England & United States · NHSBSA and CMS public data · By medicine
What health systems spend on each medicine
The cost of every medicine dispensed in the community in England, and every drug reimbursed by US Medicaid, from the two systems' own published data.
Sources: NHSBSA Prescription Cost Analysis (Open Government Licence v3.0); CMS State Drug Utilization Data and FDA NDC Directory (US public domain).
NHS to Aug 2026 · Medicaid 2025
£11.95bnNHS England medicines and appliances, Sep 2025 to Aug 2026 (+7.4% on the 12 months before)
1.31bnPrescription items dispensed in England, same 12 months
$111.94bnPaid by US Medicaid for outpatient drugs in 2025, before rebates (+8.2% on 2024)
725mMedicaid prescriptions in 2025
NHS England spent £11.95bn on medicines and appliances dispensed in the community from Sep 2025 to Aug 2026, +7.4% on the previous 12 months, at list price before discounts. Tirzepatide cost the most, at £854.0m, and the ten costliest items took 23.2% of the total. US Medicaid paid $111.94bn for outpatient drugs in 2025 before manufacturer rebates, led by semaglutide (Ozempic, Wegovy, Rybelsus) at $6.50bn. Both figures are gross: neither system publishes the discounts and rebates it receives per drug.
Showing medicines matching “Calcium”: 18 in England, 43 in Medicaid (first 100 of each).
01
NHS England: cost by medicine
Sep 2025 to Aug 2026, net ingredient cost| # | Medicine (BNF chemical substance) | Cost, 12 months | Change | Items | Cost per item |
|---|---|---|---|---|---|
| Rosuvastatin calcium Cardiovascular System |
£16.8m | +70.0% | 7,955,657 | £2.11 | |
| Calcium carbonate Nutrition and Blood |
£2.4m | +0.1% | 432,412 | £5.64 | |
| Acamprosate calcium Central Nervous System |
£2.4m | +5.7% | 175,655 | £13.56 | |
| Calcium acetate Nutrition and Blood |
£711k | +12.7% | 85,922 | £8.28 | |
| Patiromer calcium Nutrition and Blood |
£695k | +5.5% | 3,556 | £195.53 | |
| Other calcium supplement preparations Nutrition and Blood |
£624k | +5.5% | 19,210 | £32.47 | |
| Calcium folinate Malignant Disease and Immunosuppression |
£482k | -4.9% | 2,761 | £174.69 | |
| Calcium carbonate Gastro-Intestinal System |
£219k | +3.0% | 11,345 | £19.28 | |
| Powder low calcium infant formula (0913109) Nutrition and Blood |
£150k | +8.4% | 531 | £282.56 | |
| Calcium polystyrene sulfonate Nutrition and Blood |
£60k | -38.8% | 468 | £129.03 | |
| Calcium gluconate Nutrition and Blood |
£35k | +3.9% | 1,096 | £31.78 | |
| Heparin calcium Cardiovascular System |
£4k | +100.0% | 17 | £237.93 | |
| Calcium acetate/magnesium carbonate Nutrition and Blood |
£3k | -97.5% | 253 | £9.97 | |
| Fosfomycin calcium Infections |
£1k | -31.9% | 11 | £109.65 | |
| Pantothenic acid (Calcium pantothenate) Nutrition and Blood |
£103 | -13.1% | 5 | £20.64 | |
| Perindopril with calcium channel blocker Cardiovascular System |
£65 | -51.9% | 3 | £21.67 | |
| Ramipril with calcium channel blocker Cardiovascular System |
£8 | -94.8% | 1 | £7.54 | |
| Calcium lactate Nutrition and Blood |
£5 | +3.7% | 2 | £2.50 |
Net ingredient cost is the list price of what was dispensed, before discounts, fees and patient charges. It covers prescriptions dispensed in the community in England, including appliances such as glucose sensors and catheters, not hospital medicines. Where the BNF moved products to a new code during the year, no change is shown because the two periods count different products. Cost per item is calculated here.
