The top 10 medicines: introduction

The top 10 medicines present trusts with monthly opportunities to make cost savings and optimise their use of medicines. The data has demonstrated that switching to lower cost equivalent medicines has not only saved money, but benefited patients.

Lord Carter's 2016 report into unwarranted variation in the NHS recommended that NHS Improvement should develop a list of the top 10 medicines with monthly savings opportunities for trusts to pursue, for example by purchasing cheaper 'biosimilar' versions or generic rather than branded products.

Cost and usage data for the top 10 medicines comes from the Define system by Rx-Info, which is used by around 100% of acute trusts.

The first version of the top 10 medicines list including uptake levels and savings delivery targets was published in 2017/18. It has now been updated for 2021/22.

Current top ten medicines list

Medicine Classification
Adalimumab  
Best value biologic
Trastuzumab IV  Best value biologic  
Infliximab  
 Best value biologic  
Etanercept
 Best value biologic  
Rituximab  
 Best value biologic  
Bortezomib
Price drop

Azacitidine

Price drop
Posaconazole  
Price drop
  Imatinib   
Price drop
Caspofungin 
Price drop
Over time the top ten medicines list will change with some medicines being retired from the list and others being introduced to replace them. The following changes have been made or are planned:

Historic top ten medicines list

Medicine Retired from
Cyclizine 2018/19
Prednisolone 2018/19
Linezolid 2019/20
Valganciclovir 2019/20
Voriconazole 2021/22

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