PCA NI
Prescription Cost Analysis 2024
An Accredited Official Statistics Publication
Published by: BSO Family Practitioner Services Information Unit
Contact: Aileen Gordon
Telephone: 028 9536 3692
Email: Aileen.Gordon@hscni.net
Theme: General Pharmaceutical Services
Coverage: Northern Ireland
Frequency: Annual
Publication date: 27 February 2025
Key Facts
• There were 45,905,893 items dispensed in 2024 with a total spend of £500.5M, changes of 1.6% and -0.7% respectively from 2023 and increases of 10.5% and 14.3% on 2017 levels
• BNF Chapter 4 (Central Nervous System) had the most items dispensed with 11,343,210, up 1.1% from 2023 and an increase of 9.5% on 2017
• BNF Chapter 4 (Central Nervous System) had the highest ingredient cost at £102.3M, accounting for 20.4% of the total cost of all dispensed items
• Atorvastatin was the most commonly dispensed medication with 1,780,960 items dispensed, a position it has held since 2019
• Dapagliflozin was the medication with the highest ingredient cost at £10.6M, making up 2.1% of all expenditure
• BNF Chapter 4 (Central Nervous System) had the most items dispensed with 11,343,210, up 1.1% from 2023 and an increase of 9.5% on 2017
• BNF Chapter 4 (Central Nervous System) had the highest ingredient cost at £102.3M, accounting for 20.4% of the total cost of all dispensed items
• Atorvastatin was the most commonly dispensed medication with 1,780,960 items dispensed, a position it has held since 2019
• Dapagliflozin was the medication with the highest ingredient cost at £10.6M, making up 2.1% of all expenditure
1. Introduction
The Business Services Organisation (BSO) is the provider of the data. Prescription Cost Analysis (PCA) data is obtained from the BSO’s prescribing and dispensing information systems. The data covers all prescriptions including dental, those from out of hours surgeries, non-medical (i.e. Nurse, Pharmacist, Physiotherapist and Optometrist), hospice or those prescriptions prescribed in other parts of the UK but dispensed in Northern Ireland and submitted to BSO for payment.
The data includes all prescribed medicines, dressings and appliances that are dispensed across the year in Northern Ireland. If a patient does not take a prescription to a dispenser and get it provided to them, then the data will not be included in the dataset. Private prescriptions are not included in the data. Post-payment adjustments are included.
A new interactive dashboard has been developed to facilitate analysis of the dataset at varying levels of detail and across different time periods. Note that data in the dashboard is only available from 2019, based on a fully consistent BNF classification to aid trend analysis, but the series will be added to each year. The dashboard is available at the following link - PCA Dashboard.
Please note there are some small differences between the data contained in the dashboard and this report. Further information can be found in the About this Publication section.
2. Trends in Northern Ireland
This section contains overall totals for the number of items dispensed and associated ingredient cost in Northern Ireland between 2017 and 2024.
A prescription item is a single supply of a medicine, dressing or appliance written on a prescription form. For example, a prescription form that includes 3 medicines on it is counted as 3 prescription items. Item figures do not provide any indication of the length of treatment or quantity of medicine prescribed.
The ingredient cost is the basic cost of a drug as used in primary care. This is the cost at list price excluding VAT i.e. the price listed in the Northern Ireland Drug Tariff, concessionary price list, or in standard price lists and is not necessarily the price that has been paid. It does not take into account any contract prices or discounts, dispensing costs or fees, so the actual cost to the health service will be different. In other parts of the UK the equivalent is called the Net Ingredient Cost (NIC) and is used in Prescription Services reports and other analyses as it standardises prescribing costs nationally and allows comparison of data from different sources.
2.1 Trends in Items Dispensed
There were 45,905,893 items dispensed in 2024. This was 1.6% up on the previous year and a 10.5% increase on 2017. The number of items dispensed has been increasing every year since 2020. However, the rate at which they have increased has declined over the last 3 years, from a 3.0% increase between 2021 and 2022 to 2.4% between 2022 and 2023 and now 1.6% from previous year.
