FOI-03747

<p><span data-contrast="auto">Thank you for your request for information about&nbsp;the following:</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="none"><span data-ccp-charstyle="normaltextrun" data-ccp-charstyle-defn="{&quot;ObjectId&quot;:&quot;ac0262f4-8a9e-5820-b908-2d943c5f7113|1&quot;,&quot;ClassId&quot;:1073872969,&quot;Properties&quot;:[469777841,&quot;Calibri&quot;,469777842,&quot;Times New Roman&quot;,469777843,&quot;Calibri&quot;,469777844,&quot;Calibri&quot;,469769226,&quot;Calibri,Times New Roman&quot;,469775450,&quot;normaltextrun&quot;,201340122,&quot;1&quot;,134233614,&quot;true&quot;,469778129,&quot;normaltextrun&quot;,335572020,&quot;1&quot;,469778324,&quot;Default Paragraph Font&quot;]}">Request</span></span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><em><span data-contrast="auto">I am writing to make a request under the Freedom of Information Act 2000.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">I am researching NHS prescribing patterns for PCSK9 inhibitors in England, in the context of cardiovascular disease prevention policy. I would be grateful if you could provide the following information.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><strong><em><span data-contrast="auto">1 &mdash; Community prescribing (primary care and outpatient)</span></em></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">For the most recent full&nbsp;financial year&nbsp;available, and for each of the two preceding&nbsp;financial years&nbsp;(i.e. three years in total), please provide:</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(a) The total number of prescription items dispensed in the community in England for each of the following chemical substances / branded medicines:</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">&nbsp;&nbsp;&nbsp; &mdash;&nbsp;Evolocumab&nbsp;(brand name: Repatha)</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">&nbsp;&nbsp;&nbsp; &mdash; Alirocumab (brand name:&nbsp;Praluent)</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">&nbsp;&nbsp;&nbsp; &mdash;&nbsp;Inclisiran&nbsp;(brand name:&nbsp;Leqvio)</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(b) The Net Ingredient Cost (NIC) associated with each of the above for each year.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(c) Where possible, an estimate of the number of individual patients receiving each medicine (noting that one patient may generate multiple prescription items per year).</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><strong><em><span data-contrast="auto">2 &mdash; Secondary care / homecare supply</span></em></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">I understand that&nbsp;evolocumab&nbsp;in particular is&nbsp;classified as a 'red drug' on the NHS formulary and is typically supplied via hospital homecare companies rather than community pharmacies. To the extent that the NHSBSA holds or has access to secondary care medicines data (including via the Rx-Info/Prescribing Costs in Hospitals and the Community dataset):</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(a) Please provide the equivalent volume and cost data for&nbsp;evolocumab, alirocumab, and&nbsp;inclisiran&nbsp;dispensed via hospital pharmacy or homecare routes in England for the same three&nbsp;financial years.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(b) If the NHSBSA does not hold this data directly, please&nbsp;advise&nbsp;which NHS body does hold it and confirm whether an FOI request to that body would be the&nbsp;appropriate route.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><strong><em><span data-contrast="auto">3 &mdash; Private prescriptions</span></em></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(a) To the extent that the NHSBSA captures data on private prescriptions dispensed in England, please provide the number of private prescription items for&nbsp;evolocumab, alirocumab, and&nbsp;inclisiran&nbsp;for the same three&nbsp;financial years, with a note on the completeness and limitations of this data.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(b) If private prescription data for these medicines is not held, please confirm this explicitly.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><strong><em><span data-contrast="auto">4 &mdash;&nbsp;NICE expected&nbsp;uptake versus actual uptake</span></em></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(a) At the time NICE Technology Appraisal 394 (evolocumab) and Technology Appraisal 393 (alirocumab) were published in June 2016, NICE produced Resource Impact Reports estimating the expected number of patients who would be eligible for and receive these treatments. Please provide any data held by the NHSBSA on actual versus projected uptake of these medicines since 2016.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">(b) Please provide any data held in connection with the NHS England Pathway Transformation Fund for PCSK9 inhibitors, including the number of&nbsp;additional&nbsp;patients&nbsp;initiated&nbsp;on treatment&nbsp;as a result of&nbsp;that programme and in which Integrated Care Board areas.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><strong><em><span data-contrast="auto">PURPOSE OF THE REQUEST</span></em></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">This information is being&nbsp;sought&nbsp;for policy research purposes, specifically to document the scale of NHS prescribing of PCSK9 inhibitors&nbsp;relative&nbsp;to the estimated eligible population, as part of a submission to NICE and NHS England on cardiovascular disease prevention policy&nbsp;regarding&nbsp;Lipoprotein(a).