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Oral iron

Ferrous fumarate prescribing across the NHS.

Ferrous fumarate has overtaken ferrous sulfate as England's iron of choice: 5.5m items a year against 4m. The switch is tolerability folklore and formulary fashion as much as evidence, and both lines are growing as anaemia pathways push more testing.

Scorecard, last 12 months
Items
5.5m
dispensed in the last 12 months
Spend
£10.6m
at NIC, last 12 months
Year on year
+4.3% +4.3%
vs the 12 months before
Latest month
May 2026
most recent NHSBSA release
Key facts · plain English

The NHS in England dispensed 5,493,703 prescription items of Ferrous fumarate in the 12 months to May 2026, across primary care and hospitals.

Spending on Ferrous fumarate over those 12 months was £10.6m at net ingredient cost, the list price of what was dispensed before any discounts.

Items were up 4.3% on the previous 12 months.

94% of Ferrous fumarate volume moved through primary care and 6% through hospital pharmacies.

Ferrous fumarate is the largest of 7 chemical substances in Oral iron (BNF 9.1.1.1), by items dispensed.

Among Integrated Care Boards, NHS North East and North Cumbria ICB dispensed the highest volume of Ferrous fumarate.

Source: NHS Business Services Authority open data (English Prescribing Data and SCMD), OGL v3.0. Items count prescriptions dispensed, not patients treated.

National trend · since 2020
Ferrous fumarate, England: monthly items and spend
Items per month (teal) and spend, £ (orange)
items £ 2020-11 2023-08 2026-05
Source: NHSBSA English Prescribing Data (OGL v3.0).
MonthItemsSpend (NIC)
May 2026 458,008 £768k
April 2026 466,959 £834k
March 2026 472,929 £714k
February 2026 432,009 £648k
January 2026 459,134 £681k
December 2025 473,160 £998k
November 2025 436,999 £937k
October 2025 472,297 £1.0m
September 2025 461,252 £995k
August 2025 434,753 £934k
July 2025 477,653 £1.0m
June 2025 448,550 £985k

The same series as the chart, most recent month first. The full monthly history, as CSV, sits behind Apply.

Cost per item · price erosion
Ferrous fumarate, England: cost per item
Actual cost per item, primary care (£)
£2.78 £1.37 2020-11 2023-08 2026-05
Source: NHSBSA English Prescribing Data (OGL v3.0).
Market share

54.7% of its class.

Ferrous fumarate is the largest of 7 chemical substances in Oral iron (BNF 9.1.1.1), by items dispensed in May 2026. The full class league, who's gaining, and the month-by-month share movement sit behind Apply.

See the full class picture →

Seasonality
Average items by calendar month, indexed to the year (100 = average)
120 100 80 JFMAMJJASOND

Average items by calendar month across the full history, indexed to the annual mean.

Where it's prescribed · England

Ferrous fumarate across all 36 ICBs.

Every Integrated Care Board in England, shaded by how much ferrous fumarate its GPs dispense per head of population. Hover an ICB to name it. The ranked figures for all 36 ICBs, and the drill-down to practice level, are in the full report.

NHS Cheshire and Merseyside ICBNHS Staffordshire and Stoke-on-Trent ICBNHS Shropshire, Telford and Wrekin ICBNHS Lincolnshire ICBNHS Leicester, Leicestershire and Rutland ICBNHS Coventry and Warwickshire ICBNHS Herefordshire and Worcestershire ICBNHS North East London ICBNHS South East London ICBNHS South West London ICBNHS Kent and Medway ICBNHS Cornwall and the Isles of Scilly ICBNHS Devon ICBNHS Somerset ICBNHS Bristol, North Somerset and South Gloucestershire ICBNHS Bath and North East Somerset, Swindon and Wiltshire ICBNHS Dorset ICBNHS Gloucestershire ICBNHS Lancashire and South Cumbria ICBNHS North East and North Cumbria ICBNHS Humber and North Yorkshire ICBNHS West Yorkshire ICBNHS Birmingham and Solihull ICBNHS Greater Manchester ICBNHS Derby and Derbyshire ICBNHS Northamptonshire ICBNHS Nottingham and Nottinghamshire ICBNHS South Yorkshire ICBNHS Black Country ICBNHS Central East ICBNHS Essex ICBNHS Hampshire and Isle of Wight ICBNHS Norfolk and Suffolk ICBNHS Surrey and Sussex ICBNHS Thames Valley ICBNHS West and North London ICB
Items per 1,000 registered patients, 12 months
FewerMore

Darker shading marks where Ferrous fumarate is dispensed most per head of population. Exact figures for every ICB, and the drill-down to practice level, are in the full report.

