The costs incurred by the NHS in England due to the unnecessary prescribing of dependency-forming medications

James Davies, R.E. Cooper, J. Moncrieff, L. Montagu, T. Rae, M. Parhi

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This cross-sectional study estimates the costs incurred by the National Health Service (NHS) in England as a consequence of the unnecessary prescribing (i.e. non-indicated or dispensable) of dependency-forming medicines (i.e. antidepressants, opioids, gabapentinoids, benzodiazepines, Z-drugs). It assesses prescriptions dispensed in primary care from April 2015-March 2018. Analysis was based upon the following data sets: the number of adults continuously prescribed dependency forming medications and the duration of prescriptions (obtained from Public Health England); the Net Ingredient Cost (NIC) and the dispensing costs for each medicine (obtained from the NHS Business Service Authority [NHSBSA]). Consultation costs were calculated based
on guideline recommendations and the number of consultations evidenced in prior research for long-term medication monitoring. Across all medicines (antidepressants, opioids, gabapentinoids, benzodiazepines, Z-drugs) the total estimated unnecessary cost over three years (April 2015-March 2018) was £1,472,009,179 to £1,705,105,199. The data indicate that the NHS in England incurs a significant estimated annual loss of £490,669,726 to £568,368,400 as a result of non-indicated or dispensable prescribing of dependency-forming medicines. Estimates are conservative and figures could be higher.


  • Antidepressants
  • Benzodiazapines
  • Opioids
  • Z-drugs
  • Gabapentinoids
  • Dependency

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