</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><em><span data-contrast="auto">I am happy to receive the data in any standard electronic format (Excel, CSV, or PDF). If any part of this request would exceed the&nbsp;appropriate cost&nbsp;limit under Section 12 of the FOI Act, I would be grateful if you could&nbsp;advise&nbsp;which elements fall within the limit and provide those,&nbsp;advising&nbsp;me on how to refine the&nbsp;remainder.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><span data-contrast="auto">The NHS Business Services Authority (NHSBSA) received your request on&nbsp;15&nbsp;April&nbsp;2026.</span><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559737&quot;:0,&quot;335559738&quot;:0,&quot;335559739&quot;:0,&quot;335559740&quot;:259}">&nbsp;</span></p>
<p><span data-contrast="auto">We have handled your request unde</span><span data-contrast="auto">r the&nbsp;</span><span data-contrast="auto">Freedom of Information Act 2000 (FOIA).</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="none"><span data-ccp-charstyle="normaltextrun">Our response</span></span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">I can confirm that the NHSBSA holds&nbsp;some of&nbsp;the information you have&nbsp;requested&nbsp;and a copy of the information is attached.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Please read the below notes to ensure correct understanding of the data.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Data Source</span></strong><span data-contrast="auto">:&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">NHSBSA Information Services Data Warehouse</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Time Period:</span></strong><span data-contrast="auto">&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Data covers&nbsp;financial years&nbsp;2022/2023, 2023/2024 and 2024/2025.&nbsp;&nbsp;The data is presented by&nbsp;financial year.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Contents:</span></strong><span data-contrast="auto">&nbsp;&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">The data in this FOI release relates to prescribing of the following PCSK9 inhibitors (BNF Chemical Substance code in brackets):</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Inclisiran&nbsp;(0212000AM)</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Evolocumab&nbsp;(0212000AH)</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Alirocumab (0212000AI)</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">The data provided is based on prescribing by GP practices in England only.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">In the UNIQUE_IDENTIFIED_PATIENTS totals in the question 1 data, patients who could not be&nbsp;identified&nbsp;by means of&nbsp;a valid NHS number on the prescription form are excluded. The figures for the number of identifiable patients should not be combined and reported at any other level than provided as this may result in the&nbsp;double-counting&nbsp;of patients.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Exclusions:</span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">The data excludes:</span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="2" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Items not dispensed, disallowed and those returned to the contractor for further clarification.&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></li>
</ul>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="2" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="2" data-aria-level="1"><span data-contrast="auto">Prescriptions prescribed and dispensed in Prisons, Hospitals and Private prescriptions.</span><span data-ccp-props="{}">&nbsp;</span></li>
</ul>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="2" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="3" data-aria-level="1"><span data-contrast="auto">Items prescribed but not presented for dispensing or not&nbsp;submitted&nbsp;to NHS Prescription Services by the dispenser.</span><span data-ccp-props="{}">&nbsp;</span></li>
</ul>
<p><span data-contrast="auto">Please note we are unable to categorically state what medication was physically dispensed by the contactor; the data shows the medication for which payment was&nbsp;claimed.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">NHSBSA Prescription Services process prescriptions and information is then used to make payments to pharmacists and appliance contractors (in England) for prescriptions dispensed in primary care settings. This involves processing approximately 1 billion prescription items and payments totalling over &pound;9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health users.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Question 1</span></strong><span data-contrast="auto">:&nbsp;</span><strong><span data-contrast="auto">Community prescribing (primary care and outpatient)</span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">I can confirm that the NHSBSA holds the information you have requested and a copy of the information is attached.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Question 2:</span></strong><span data-contrast="auto">&nbsp;</span><strong><span data-contrast="auto">Secondary care / homecare supply</span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="none">Under Section 21 of the&nbsp;FOIA&nbsp;we&nbsp;are not required to&nbsp;provide information in response to a request if it is already reasonably accessible to you.