Statistics on Obesity, Physical Activity and Diet, England 2021

This part presents information on the number of prescriptions for drugs used to treat obesity and the Net Ingredient Cost (NIC) of these prescriptions. The data source is Prescription Analysis and Cost (PACT) data from NHS Prescription Services. It includes items prescribed in primary care and dispensed in the community. It excludes prescriptions written in hospitals that are dispensed in the community, prescriptions dispensed in hospitals, dental prescribing and private prescriptions.

The NIC is the basic cost of a drug as listed in the Drug Tariff or price lists; it does not include discounts, dispensing costs, prescription charges or fees.

Since 2010, Orlistat (Xenical®) is the only drug available in the UK that is recommended specifically for the management of obesity. Orlistat acts by reducing the absorption of dietary fat. Clinical guidelines state that pharmacological interventions should only be used in conjunction with other interventions (exercise, diet).

NICE guidance on identifying, assessing and managing obesity

Prescribing data is reported by financial year (previously calendar year). However, as financial year data is only available from 2014/15, time series analysis will continue to be based on calendar years. Calendar year data is shown in table 6.1b.

Items prescribed, by year

294 thousand items (Orlistat) were prescribed for the treatment of obesity in primary care in 2020. That is 17% fewer than in 2019 when there were 355 thousand items, and continues a long-term downward trend.

Please note that there was a stock shortage of Orlistat in 2012 and this is reflected in the time series charts below. Please see Stock Shortages Update for more details.

Net Ingredient Cost (NIC) of items, by year

The NIC of items (Orlistat) fell to £8.8 million in 2020, an decrease of 16% from £10.4 million in 2019. This is 76% lower than 2010, when the NIC of items (Orlistat) was £36.3 million.

As such the NIC per item (Orlistat) in 2020 was £30, which is similar to 2019 (£29) but £5 lower compared to a peak in 2013 (£35).

Prescription items per 1,000 population, by Clinical Commissioning Group (CCG)

NHS Barnsley had the highest prescription rate with 17 items per 1,000 population. NHS Stoke on Trent had a prescription rate of 16 items per 1,000 population, and NHS Knowsley had a prescription rate of 15 per 1,000 population.

NHS Bury, NHS Nene and NHS Mansfield and Ashfield all recorded almost zero rates.

Prescription items per 1,000 population, by Clinical Commissioning Group (CCG)

Prescription items per 1,000 population, by NHS Commissioning Region

In 2019/20, North West had the highest prescription rate with 9 items per 1,000 population, and South East had the lowest rate with 4.

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For more data/information on this section see:

Tables 6.1a to 6.2 of  Statistics on Obesity, Physical Activity and Diet - England 2021