02
US Medicaid: spending by drug
2025, amount Medicaid reimbursed| # | Drug (active ingredient) | Medicaid paid, 2025 | Change on 2024 | Prescriptions | Per prescription |
|---|---|---|---|---|---|
| Calcium, magnesium, potassium, and sodium oxybates Xywav |
$156.0m | +13.0% | 9,685 | $16,105.50 | |
| Atorvastatin calcium Atorvastatin Calcium, Atorvastatin calcium, Atorvastatin Calcium, atorvastatin calcium |
$94.5m | +13.3% | 9,112,795 | $10.37 | |
| Rosuvastatin calcium Rosuvastatin Calcium, Rosuvastatin calcium, Rosuvastatin, Crestor |
$45.9m | +7.7% | 3,962,984 | $11.58 | |
| Atorvastatin calcium Atorvastatin Calcium, Atorvastatin Calcium |
$35.1m | -25.0% | 3,147,505 | $11.14 | |
| Calcium gluconate Calcium Gluconate, Calcium Gluconate, Calcium Gluconate in Sodium Chloride, calcium gluconate |
$18.0m | +0.9% | 61,021 | $294.35 | |
| Sodium chloride, potassium chloride, sodium lactate and calcium chloride Lactated Ringers, Lactated Ringers, Lactated Ringers Irrigation |
$13.4m | -77.4% | 844,920 | $15.84 | |
| Leucovorin calcium Leucovorin Calcium, Leucovorin Calcium, leucovorin calcium, Leucovorin calcium |
$12.3m | +51.1% | 163,087 | $75.62 | |
| Doconexent, niacinamide, .alpha.-tocopherol acetate, dl-, cholecalciferol, .beta.-carotene, ascorbic acid, thiamine mononitrate, riboflavin, pyridoxine hydrochloride, cyanocobalamin, iron, zinc oxide, cupric oxide, potassium iodide, magnesium oxide, folic acid, and levomefolate calcium Vitafol, Vitafol Fe Plus |
$12.2m | -12.5% | 81,565 | $149.50 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, pyridoxine hydrochloride, folic acid, levomefolate calcium, cyanocobalamin, biotin, calcium carbonate, ferrous asparto glycinate, iron, potassium iodide, magnesium oxide, doconexent and lowbush blueberry Prenate Mini |
$10.2m | +267.3% | 19,273 | $531.59 | |
| Acamprosate calcium enteric-coated Acamprosate Calcium, acamprosate calcium |
$8.3m | -7.3% | 92,701 | $90.01 | |
| Calcium acetate Calcium Acetate, calcium acetate, Calcium Acetate, Calcium Chloride |
$3.6m | +11.6% | 88,980 | $40.16 | |
| Fenoprofen calcium Fenopron, Fenoprofen Calcium |
$2.9m | +365.3% | 1,940 | $1,513.61 | |
| Antacid tablets Major Regular Strength, Rugby Cal-Gest Antacid, Calcium Carbonate, Rugby |
$2.4m | +6.6% | 251,611 | $9.55 | |
| Pitavastatin calcium Livalo, Pitavastatin, pitavastatin calcium, Pitavastatin Calcium |
$1.8m | -37.6% | 14,771 | $121.76 | |
| Levomefolate magnesium, leucovorin, folic acid, ferrous cysteine glycinate, magnesium ascorbate, zinc ascorbate, cocarboxylase, flavin adenine dinucleotide, nadh, pyridoxal phosphate anhydrous, cobamamide, betaine, magnesium l-threonate, 1,2-docosahexanoyl-sn-glycero-3-phosphoserine calcium, 1,2-icosapentoyl-sn-glycero-3-phosphoserine calcium, and phosphatidyl serine EnBrace HR |
$1.7m | -11.8% | 12,038 | $138.21 | |
| Vitamin a, vitamin c, vitamin d, vitamin e, thiamine, riboflavin, niacin, vitamin b6, folic acid, vitamin b12, calcium, iron, zinc, copper M-Natal Plus |
$1.5m | +4.4% | 139,503 | $10.86 | |
| Drospirenone, ethinyl estradiol and levomefolate calcium and levomefolate calcium drospirenone, ethinyl estradiol and levomefolate calcium and levomefolate calcium, Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium, Beyaz, Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium |
$1.4m | -14.3% | 12,775 | $113.09 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, folic acid, levomefolate calcium, pyridoxine hydrochloride, cyanocobalamin, calcium formate, ferrous asparto glycinate, magnesium oxide and doconexent Prenate Dha |
$1.3m | +7.0% | 2,569 | $508.45 | |
