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Expenditure on retail pharmaceuticals per capita, USD PPP, 2021
– Prescription medicines: $314
– Over-the-counter medicines: $152
– Total: $466
Expenditure on retail pharmaceuticals by type of financing, 2021:
– Government/compulsory schemes: 65%
– Voluntary health insurance schemes: 0%
– Out-of-pocket spending: 35%
– Other: 0%
Practicing pharmacists per 100,000 population, 2021: 84
Community pharmacies per 100,000 population, 2021: 21

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

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“Patients are not charged for pharmaceuticals used in inpatient care. Patients in England are however charged for prescriptions in the community at a fixed flat rate of £9.15 (€10.80) per item as of 2020/2021 (see Section 3.4.1, Cost sharing (user charges)). Patients can also pay for a yearly subscription service capped at £105.90 (€125) per year (NHS England, 2021q). Exemptions cover a broad range of people, including individuals under 16 and over 60 years of age, those with low incomes, during pregnancy, and for chronic diseases such as diabetes or epilepsy, so that about 90% of all prescriptions are distributed free of charge (NHS England, 2021q). Prescription charges were abolished in Wales in 2007, in Scotland in 2011 and in Northern Ireland in 2010 (Kulakiewicz, Parkin & Powell, 2022) (see Section 3.4.1, Cost-sharing (user charges)).

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

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“The United Kingdom is a major producer of pharmaceuticals, and the government is acutely aware of the pharmaceutical industry’s contribution, adding around £14 billion (€16.5 billion) to the economy and creating 60 000 jobs (ABPI, 2021). Data on per capita spending on pharmaceuticals show that the United Kingdom is towards the lower end of the distribution of other high-income countries and has a comparably lower proportion of private spending (Fig. 5.3). There are several factors that contribute to these trends (see Box 5.5 and Section 2.7.3, Regulation of services and goods). The first is the work of health technology assessment agencies, such as NICE, on making cost-effectiveness recommendations about selected products and the impacts that patient access schemes have on their affordability (see Section 2.7.3, Regulation of services and goods). The second is the commercial capabilities of NHS England and parallel bodies in other United Kingdom constituent countries to purchase medicines and allied specialised care items at costs below NHS list prices and those accepted by health technology assessment agencies as cost-effective. Third, the purchasing and prescribing activities of individual pharmacies and pharmacists and members of the medical profession and the institutions in which they work, which can involve importing products from outside the United Kingdom if they are cheaper.”

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

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“The manufacture, licensing and regulation of medicines and the control of pharmaceutical prices is all done at United Kingdom level (Cylus et al., 2015). From 1 January 2021, following the withdrawal of the United Kingdom from the European Union, the MHRA became the United Kingdom’s standalone medicines and medical devices regulator. Before this, medicines could be launched in the United Kingdom via the European Medicines Agency centralised authorisation procedure (Criado & Bancsi, 2021). The MHRA is an executive agency of the DHSC; it authorises clinical trials of drugs, assesses the results of trials, monitors the safety and quality of products and can remove products from the supply chain if it finds sufficient evidence that they are substandard.

“The 2012 Human Medicines Regulations is the main legislation that governs medicines in all four United Kingdom constituent countries, replacing the previous 1968 Medicines Act. The regulations are concerned with processes for the authorisation of medicinal products for human use; for the manufacture, import, distribution, sale and supply of those products; for their labelling and advertising; and for pharmacovigilance (UK Government, 2021c). The regulations list three types of pharmaceutical products: those on the General Sale List, which do not need a pharmacist and can be sold over the counter; those dispensed through pharmacists only; and prescription-only medicines. There is a formulary of licensed medicines, known as the British National Formulary, that contains available medicines, dosages, known sideeffects and monitoring requirements. Health care professionals are required to report suspected adverse effects to the MHRA through the Yellow Card Scheme, which is the system for recording adverse incidents with medicines and medical devices in the United Kingdom (MHRA, 2021). Advertising of prescription drugs is not allowed and advertisements for non-prescription medicines are strictly regulated.”

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

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“Community pharmacists are paid from a combination of retained profit of their pharmacies (the difference between what they pay for drugs and the amount the DHSC reimburses them), the global sum and the budgets of their commissioning bodies. Pharmacies receive a dispensing fee per item (negotiated by the Pharmaceutical Services Negotiating Committee). Pharmacies receive practice payments from their commissioning bodies; these payments are related to the quantity of prescriptions dispensed, at fixed fees within pay bands.

“Over the last decade, amendments to the community pharmacy contracts across the United Kingdom have focused on expanding their role and facilitated greater integration with primary care. In England, quality payments were introduced in 2016 to incentivise additional action across several domains including infection prevention and control, antimicrobial stewardship, prevention and risk management (NHS England, 2020h). In 2019, a new 5-year contract was agreed, which also included the development of an NHS Community Pharmacist Consultation Service, via which NHS providers can refer service users to community pharmacists (NHS England, 2019c). Similar contracts have also been agreed in Wales (PSNC, 2020), Northern Ireland (Department of Health Northern ireland, 2020d) and Scotland (Community Pharmacy Scotland, 2021).”

Source: Anderson M, Pitchforth E, Edwards N, Alderwick H, McGuire A, Mossialos E. The United Kingdom: Health system review. Health Systems in Transition, 2022; 24(1): i–192.

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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated March 21, 2025 by Doug McVay, Editor.