Chart
Figure 2.1: Number of Items Dispensed in Northern Ireland, 2017 to 2024
Table
Table 2.1: Number of Items Dispensed in Northern Ireland, 2017 to 2024
| Year | Number of Items |
|---|---|
| 2017 | 41,544,548 |
| 2018 | 41,893,076 |
| 2019 | 42,538,093 |
| 2020 | 42,298,448 |
| 2021 | 42,812,976 |
| 2022 | 44,111,571 |
| 2023 | 45,185,064 |
| 2024 | 45,905,893 |
Download data:
2.2 Trends in Ingredient Cost
The total ingredient cost in 2024 was £500,453,533. This was a 0.7% decrease on the previous year and 14.3% up on 2017. This is the first decrease in ingredient cost since 2018. This decrease follows the highest increase of the series from 2022 to 2023 when ingredient cost increased by 7.1%.
Chart
Figure 2.2: Ingredient Cost in Northern Ireland, 2017 to 2024
Table
Table 2.2: Ingredient Cost in Northern Ireland, 2017 to 2024
| Year | Ingredient Cost Before Discount (£) |
|---|---|
| 2017 | 438,012,566 |
| 2018 | 423,404,437 |
| 2019 | 435,226,737 |
| 2020 | 455,146,101 |
| 2021 | 458,347,579 |
| 2022 | 470,936,007 |
| 2023 | 504,113,631 |
| 2024 | 500,453,533 |
Download data:
3. BNF Chapters
The British National Formulary (BNF) is a medical and pharmaceutical publication that has information and advice on prescribing and pharmacology. It also includes information about all medicines available on the NHS. The BNF groups products into therapeutic classifications called BNF Chapters which are further broken down into BNF Sections, BNF Paragraphs and BNF Sub-Paragraphs. Medication may also be prescribed for medical conditions other than their primary use, for example, certain anti-depressants may be recommended to individuals experiencing chronic pain. BSO does not capture the indication for which a drug has been prescribed.
The following section provides details of the number of items dispensed and ingredient cost by BNF Chapter Name and Number.
3.1 Items Dispensed by BNF Chapter
BNF Chapter 4 (Central Nervous System) had the highest number of items dispensed in 2024 with 11,343,210 which made up 24.7% of the total items dispensed. Chapter 2 (Cardiovascular System) followed with 10,665,474 items dispensed, accounting for 23.2% of the total items. The third highest number of items dispensed were from Chapter 1 (Gastro-Intestinal System) with 4,462,645 which represented 9.7% of the total items.
Chart
Figure 3.1: Number of Items Dispensed by BNF Chapter in 2024
Table
Table 3.1: Number of Items Dispensed by BNF Chapter in 2024
| BNF Chapter | BNF Chapter Name | Number of Items |
|---|---|---|
| 1 | Gastro-Intestinal System | 4,462,645 |
| 2 | Cardiovascular System | 10,665,474 |
| 3 | Respiratory System | 3,121,893 |
| 4 | Central Nervous System | 11,343,210 |
| 5 | Infections | 2,135,439 |
| 6 | Endocrine System | 4,272,355 |
| 7 | Obstetrics,Gynaecology & Urinary-Tract Disorders | 1,157,726 |
| 8 | Malignant Disease & Immunosuppression | 188,756 |
| 9 | Nutrition & Blood | 2,363,544 |
| 10 | Musculoskeletal & Joint Diseases | 1,485,422 |
| 11 | Eye | 403,763 |
| 12 | Ear, Nose & Oropharynx | 557,689 |
| 13 | Skin | 1,463,509 |
| 14 | Immunological Products & Vaccines | 24,721 |
| 15 | Anaesthesia | 83,187 |
| 19 | Other Drugs & Preparations | 36,695 |
| 20 | Dressings | 323,676 |
| 21 | Appliances | 1,457,991 |
| 22 | Incontinence Appliances | 69,796 |
| 23 | Stoma Appliances | 234,253 |
Download data:
3.2 Ingredient Cost by BNF Chapter
In 2024, the three BNF Chapters with the highest ingredient costs were Chapter 4 (Central Nervous System), Chapter 6 (Endocrine System) and Chapter 2 (Cardiovascular System) accounting for £102,275,542 (20.4%), £72,579,096 (14.5%) and £56,067,376 (11.2%) respectively.