&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">The information you requested on hospital activity data is available on the NHSBSA Open Data Portal at:</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><a href="https://opendata.nhsbsa.net/dataset/secondary-care-medicines-data-indicative-price"><span data-contrast="auto">https://opendata.nhsbsa.net/dataset/secondary-care-medicines-data-indicative-price</span></a><span data-contrast="auto">&nbsp;&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Please note this data relates to information on hospital pharmacy stock control, and is provided by&nbsp;RxInfo, a third-party organisation that collates the data and provides a copy to NHSBSA for release.&nbsp;&nbsp;Any queries relating to the sourcing or collation of the data should be directed to&nbsp;RxInfo.&nbsp;&nbsp;The data may&nbsp;contain&nbsp;activity&nbsp;which is supplied by Homecare organisations, but this is not made explicit in the data provided.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="none">Please see the following link to view the section 21 in full -&nbsp;</span><a href="https://www.legislation.gov.uk/ukpga/2000/36/section/21"><span data-contrast="none"><span data-ccp-charstyle="Hyperlink">https://www.legislation.gov.uk/ukpga/2000/36/section/21</span></span></a><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Question 3:</span></strong><span data-contrast="auto">&nbsp;</span><strong><span data-contrast="auto">Private prescriptions</span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="none">I am writing to&nbsp;advise&nbsp;you that following a search of our paper and electronic records, I have&nbsp;established&nbsp;that the information you requested is&nbsp;</span><span data-contrast="auto">not held by the NHSBSA.</span><span data-contrast="auto">&nbsp;No private prescriptions for the chemical substances in question were&nbsp;submitted&nbsp;to NHSBSA for payment in the&nbsp;time&nbsp;period&nbsp;specified.&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Additionally,&nbsp;the&nbsp;NHSBSA do not hold information on treatments which have been provided as a private service by pharmacies,&nbsp;or other healthcare providers.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="auto">Question 4:</span></strong><span data-contrast="auto">&nbsp;</span><strong><span data-contrast="auto">NICE expected&nbsp;uptake versus actual uptake</span></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><span data-contrast="none">I am writing to&nbsp;advise&nbsp;you that following a search of our paper and electronic records, I have&nbsp;established&nbsp;that the information you requested is&nbsp;</span><span data-contrast="auto">not held by the NHSBSA.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><span data-contrast="none"><span data-ccp-charstyle="normaltextrun" data-ccp-charstyle-defn="{&quot;ObjectId&quot;:&quot;ac0262f4-8a9e-5820-b908-2d943c5f7113|1&quot;,&quot;ClassId&quot;:1073872969,&quot;Properties&quot;:[469777841,&quot;Calibri&quot;,469777842,&quot;Times New Roman&quot;,469777843,&quot;Calibri&quot;,469777844,&quot;Calibri&quot;,469769226,&quot;Calibri,Times New Roman&quot;,469775450,&quot;normaltextrun&quot;,201340122,&quot;1&quot;,134233614,&quot;true&quot;,469778129,&quot;normaltextrun&quot;,335572020,&quot;1&quot;,469778324,&quot;Default Paragraph Font&quot;]}">Data Queries</span></span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="none">Please contact&nbsp;</span><a href="mailto:foirequests@nhsbsa.nhs.uk"><span data-contrast="none"><span data-ccp-charstyle="Hyperlink">foirequests@nhsbsa.nhs.uk</span></span></a><span data-contrast="none">&nbsp;ensuring you quote the above reference if you have any specific questions&nbsp;regarding&nbsp;this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan&nbsp;on publishing&nbsp;the data.</span><span data-ccp-props="{&quot;335559739&quot;:240}">&nbsp;</span></p>
<p><strong><span data-contrast="none"><span data-ccp-charstyle="normaltextrun">Reusing the data and copyright</span></span></strong><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">If you plan&nbsp;on producing&nbsp;a press or broadcast story based upon the&nbsp;data&nbsp;please contact&nbsp;</span><a href="mailto:communicationsteam@nhsbsa.nhs.uk"><span data-contrast="none"><span data-ccp-charstyle="Hyperlink">communicationsteam@nhsbsa.nhs.uk</span></span></a><span data-contrast="auto">. This is important to ensure that the figures are not misunderstood or misrepresented.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright.&nbsp;This information is licenced under the terms of the Open Government Licence&nbsp;detailed at:</span><span data-ccp-props="{&quot;335557856&quot;:16777215}">&nbsp;</span></p>
<p><a href="http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/"><span data-contrast="none"><span data-ccp-charstyle="Hyperlink">http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/</span></span></a><span data-contrast="auto">&nbsp;</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Should you wish to re-use the information you must include the following statement:&nbsp;</span><span data-contrast="auto">&ldquo;NHSBSA Copyright 2026&rdquo;.</span><span data-contrast="auto">&nbsp;Failure to do so is a breach of the terms of the licence.</span><span data-ccp-props="{}">&nbsp;</span></p>
<p><span data-contrast="auto">Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.</span><span data-ccp-props="{}">&nbsp;</span></p>

Tags: Alirocumab, Evolocumab, Inclisiran, PCSK9 inhibitors
Organization: Freedom of Information Disclosure Log