National Prescribing Trends and Cost Analysis of Antidepressants, Anxiolytics, and Hypnotics in England, 2010–2023
Mike Stedman, Mark Davies, John Warner‐ Levy, Joseph Ingram, David Taylor, Adrian HealdABSTRACT
Introduction
We describe prescribing of anxiolytics/hypnotics/antidepressants at an all‐England level between 2010 and 2023, taking account of the influence of the COVID‐19 pandemic‐period.
Methods
All Primary Care Prescribing data for England for anxiolytics/hypnotics/antidepressant agents taken as tablets or capsules from 1 January 2010 to 31 December 2023 were considered.
Results
Antidepressants: the greatest increases were in sertraline prescriptions increasing from 2.9million 2010 by 685% to 23.0 million‐2023; duloxetine increased by 545% to 3.9million prescriptions; mirtazapine by 269% to 12.4million prescriptions. Regarding cost, overall average cost fell 2010‐2023 by 54% from £4.86(Euros 5.68) to £2.25(Euros 2.63) per prescription. Anxiolytics: the number of prescriptions for anxiolytics fell 6.5–4.8 m (−27%) overall, with all anxiolytics falling except buspirone. The greatest period of fall was seen between 2018 and 2023. Lorazepam/diazepam/chlordiazepoxide were down 23%,16%, 88% respectively. Average cost of prescriptions fell by 13% to £3.20(Euros 3.74). Hypnotics: the number of prescriptions for hypnotics fell 41% from 9.8million to 5.8million in 2023. All prescriptions fell in number. Annual trends showed no deviations for the COVID‐19 core pandemic (2020/2021) years.
Conclusion
Overall trends demonstrate a more than doubling of antidepressant prescribing over the period 2010–2023, with similar volume reduction in anxiolytics/hypnotics over the same period. Such real world data facilitate the development of policy influencing insights for psychotropic prescribing management now and in coming years.