Chart
Figure 3.2: Ingredient Cost by BNF Chapter in 2024
Table
Table 3.2: Ingredient Cost by BNF Chapter in 2024
| BNF Chapter | BNF Chapter Name | Ingredient Cost Before Discount (£) |
|---|---|---|
| 1 | Gastro-Intestinal System | 34,407,541 |
| 2 | Cardiovascular System | 56,067,376 |
| 3 | Respiratory System | 50,614,339 |
| 4 | Central Nervous System | 102,275,542 |
| 5 | Infections | 12,422,849 |
| 6 | Endocrine System | 72,579,096 |
| 7 | Obstetrics,Gynaecology & Urinary-Tract Disorders | 10,526,956 |
| 8 | Malignant Disease & Immunosuppression | 13,622,773 |
| 9 | Nutrition & Blood | 40,909,785 |
| 10 | Musculoskeletal & Joint Diseases | 8,249,275 |
| 11 | Eye | 4,131,912 |
| 12 | Ear, Nose & Oropharynx | 5,003,949 |
| 13 | Skin | 15,696,372 |
| 14 | Immunological Products & Vaccines | 466,932 |
| 15 | Anaesthesia | 3,008,100 |
| 19 | Other Drugs & Preparations | 337,526 |
| 20 | Dressings | 12,376,806 |
| 21 | Appliances | 30,393,064 |
| 22 | Incontinence Appliances | 2,108,193 |
| 23 | Stoma Appliances | 15,224,951 |
Download data:
4. Chemical Names
The chemical name indicates the active ingredients in pharmaceutical products. Within each chemical name grouping there will be a range of products in terms of formulations, strengths, brands and generics.
This section provides details of the most commonly dispensed chemical names in Northern Ireland in 2024 by number of items and ingredient cost. Comparisons are also made with 2023 to show the chemical names with the greatest increases and decreases by items and ingredient cost.
4.1 Top 10 Most Dispensed Chemicals in 2024
Atorvastatin was the most dispensed chemical in Northern Ireland with 1,780,960 items dispensed in 2024. There were 4 other chemicals with over 1 million items dispensed, namely Omeprazole (1,492,248 items), Co-codamol (1,258,273 items), Levothyroxine (1,121,635 items) and Sertraline (1,038,676 items).
Chart
Figure 4.1: Top 10 Chemicals by Number of Items Dispensed in 2024
Table
Table 4.1: Top 10 Chemicals by Number of Items Dispensed in 2024
| Chemical Name | Number of Items |
|---|---|
| Atorvastatin | 1,780,960 |
| Omeprazole | 1,492,248 |
| Co-codamol | 1,258,273 |
| Levothyroxine | 1,121,635 |
| Sertraline | 1,038,676 |
| Bisoprolol | 886,228 |
| Amlodipine | 840,214 |
| Lansoprazole | 839,667 |
| Salbutamol | 831,923 |
| Ramipril | 782,355 |
Download data:
Dapagliflozin was the chemical with the highest ingredient cost in Northern Ireland in 2024. The ingredient cost for Dapagliflozin was £10,643,728 which was £1,318,591 higher than the second highest chemical Sacubitril + Valsartan (£9,325,137). The chemicals ranked third to fifth highest all had similar total ingredient costs, namely Empagliflozin (£7,636,562), Budesonide + Formoterol (£6,935,995) and Semaglutide (£6,800,035).
Chart
Figure 4.2: Top 10 Chemicals by Ingredient Cost in 2024
Table
Table 4.2: Top 10 Chemicals by Ingredient Cost in 2024
| Chemical Name | Ingredient Cost Before Discount (£) |
|---|---|
| Dapagliflozin | 10,643,728 |
| Sacubitril + Valsartan | 9,325,137 |
| Empagliflozin | 7,636,562 |
| Budesonide + Formoterol | 6,935,995 |
| Semaglutide | 6,800,035 |
| Omeprazole | 5,258,325 |
| Beclometasone + Formoterol + Glycopyrronium bromide | 4,852,634 |
| Insulin aspart | 4,841,132 |
| Lamotrigine | 4,632,023 |
| Fluticasone + Umeclidinium bromide + Vilanterol | 4,603,393 |
Download data:
4.2 Top 10 Chemicals by Increase in Dispensing in 2024
The number of items dispensed for Atorvastatin rose from 1,683,644 in 2023 to 1,780,960 in 2024, a 5.8% increase. This was the largest absolute increase in number of items across all of the chemicals. The next highest were Dapagliflozin and Sertraline with item increases of 55,051 (33.6%) and Sertraline 48,371 (4.9%) respectively.
