Public hospitals represent a very important market segment for most biopharmaceutical companies in Europe. They are the often the only market for the increasing numbers of speciality drugs emerging from R&D, with many primary care products also unable to get established for maintenance therapy in the community without hospital recommendation first. Though the processes for achieving hospital usage are very different to the reimbursed GP/community pharmacy sector, they have been poorly documented and often little understood. This report aims to clarify the situation for the UK, a particularly challenging country with four different public healthcare systems, numerous stakeholders, regular reforms, and rigorous health technology assessment.

Medicines prescribed in English hospitals in 2006 were valued at £2.7 billion (€3.4 billion). This represented 24% of the English NHS drugs bill (hospital prescribing in London alone accounted for 40% of all prescribing costs in the capital). Even more significantly, the hospital drug bill has been rising at more than twice the rate of GP prescribing costs.

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