Data: NHSBSA English Prescribing Data (OGL v3.0). Boundaries: ONS Open Geography portal, ICBs April 2026, contains OS data © Crown copyright and database right 2026.

Zoomed out to the 7 NHS regions.

The same 12 months rolled up to NHS England's seven regions, ranked by intensity.

North WestMidlandsMidlandsMidlandsMidlandsMidlandsMidlandsLondonLondonLondonSouth EastSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestNorth WestNorth East and YorkshireNorth East and YorkshireNorth East and YorkshireMidlandsNorth WestMidlandsMidlandsMidlandsNorth East and YorkshireMidlandsEast of EnglandEast of EnglandSouth EastEast of EnglandSouth EastSouth EastLondon
Items per 1,000 registered patients, 12 months
North East and Yorkshire
North West
London
Midlands
South East
East of England
South West
Data: NHSBSA English Prescribing Data (OGL v3.0). Regions: ONS Open Geography portal, NHS England regions April 2026. Contains OS data © Crown copyright and database right 2026.
Top 3 previews

The teaser view.

Three rows each. The full 36-ICB view, every prescribing organisation, every strength and the hospital picture sit below the fold, behind Apply.

Top ICBs by volume
  1. 1 NHS North East and North Cumbria ICB 424k
  2. 2 NHS West and North London ICB 376k
  3. 3 NHS North East London ICB 343k
  4. + 33 more. Unlock the full 36-ICB table. Unlock →
Fastest-growing ICBs (YoY)
  1. 1 NHS Coventry and Warwickshire ICB +20.8%
  2. 2 NHS West Yorkshire ICB +16.2%
  3. 3 NHS South West London ICB +10.9%
  4. + 33 more. Unlock every ICB, ranked. Unlock →
Top formulations
  1. 1 Ferrous fumarate 210mg tablets 79%
  2. 2 Ferrous fumarate 322mg tablets 10%
  3. 3 Ferrous fumarate 305mg capsules 6%
  4. + 3 more. Unlock every strength and pack. Unlock →
Primary vs secondary care
Primary 94% Hospital 6%

Split of items across NHSBSA primary care and SCMD hospital dispensing.

Deprivation · IMD 2019

Prescribing by deprivation.

Items per 1,000 registered patients by IMD decile — 1 = most deprived, 10 = least
50.1 0 12345678910

Items per 1,000 registered patients by deprivation decile (1 = most deprived), practice deprivation weighted by where each practice's patients live. Read the shape rather than the absolute level: the most and least deprived deciles cover far fewer practices, and age structure drives much of the gradient.

Beyond England

The devolved nations.

NationItems · 12 monthsData to
England 5.5m May 2026
Northern Ireland 182k May 2026
Scotland 516k April 2026
Wales 486k April 2026

Each nation publishes its own community prescribing data, with different coding and list rules, so read these per-nation rather than as an exact UK total. Sources: NHSBSA (England), Public Health Scotland.

Honesty strip

What open data won't tell you about ferrous fumarate.

Neither line shows whether anyone's haemoglobin improved, or how many packets sat unfinished because of the side effects that make oral iron notorious.

Read exactly what the data covers →

Common questions

Asked and answered.

Is ferrous fumarate prescribing rising or falling in the NHS?

Rising. England dispensed 5,493,703 items of Ferrous fumarate in the 12 months to May 2026, up 4.3% on the previous 12 months. Items count prescriptions dispensed, not patients treated, so the change can reflect dose and duration shifts as well as patient numbers.

How much does the NHS spend on ferrous fumarate?

£10.6m at net ingredient cost in the 12 months to May 2026. Net ingredient cost is the list price of the medicine before discounts and rebates; the NHS's final bill, especially for hospital medicines, is usually lower.

Where in England is ferrous fumarate prescribed most?

By raw volume, NHS North East and North Cumbria ICB dispensed the most ferrous fumarate in the last 12 months. Raw volume favours the biggest populations; the map on this page shades every ICB by items per head to correct for that.

How up to date is this data?

This page runs to May 2026, the most recent NHSBSA release. Prescribing data publishes roughly six to eight weeks in arrears, and DoseTrend refreshes within 48 hours of each monthly release.

Locked · Applicants only

The full breakdown.

Every ICB, every prescribing organisation, every strength, the hospital view, and the monthly briefing PDF. Sample rows shown below with the numbers obscured.

Locked · Applicants only

See the full picture for Ferrous fumarate.

All 36 ICBs, prescribing organisations, formulation splits and the hospital view. £1,500 a month per molecule, price published, applications reviewed by a human within one working day.

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