Page 37 - P4304.1-V115 PS Magazine November 2025

The 10 most dispensed chemical substances by cost in 2024/25

Here’s the profitability Drug Cat Basic Net Margin Net Margin
analysis for high-cost Price (£) (25% Disc) (50% Disc)
list (Sept 2025 DT), (£) (£)
with hypothetical 25%
or 50% discount and Dapagliflozin M 30.15 4.17 11.70
11.18% clawback: Beclometasone C 7.42 1.03 2.88
dipropionate
Edoxaban C 17.50 2.42 6.79

Empagliflozin C 55.88 7.72 21.69
Beclomet/Formoterol/ C 74.97 10.36 29.10
Glycopyrronium
Semaglutide C 73.25 10.12 28.44
Sacubitril/ C 91.56 12.65 35.54
valsartan(Entresto)
Budesonide (Symbicort) C 14.00 1.93 5.43
Influenza — — — —
Tirzepatide C 255.00 35.24 98.99

Key points:

• High-cost Cat C items can generate very large potential margins, especially if 50%
discounting is secured (not necessarily possible but illustrates the point)
• Even mid-range products like empagliflozin or triple inhalers can return £20–30 net per
item at 50% discount.
• By contrast, everyday generics (Cat M) return pennies per item.
• This underscores how Cat C / Brand optimisation is the real determinant of
practice profitability.
I know not all Cat C or branded items carry discounts, but many do and you MUST seek these
out if you are to create enough value margin. Low-cost items are our nemesis, and opportunity
lies with the higher cost branded lines or category C items where we have a choice of product
to dispense when the prescription is written generically.

The hard fact is that 75% of your packs purchased on average are
generics, but 75% of your spend monthly goes on branded lines.

The financial reality is clear:

Failure to secure discounts on Branded medicines (and Cat C) risks wiping out all the profit
from dispensing Category M generics. You must work hard here to make sure you are signed
up to all the MDS schemes available and you really use your purchase reports to identify lines
where you might want to prescribe an alternative brand that will not create much needed
larger profits or use a particular cheaper available brand against a Cat M generic prescription.

Generics matter of course but your attention must be on brand deals to supplement the
woeful margins such small value creates. Please make sure one of your team have their eye on
the manufacturer discounts available and you act promptly when opportunities arise.

Impact of Drug Tariff Categories | PS Magazine 37

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P4304.1-V115 PS Magazine November 2025.indd 37 13/10/2025 14:07:27