| Vitamin a, ascorbic acid, vitamin d, .alpha.-tocopherol, thiamine mononitrate, riboflavin, niacin, pyridoxine hydrochloride, folic acid, cyanocobalamin, calcium, iron, magnesium, zinc, copper, and doconexent Vitafol-OB Plus DHA |
$1.2m | -17.8% | 8,233 | $146.65 | |
| .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, thiamine, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, cyanocobalamin, calcium pantothenate, calcium carbonate, ferrous fumarate, zinc oxide and docusate sodium Se-Natal 19 |
$1.1m | +2.3% | 39,538 | $28.00 | |
| .beta.-carotene, vitamin a acetate, ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, levomefolate calcium, cobalamin, iron, magnesium oxide, zinc oxide, and doconexant Select-OB Plus DHA |
$1.1m | -5.4% | 8,040 | $135.97 | |
| Calcium polycarbophil Fiber Lax, Fiber Tabs, Calcium Polycarbophil, Foster and Thrive Fiber Laxative 147 |
$1.1m | -2.3% | 114,878 | $9.45 | |
| Vitamin c, calcium, iron, vitamin d3, vitamin e, thiamin, riboflavin, niacinamide, vitamin b6, folic acid, iodine, zinc, copper, docusate sodium CitraNatal 90 DHA |
$509k | -26.9% | 3,941 | $129.09 | |
| Ascorbic acid, biotin, cholecalciferol, cyanocobalamin, levomefolate calcium, folic acid, ferrous asparto glycinate, potassium iodide, pyridoxine hydrochloride, .alpha.-tocopherol acetate, dl-, docosahexaenoic acid, and blueberry Prenate Pixie |
$432k | -14.0% | 1,076 | $401.57 | |
| Leucine, phenylalanine, lysine, methionine, isoleucine, valine, histidine, threonine, tryptophan, alanine, glycine, arginine, proline, serine, tyrosine, dibasic potassium phosphate, magnesium chloride, sodium chloride, calcium chloride, dextrose Clinimix E |
$401k | -24.3% | 787 | $510.09 | |
| .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, levomefolate calcium, calcium formate, ferrous asparto glycinate, cyanocobalamin, biotin, potassium iodide, magnesium oxide, zinc oxide and cupric oxide Prenate Elite |
$398k | +15.7% | 939 | $423.71 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, pyridoxine, folic acid, cyanocobalamin, calcium, ferrous fumarate, magnesium, doconexent Pnv-dha |
$218k | -69.6% | 4,658 | $46.86 | |
| Edetate calcium disodium Edetate Calcium Disodium |
$204k | -94.3% | 183 | $1,114.84 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, folic acid, pyridoxine hydrochloride, cyanocobalamin, biotin, calcium carbonate, ferrous fumarate, magnesium oxide, lactic acid and doconexent PRENATE Enhance |
$188k | +114.1% | 1,751 | $107.14 | |
| Sodium chloride, sodium lactate, potassium chloride, calcium chloride and dextrose monohydrate Lactated Ringers and Dextrose, Dextrose in Lactated Ringers, Potassium Chloride in Lactated Ringers and Dextrose |
$179k | -68.6% | 16,195 | $11.03 | |
| Levoleucovorin Khapzory, Levoleucovorin, Levoleucovorin Calcium |
$127k | -42.3% | 573 | $221.67 | |
| Ascorbic acid, calcium citrate, iron, vitamin d, dl- alpha- tocopherol acetate, thiamine, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, iodine, zinc, copper, docusate sodium, doconexent and icosapent CitraNatal Assure |
$88k | -28.7% | 668 | $131.02 | |
| Calcium carbonate, cholecalciferol, magnesium oxide, boron, folic acid, levomefolate glucosamine, pyridoxine hydrochloride, cyanocobalamin, biotin and blueberry Prenate Chewable |
$85k | -26.8% | 177 | $478.66 | |
| Vitamin a acetate, ascorbic acid, cholecalciferol, alpha-tocopherol acetate, dl, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, cyanocobalamin, biotin, calcium pantothenate, calcium carbonate, ferrous fumarate, potassium iodide, magnesium oxide, zinc oxide and cupric oxide PNV-Select |
$75k | -39.0% | 1,795 | $41.73 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, pyridoxine hydrochloride, folic acid, levomefolate calcium, cyanocobalamin, biotin, calcium formate, ferrous asparto glycinate, potassium iodide, magnesium oxide, doconexent and icosapent Prenate Essential |
