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 £11.89bn on medicines and appliances dispensed in the community from Aug 2025 to Jul 2026, +6.6% on the previous 12 months, at list price before discounts. Tirzepatide cost the most, at £795.3m, and the ten costliest items took 22.6% 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 “Fintepla”: 0 in England, 1 in Medicaid (first 100 of each).
No medicine in the NHS England data matches that search.
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.
| # | Drug (active ingredient) | Medicaid paid, 2025 | Change on 2024 | Prescriptions | Per prescription |
|---|---|---|---|---|---|
| Fenfluramine Fintepla |
$228.2m | +30.6% | 18,083 | $12,616.93 |
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.
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.
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 30 Sep 2026. How every register is built: methodology · fixes we have made: corrections log.