Chart
Figure 4.3: Top 10 Chemicals by Increase in Number of Items Dispensed in 2024 Compared to 2023
Table
Table 4.3: Top 10 Chemicals by Increase in Number of Items Dispensed in 2024 Compared to 2023
| Chemical Name | Increase in Number of Items |
|---|---|
| Atorvastatin | 97,316 |
| Dapagliflozin | 55,051 |
| Sertraline | 48,371 |
| Amlodipine | 35,175 |
| Amitriptyline | 32,062 |
| Apixaban | 27,905 |
| Ramipril | 25,881 |
| Semaglutide | 25,824 |
| Estradiol | 25,535 |
| Docusate | 24,888 |
Download data:
Dapagliflozin was the chemical with the largest absolute increase in ingredient cost when compared with the previous year at £2,751,189. The ingredient cost went up from £7,892,539 to £10,643,728 which is a 34.9% increase. The second highest increase in ingredient cost came from Semaglutide with £2,278,519 (50.4%) while the third was attributable to Sacubitril + Valsartan with £1,444,384 (18.3%).
Chart
Figure 4.4: Top 10 Chemicals by Increase in Ingredient Cost in 2024 Compared to 2023
Table
Table 4.4: Top 10 Chemicals by Increase in Ingredient Cost in 2024 Compared to 2023
| Chemical Name | Increase in Ingredient Cost (£) |
|---|---|
| Dapagliflozin | 2,751,189 |
| Semaglutide | 2,278,519 |
| Sacubitril + Valsartan | 1,444,384 |
| Empagliflozin | 1,275,214 |
| Ezetimibe | 1,047,921 |
| Beclometasone + Formoterol + Glycopyrronium bromide | 927,684 |
| Quetiapine | 882,639 |
| Budesonide + Formoterol | 644,920 |
| Beclometasone + Formoterol | 592,897 |
| Theophylline | 571,614 |
Download data:
4.3 Top 10 Chemicals by Decrease in Dispensing in 2024
Folic acid was the chemical with the largest decrease in number of items dispensed with 43,699 fewer items dispensed in 2024 (303,124) than in 2023 (346,823). This constitutes a 12.6% reduction in the number of items dispensed. The second largest absolute decrease was for Simvastatin with 34,447 (8.3%) less items dispensed and the third largest came from Phenoxymethylpenicillin with 26,068 (16.5%) fewer items.
Chart
Figure 4.5: Top 10 Chemicals by Decrease in Number of Items Dispensed in 2024 Compared to 2023
Table
Table 4.5: Top 10 Chemicals by Decrease in Number of Items Dispensed in 2024 Compared to 2023
| Chemical Name | Decrease in Number of Items |
|---|---|
| Folic acid | 43,699 |
| Simvastatin | 34,447 |
| Phenoxymethylpenicillin | 26,068 |
| Hydrocortisone + Miconazole | 22,884 |
| Bendroflumethiazide | 20,953 |
| Piroxicam | 17,334 |
| Pregabalin | 15,712 |
| Chloramphenicol | 13,761 |
| Aspirin | 13,751 |
| Tramadol | 13,179 |
Download data:
The ingredient cost for Apixaban decreased by £14,402,270 in 2024 compared to 2023. This is a reduction of 84.6% with the spend decreasing from £17,028,490 in 2023 to £2,626,220. There is a significant drop to the next largest absolute decreases on cost which were £2,505,325 (32.3%) for Omeprazole products and £2,024,052 (30.6%) for Melatonin products.
