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NHS spending on drugs fell in 2011

Published on 04/04/12 at 04:09pm
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The NHS in England spent less on its drugs budget last year, bucking the longstanding upward trend.

This is because a number of major drugs have lost patent protection in the last few years. 

The NHS in England spent £8.81 billion for all of its prescription medicines in primary care last year, a 0.1% drop compared to the £8.83 billion spent in 2010. 

The data comes from the NHS Information Centre and shows that amount spent on prescription drugs by GPs in England.

In previous years the spend on the drugs budget has grown by around 3 – 4 % per annum, but the uptake of generics and a cost-conscious NHS has seen this trend reversed in 2011.

The biggest drop in spending came from drugs to treat cardiovascular problems, dropping from £1.51 billion in 2010, to £1.35 billion last year.

This has been aided by the continuing slide in the use of Sanofi and BMS’ anti-clotting treatment Plavix (clopidogrel), with spending on the drug falling from £46 million in 2010, to just £12 million last year.

Plavix’s patent is valid until 2013, but a number of generic firms have exploited a loophole in the drug’s patent, and generic copies have been on the market since 2009.

Big patent losses 

The NHS in England can expect to make more savings, as in the last three months AstraZeneca’s antipsychotic Seroquel (quetiapine) and Pfizer and Eisai’s Alzheimer’s drug Aricept (donepezil), have both lost patent protection.

The NHS in England spent £170 million on these drugs last year, making them two of the most costly treatments for the health service.  

Drugs for the central nervous system make up the highest spend from any therapy area, and cost the NHS £1.95 billion last year.

But the losses of patent protection for Aricept and Seroquel will dramatically reduce this spend in the coming years. 

This reduction will be helped by the loss of protection for Lilly’s antipsychotic Zyprexa (olanzapine) last year.

The NHS spent £120.7 million on Zyprexa in 2011, making it one of the most costly CNS drugs.


Pfizer’s statin Lipitor (atorvastatin) saw the second biggest spend of any drug last year, with the NHS in England spending £310.8 million on the treatment, up £5 million from 2010. 

But this will be the last big spend on the drug in the UK, as it loses its patent protection next month.

A flood of copycat drugs will decimate sales of the drug in the UK from May, and GPs are already being urged by NHS managers to switch to the new generics as soon as they become available.

Mixed bag for diabetes treatments

Spending on new treatments for diabetes should be one of the biggest growth drivers, but the data shows mixed results.

New treatments are growing strongly – spend on Novo Nordisk’s new injectable GLP-1 drug Victoza (liraglutide) shot up from £9.6 million in 2010 to £21.9 million last year.

Merck’s diabetes pill Januvia (sitagliptin) has also seen a substantial increase in spending, up from £27 million in 2010 – when it was recommended for use by NICE – to £45 million last year. 

But other drugs have seen stagnation and even a fall in spending, even though diabetes is one of the fastest growing diseases in the UK.

Spending on Novo’s insulin detemir increased to £39.9 million last year, a growth of just £1.2 million from 2010.

And spending on the firm’s fast-acting insulin aspart (NovoRapid) actually fell for the first time, down from £63.4 million in 2010 to £62.7 million in 2011. 

The health service’s cost-saving agenda has put insulin firmly within its crosshairs.

The National Prescribing Centre has said that insulin analogues such as NovoRapid should be considered only in specific circumstances, and should not be used as standard.

A therapeutics document from the NPC last year reminded doctors that they should be prescribing the cheaper isophane insulin, ahead of other synthetic products, in order to bring down costs.

Based on this latest data, this message seems to have not been lost on prescribers, and goes some way to explaining a lesser spend on insulin products.

Ben Adams

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