterol)
• Blood thinners (like apixaban)
• Blood pressure drugs
• Antidepressants

All of these are heavily prescribed and add to the NHS’s medication bill.

4. Newer Drugs Are More Expensive

While older drugs can often be bought cheaply as generics, new medications-especially those for complex conditions like heart failure or cancer-tend to be branded and costly.

Even if only a small number of patients need them, the cost per item can be hundreds of pounds-quickly adding up.

Why This Matters to Physiotherapists and Clinicians

This increase in prescription use doesn’t just impact NHS budgets-it affects how other healthcare professionals, like physiotherapists, work with patients.

Here’s why it matters:

• Blood thinners (like apixaban) increase the risk of falls and bruising-something physios must consider when doing balance or mobility exercises.
• Diabetes drugs can affect hydration and energy levels, making some patients feel tired or dizzy during sessions.
• Statins may cause muscle pain or weakness, which can be mistaken for a musculoskeletal issue.
• Multiple medications can cause side effects like confusion or fatigue, affecting how well someone can participate in rehab.

As a result, physiotherapists are now more likely to coordinate with GPs and pharmacists to tailor treatment plans around a patient’s medications.

Can the NHS Afford This Long-Term?

The NHS has introduced several strategies to try and manage rising drug costs, such as:

• Promoting generics (cheaper versions of the same medicine)
• Rebate schemes from drug manufacturers
• Tighter prescribing guidance for high-cost treatments

These helped slow spending for a few years between 2016 and 2018-but overall, spending continued to rise.

Between 2020 and 2025 alone, the community prescription budget still grew by over 21% in real terms, despite cost-saving efforts. ^4,5

What Does This Tell Us?

The growth in the NHS prescription budget is about more than just money. It reflects:

• A rise in chronic illnesses across the UK
• The ageing population
• The increasing complexity of modern medicine
• The growing role of multi-disciplinary care, including physiotherapy, nursing, and mental health services

Prescription medicines are now a bigger part of people’s everyday health journeys. But they must be used wisely. More than ever, the NHS needs to ensure that every prescription:

• Improves outcomes
• Minimises side effects
• Supports wider treatment and recovery plans
  

From £9.27 billion in 2015 to £11.2 billion in 2025, NHS prescription costs have risen steadily over the decade.

This isn’t just about more pills. It’s about how Britain’s healthcare needs are changing-with more long-term illness, more older patients, and more complex treatment options than ever before.

It also highlights the importance of teamwork across the NHS: doctors, physios, pharmacists, and nurses all playing their part in making sure that medicines work with other therapies, not against them.

As the NHS moves forward, careful prescribing-and close collaboration-will be key to delivering the best value for patients and the health system alike.

References

1. NHS Business Services Authority. Prescription Cost Analysis England 2015 (April 2016).
2. NHSBSA. PCA Summary Tables 2016–2018.
3. NHSBSA. Prescription Cost Analysis England 2020/21.
4. NHSBSA. Prescription Cost Analysis England 2022/23 (June 2023).
5. NHSBSA. Prescription Cost Analysis England 2024/25 (June 2025).
6. Diabetes Research & Wellness Foundation. Diabetes prescription trends in England: 2015–2024.