Chart
Figure 4.6: Top 10 Chemicals by Decrease in Ingredient Cost in 2024 Compared to 2023
Table
Table 4.6: Top 10 Chemicals by Decrease in Ingredient Cost in 2024 Compared to 2023
| Chemical Name | Decrease in Ingredient Cost (£) |
|---|---|
| Apixaban | 14,402,270 |
| Omeprazole | 2,505,325 |
| Melatonin | 2,024,052 |
| Sitagliptin | 1,769,746 |
| Rivaroxaban | 1,070,553 |
| Ranolazine | 1,018,587 |
| Liraglutide | 973,819 |
| Promethazine hydrochloride | 842,010 |
| Phenoxymethylpenicillin | 753,465 |
| Amoxicillin | 676,422 |
Download data:
About this Publication
Prescription Cost Analysis Tables
The Prescription Cost Analysis (PCA) data can be downloaded by clicking on the button below. The data contains item counts, quantity, and spend for all prescriptions that were submitted to BSO for payment in 2024. The information is provided at the following levels:
- BNF chapter, BNF section, BNF paragraph, BNF sub-paragraph and individual preparation
- BNF chapter and BNF section
- BNF chapter
Download data:
There is another version of the PCA published that contains similar information, but for each Local Commissioning Group (LCG) within Northern Ireland. Where broken down by LCG, the data will only cover prescriptions from GP’s, out of hours surgeries and those from non-medical prescribers who are employed within a GP surgery. Dental prescriptions, hospice items and those items prescribed in other parts of the UK but dispensed in NI are excluded from the LCG breakdown and accounted for around 2% of all items dispensed. This data can be downloaded using the button below.
Download data:
PCA data from previous years can also be found on the BSO website at the Prescription Cost Analysis page.
The data within this report is based on the annual Prescription Cost Analysis publications and will match exactly to the figures as published. While the PCA is published annually for standalone years, the dashboard brings together multiple years of data to help make trend analysis easier. The data contained within the dashboard will however differ slightly from previous years PCA publications. To allow easier comparisons across years the data within the dashboard will be refreshed each year to ensure product information reflects current categorisation i.e. the most up to date product name, chemical name, BNF Chapter / Section / Paragraph / Sub Paragraph.
This publication has been produced by independent statisticians within the FPS Information Unit. They are on secondment from the Northern Ireland Statistics and Research Agency (NISRA). It has been compiled in accordance with the Code of Practice for Statistics.
Further information about the work of FPS and the manner in which these statistics were produced can be found at the end of this publication.
User Engagement
Statisticians in the Information Unit are regularly in contact with key users of the statistics. While previously readership surveys alone were used to provide an overall assessment of whether user needs were being met, the current approach employed is to supplement these surveys with focused consultations with key users on a rolling basis. This approach helps to gain greater insight into how the statistics are used and to identify additional specific requirements. In addition, any ad hoc requests for information are recorded centrally in a database and these records are used to provide intelligence from a wider set of users in relation to changing requirements. Statisticians have also piloted an online user engagement showcase event to exchange information with users on potential future developments in relation to the publications.
This is an Accredited Official Statistics Publication
Accredited official statistics are called National Statistics in the Statistics and Registration Service Act 2007 – the Office for Statistics Regulation (OSR) provide a further explanation of this terminology on their website. These accredited official statistics were independently reviewed by the OSR and received formal accreditation on 11th May 2022. More information can be found in the assessment of compliance. As such they comply with the standards of trustworthiness, quality and value as set out in the Code of Practice for Statistics.
We have developed a series of statements to demonstrate how we meet the Code in our everyday work. These cover our independence, data quality procedures, how we make our statistics accessible whilst protecting your data, engage with you to meet your needs and, when things go wrong, how we make corrections or, should our services fall below the required standard, how you can make a complaint. All of this information is included in our Statistics Charter.
Since the assessment by the OSR, we have continued to comply with the Code of Practice for Statistics, and have made the following improvements:
- On 28th March 2023 a pilot User Engagement showcase event was held to advise users of the current capabilities and future developments of the statistics and obtain feedback from users
- On 29th February 2024 the Prescription Cost Analysis (PCA) was produced for the first time using an innovative methodology termed a Reproducible Analytical Pipeline (RAP). This should greatly increase the efficiency of production in future and improve compliance with accessibility
- On 27th February 2025 this HTML report was published alongside the PCA, providing highlights from the publication. A dashboard was also published at this time to accompany the PCA, bringing together multiple years of data to allow for trend analysis.
Our statistical practice is regulated by the OSR. You are welcome to contact the responsible statistician directly (listed at the beginning of this publication) with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or visiting the OSR website.
