Variation in duration of repeat prescriptions

New research has revealed dramatic and unexplained variation in how long repeat prescriptions last across England, with some areas issuing mostly month-long prescriptions while others favour two-month supplies for the same medicines. The study found that 48.5% of prescriptions were for 28 days and 43.6% for 56 days, but regional variation was striking – in some parts of England just 7% of prescriptions were for 28 days, while in others it was as high as 95%.

These findings are important because repeat prescriptions represent a huge part of how people interact with the NHS – around two-thirds of the 1.1 billion annual prescriptions are repeats, mostly for long-term conditions. The wide variation suggests that factors such as local policy, payment structures, and computer system defaults may be influencing prescription length more than clinical need, potentially creating unnecessary work for patients, GPs, and pharmacies. Longer prescriptions could reduce inconvenience for patients and save time for NHS staff, yet there's currently no national guidance driving consistent practice.

Dr Helen Curtis, a Senior Researcher in the Bennett Institute and senior author on the paper, said: ‘This research shows that there is no consistent approach to how long repeat prescriptions last in England, even for the same medicines and conditions. While some variation may be clinically appropriate, the scale of the differences suggests that local policy, payment structures, and system design are also playing a role.’

The research team analysed over 160 million prescriptions issued between December 2018 and November 2019 using OpenPrescribing data. They focused on five commonly used medicines for long-term conditions including hypertension, hypercholesterolaemia, and thyroid problems: amlodipine, ramipril, atorvastatin, simvastatin, and levothyroxine.

MacKenna B, et al. Br J Gen Pract 2025;75 (756):e448-e456 https://doi.org/10.3399/BJGP.2024.0326