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.
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 “Dextromethorphan”: 2 in England, 23 in Medicaid (first 100 of each).
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 |
|---|---|---|---|---|---|
| Dextromethorphan hydrobromide Respiratory System |
£57k | -50.8% | 1,792 | £31.63 | |
| Dextromethorphan hydrobrom compound prepartions Respiratory System |
£307 | +39.3% | 61 | £5.03 |
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.
US Medicaid: spending by drug
2025, amount Medicaid reimbursed| # | Drug (active ingredient) | Medicaid paid, 2025 | Change on 2024 | Prescriptions | Per prescription |
|---|---|---|---|---|---|
| Dextromethorphan hydrobromide, bupropion hydrochloride Auvelity |
$139.2m | +64.9% | 137,295 | $1,013.62 | |
| Dextromethorphan hydrobromide and quinidine sulfate Nuedexta, Nuedexta |
$28.9m | -11.7% | 23,119 | $1,250.79 | |
| Brompheniramine maleate, pseudoephedrine hydrochloride and dextromethorphan hydrobromide Brompheniramine Maleate, Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide, Brompheniramine Maleate, Pseudoephedrine Hydrochloride, Dextromethorphan Hydrobromide, Brompheniramine Maleate, Pseudoephedrine Hydrochloride, and Dextromethorphan Hydrobromide, Brompheniramine maleate, pseudoephedrine hydrochloride, |
$28.0m | +10.1% | 1,630,969 | $17.18 | |
| Promethazine hydrochloride and dextromethorphan hydrobromide Promethazine Hydrochloride and Dextromethorphan Hydrobromide, Promethazine DM |
$11.2m | +33.3% | 802,063 | $13.91 | |
| Guaifenesin, dextromethorphan hbr Mucus Relief DM Extended Release Caplets, robafen dm, Chest Congestion Relief, Guaifenesin and Dextromethorphan Hydrobromide |
$7.7m | +29.6% | 510,171 | $15.18 | |
| Brompheniramine maleate, dextromethorphan hydrobromide, phenylephrine hydrochloride Rynex, dimaphen dm, EndaCof DM, Good Sense Childrens Cold and Cough |
$1.7m | -41.0% | 123,836 | $13.80 | |
| Dextromethorphan hydrobromide, guaifenesin, and phenylephrine hydrochloride DEXTROMETHORPHAN HYDROBROMIDE, Guaifenesin, and PHENYLEPHRINE HYDROCHLORIDE, Vanacof Dm, Deconex, Tussin Multi Symptom Cold CF |
$1.2m | -6.1% | 63,630 | $18.34 | |
| Dextromethorphan polistirex dextromethorphan polistirex extended release, cough dm, leader childrens cough dm, Leader Cough |
$940k | +9.9% | 65,133 | $14.43 | |
| Dextromethorphan hydrobromide, guaifenesin and pseudoephedrine hydrochloride Capmist DM, Poly-Vent DM |
$518k | +1.8% | 36,940 | $14.02 | |
| Dextromethorphan hbr and pyrilamine maleate Capron DM, Pyrilamine Maleate and Dextromethorphan Hydrobromide, Capron DMT, Capron Max |
$329k | -26.8% | 17,246 | $19.10 | |
| Chlorpheniramine maleate, dextromethorphan hydrobromide and phenylephrine hydrochloride NoHist DM, Ed A-hist Dm |
$215k | -43.6% | 24,400 | $8.79 | |
| Dextromethorphan hydrobromide, phenylephrine hydrochloride, and triprolidine hydrochloride Histex-dm |
$129k | -34.9% | 13,039 | $9.89 | |
| Dextromethorphan hbr, pheniramine maleate, phenylephrine hcl Alahist Dm |
$51k | +282.2% | 5,356 | $9.54 | |
| Chlorpheniramine maleate, dextromethorphan hbr Cough and Cold HBP, Cough and Cold |
$13k | +382.8% | 1,803 | $7.10 | |
| Acetaminophen, dextromethorphan hbr, guaifenesin, pseudoephedrine hcl Duraflu |
$6k | +41.8% | 299 | $19.60 | |
| Dextromethorphan hbr, phenylephrine hcl, pyrilamine maleate Polytussin DM |
$2k | +213.6% | 207 | $10.81 | |
| Acetaminophen, dextromethorphan hbr, guaifenesin, phenylephrine hcl Severe Cold and Flu, foster and thrive daytime severe cold and flu relief, Cold Flu Severe |
$2k | -59.3% | 200 | $8.42 | |
| Acetaminohpen, dextromethorphan hbr, phenylephrine hcl Cold and Flu Relief, foster and thrive daytime cold and flu relief |
$1k | -36.5% | 93 | $12.41 | |
| Brompheniramine maleate, dextromethorphan hydrobromide childrens cold and cough, good sense childrens cold cough, Leader Childrens Cold and Cough, Foster and Thrive childrens cold cough relief dm |
$961 | new | 84 | $11.44 | |
| Triprolidine hcl, dextromethorphan hbr Endal |
$382 | +210.4% | 41 | $9.31 | |
| Dexbrompheniramine maleate, dextromethorphan hydrobromide, pseudoephedrine hydrochloride | $0 | -100.0% | 0 | — | |
| Acetaminophen, chlorpheniramine maleate, dextromethorphan hydrobromide, and phenylephrine hydrochloride | $0 | -100.0% | 0 | — | |
| Benzocaine and dextromethorphan hydrobromide | $0 | -100.0% | 0 | — |
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.