Publication Notes
Family Practitioner Services
Family Practitioner Services (FPS) is part of the BSO’s Operations Directorate. It provides a range of essential services to Health and Social Care organisations, primary care contractors and patients.
FPS calculates payments to health professionals in the dental, pharmacy, general practice and ophthalmic sectors through Northern Ireland. It also maintains the central register of patients registered with GP Practices in Northern Ireland, issuing medical cards and processing changes such as name, address and doctor.
It provides professional advice, support and information to customers and members of the public and maintains the pharmaceutical, dental and the Northern Ireland Primary Medical Performers lists. FPS also provides the call and recall services for cervical and bowel cancer screening in Northern Ireland.
Next Edition
This publication is issued annually. It is expected that the next edition shall be published in February 2026. Further quarterly and annual pharmacy statistics are also published on the BSO website on the General Pharmaceutical Services and Prescribing Statistics page. The release calendar for future statistical publications is available on the BSO website.
Technical Notes
Target Audience
This report is intended to provide quick detailed analysis for the more informed or expert user. Users who require further analysis in addition to this report and dashboard can find additional trend analysis, charts, commentary and demographic information of patients within the FPS General Pharmaceutical Services Statistics for Northern Ireland, which is based on financial year or tables showing the latest quarterly update. These can be found on the BSO website on the General Pharmaceutical Services and Prescribing Statistics page.
Main Usages
This publication contains accredited official statistics on pharmaceutical dispensing for the most recent calendar year.
They can be used to monitor trends in general pharmaceutical services over time.
The information can be used to support decision making, inform policy, provide advice to ministers, answer a wide range of Assembly Questions and Freedom of Information requests, for national and local press articles and, where appropriate, for international comparison.
Data Quality Summary
The data has been sourced from the FPS Pharmacy Payment System. This enables BSO to make payments to pharmaceutical contractors for dispensing prescription items that have been prescribed in primary care. The Pharmacy Payment System is a business-critical payment system which is subject to period audit. The data quality is assessed as very good based on the low percentage of claims which have to be adjusted following payment.
As an administrative data system, there will inevitably be some manual entry errors and, even for automated processes, there may be errors within the claims submitted by primary care contractors.
During 2021 a new SQL database was introduced to record the dispensing of prescriptions in primary care. This database incorporated a number of improvements to the data source previously used to produce these statistics. While these enhancements improve the quality of the statistics produced, it is almost inevitable that they will result in minor discontinuities with earlier series of data. One change affecting the PCA statistics relates to quantities for some inhalers, sprays and solutions. Where quantities were previously listed as a device, this may now show the amount of doses dispensed. Care should therefore be taken when comparing quantity figures prior to 2021 for inhalers, sprays and solutions.
Improvements have been made to BNF chapter classifications to ensure consistency between Northern Ireland and England. Previously over 99.5% of items prescribed and dispensed in Northern Ireland had the same BNF chapter classification as England. Of the 0.5% of items that originally differed in classification, around 99.6% referred to items previously counted as Appliances (Chapter 21) being reclassified into the Eye (Chapter 11), Ear, Nose and Oropharynx (Chapter 12) and Skin (Chapter 13) chapters. Caution should therefore be exercised when comparing figures prior to 2021 for chapters 11, 12, 13 and 21. Any in-year changes in BNF classification made by the Business Services Authority in England are incorporated in this report so that each product has only one BNF classification across the year. Please be aware that BNF 9.4 is being replaced by BNF 9.13 and 9.14, although not all products have yet been updated.
UK Comparisons
Prescription Cost Analysis are also published by England, Scotland and Wales at the following links:
Prescription Cost Analysis - England
Dispenser Payments and Prescription Cost Analysis - Scotland
Further Information
Further statistics published by the FPS Information Unit relating to Dental, Ophthalmic and General Medical Services can be found at the following links:
Feedback is welcome and if you have requirements for any further information please contact us by emailing info.bso@hscni.net.
Copyright and Licence
© 2025 Crown Copyright. This publication may be reproduced free of charge in any format or medium. Any material used must be acknowledged, and the title of the publication specified.
Open Government Licence. All content is available under the Open Government Licence v3.0, except where otherwise stated.