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High Cost Drugs

The High Cost Drugs (HCD) data is a dataset containing specialist medicines prescribed by hospitals to patients for the management of long term conditions.


  • Data provider North East Commissioning Support Unit (NECS) with approvals from NHS Digital.
  • Participation / Coverage Hospital prescribing of high cost drugs across all 135 CCGs nationally.
  • Update frequency in OpenSAFELY Data covering April 2018 to March 2020 is currently available in OpenSAFELY, with no updates planned (see discussion section of paper for our proposal).
  • Delay between event occurring and event appearing in OpenSAFELY NA - currently a one off extract.
  • Collected information Patient characteristics; clinical indications; medicine prescribed.

Basic Background๐Ÿ”—

Hospitals in England supply medicines to patients either directly or through โ€œhomecareโ€ providers who deliver medicines to a patient's home. The majority of medicines are funded through overall hospital contracts, included in tariffs; however, for certain HCDs, hospitals are required to provide a submission for each patient to the relevant commissioner, either NHSE or one of 135 local CCGs, in order to receive payment.

The majority of submissions relate to a prescription of a HCD, although some submissions relate to associated services (i.e. home care delivery charges). There is a national list of the medicines that are funded by NHSE and locally agreed lists for each CCG. These patient-level submissions are processed by intermediate organisations, Commissioning Support Units (CSUs), to support financial payments and associated activities like summary reporting. This dataset contains data collated from all 135 CCGs to create a single comprehensive dataset.

The HCD dataset is a patient-level dataset and includes variables on patient characteristics, clinical indications and medicine prescribed. Details of the national specification for submissions to the dataset are published in the NHS data dictionary.

A paper describing the HCD dataset was published in December 2021.

More information๐Ÿ”—