$56k | -45.1% | 146 | $383.60 | |
| Fosamprenavir calcium Fosamprenavir Calcium |
$40k | -39.2% | 30 | $1,332.32 | |
| Multi-vitamin/mineral supplement with sodium ascorbate, cholecalciferol, di-alpha-tocopheryl acetate, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hcl, folic acid, cyanocobalamin, calcium formate, calcium carbonate, ferrous (ii) bis-glycinate chelate, potassium iodide, zinc oxide, and choline bitartrate Nestabs |
$37k | -85.7% | 578 | $64.78 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, dl-, folic acid, pyridoxine hydrochloride, cyanocobalamin, biotin, calcium, iron, magnesium oxide, lactic acid and doconexent PRENATE Restore |
$26k | -50.1% | 73 | $360.71 | |
| Vitamin a, calcium pantothenate, ascorbic acid, cholecalciferol, .alpha.-tocopherol succinate, d-, thiamine, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, biotin, cyanocobalamin, selenium, magnesium oxide, zinc oxide, cupric sulfate, manganese, chromium, .alpha.-lipoic acid, and lutein Strovite One |
$23k | -61.4% | 276 | $82.47 | |
| Ascorbic acid, cholecalciferol, .alpha.-tocopherol, pyridoxine hydrochloride, folic acid, cyanocobalamin, calcium corbonate, ferrous fumarate, potassium iodide, magnesium, doconexent, icosapent PNV-Omega |
$19k | -6.3% | 337 | $55.04 | |
| Famotidine, calcium carbonate and magnesium hydroxide foster and thrive acid reducer antacid, leader acid reducer complete |
$13k | +82.0% | 685 | $18.80 | |
| Sodium ascorbate, cholecalciferol, di-alpha-tocopheryl acetate, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hcl, folic acid, cyanocobalamin, calcium formate, calcium carbonate, ferrous (ii) bis-glycinate chelate, potassium iodide, zinc oxide, choline bitartrate, with doconexent and icosapent Nestabs Dha |
$9k | -93.9% | 40 | $213.92 | |
| Sodium chloride, sodium lactate, calcium chloride, magnesium chloride and dextrose DIANEAL Low Calcium with Dextrose |
$219 | new | 12 | $18.26 |
The amount Medicaid reimbursed pharmacies for outpatient drugs, national totals from all states, before the manufacturer rebates Medicaid receives (CMS does not publish rebates per drug). Rows CMS suppresses because they cover fewer than 11 prescriptions are left out. Products are grouped by active ingredient using the FDA NDC Directory, which named 99.4% of the spending; the rest keeps CMS's short product name and is only in the product totals. Cost per prescription is calculated here.
How this page is built
Every amount is the sum of the source's own published figures. Contains public sector information licensed under the Open Government Licence v3.0 (NHSBSA). Changes, shares and costs per item or prescription are calculated here and labelled.
- NHSBSA Prescription Cost Analysis, monthly ↗ net ingredient cost and items by BNF presentation, England, Open Government Licence v3.0
- CMS State Drug Utilization Data 2025 ↗ national totals (state XX) by NDC, US public domain
- FDA National Drug Code Directory ↗ brand, active ingredient and labeler for each NDC product, including delisted products
A job downloads both datasets every week, sums them by medicine and keeps the previous version if either source fails or returns far fewer medicines than before. No AI drafting and no editorial pass. See our methodology. The NHSBSA and CMS data on this page was last retrieved on 9 Nov 2026. How every register is built: methodology · fixes we have made: corrections log.
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team holds life-science qualifications, not clinical ones. It is not exhaustive and may not reflect the most
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