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Triple therapy inhaler (ICS/LABA/LAMA)

Fluticasone/umeclidinium/vilanterol prescribing across the NHS.

The once-daily triple: 1.6m items and £79m at list price a year, at about £49 an item. Triple therapy is where COPD prescribing has consolidated, and the money follows; the three triple lines on this site are collectively among respiratory's largest spend.

Scorecard, last 12 months
Items
1.6m
dispensed in the last 12 months
Spend
£78.7m
at NIC, last 12 months
Year on year
+4.5% +4.5%
vs the 12 months before
Latest month
May 2026
most recent NHSBSA release
Key facts · plain English

The NHS in England dispensed 1,617,186 prescription items of Fluticasone/umeclidinium/vilanterol in the 12 months to May 2026, across primary care and hospitals.

Spending on Fluticasone/umeclidinium/vilanterol over those 12 months was £78.7m at net ingredient cost, the list price of what was dispensed before any discounts.

Items were up 4.5% on the previous 12 months.

100% of Fluticasone/umeclidinium/vilanterol volume moved through primary care and 0% through hospital pharmacies.

Fluticasone/umeclidinium/vilanterol ranks #6 of 11 chemical substances in Corticosteroids (respiratory) (BNF 3.2), by items dispensed.

Among Integrated Care Boards, NHS North East and North Cumbria ICB dispensed the highest volume of Fluticasone/umeclidinium/vilanterol.

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
Fluticasone/umeclidinium/vilanterol, 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 133,304 £6.5m
April 2026 136,281 £6.6m
March 2026 138,404 £6.7m
February 2026 126,136 £6.1m
January 2026 136,787 £6.7m
December 2025 142,776 £7.0m
November 2025 128,644 £6.3m
October 2025 140,133 £6.8m
September 2025 135,189 £6.6m
August 2025 129,205 £6.3m
July 2025 140,130 £6.8m
June 2025 130,197 £6.3m

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

Cost per item · price erosion
Fluticasone/umeclidinium/vilanterol, England: cost per item
Actual cost per item, primary care (£)
£53.73 £0.00 2020-11 2023-08 2026-05
Source: NHSBSA English Prescribing Data (OGL v3.0).
Market share

6.1% of its class.

Fluticasone/umeclidinium/vilanterol ranks #6 of 11 chemical substances in Corticosteroids (respiratory) (BNF 3.2), 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)
124.10130610831 100 75.898693891692 JFMAMJJASOND

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

Where it's prescribed · England

Fluticasone/umeclidinium/vilanterol across all 36 ICBs.

Every Integrated Care Board in England, shaded by how much fluticasone/umeclidinium/vilanterol 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 Fluticasone/umeclidinium/vilanterol 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
South West
East of England
South East
Midlands
London
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 146k
  2. 2 NHS Cheshire and Merseyside ICB 128k
  3. 3 NHS Greater Manchester ICB 125k
  4. + 33 more. Unlock the full 36-ICB table. Unlock →
Fastest-growing ICBs (YoY)
  1. 1 NHS Derby and Derbyshire ICB +20.8%
  2. 2 NHS West and North London ICB +16.5%
  3. 3 NHS Central East ICB +14.2%
  4. + 33 more. Unlock every ICB, ranked. Unlock →
Top formulations
  1. 1 Trelegy Ellipta 92microg/55microg/22microg/dose dry pdr inh 100%
  2. 2 Generic Trelegy Ellipta 92microg/55microg/22microg/dose inh 0%
  3. + 0 more. Unlock every strength and pack. Unlock →
Primary vs secondary care
Primary 100% Hospital 0%

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
24.3 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 1.6m May 2026
Northern Ireland 102k May 2026
Scotland 227k April 2026
Wales 0 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 fluticasone/umeclidinium/vilanterol.

Whether every patient on triple therapy needed the step up is a live audit question; uptake data records the decision, not its justification.

Read exactly what the data covers →

Common questions

Asked and answered.

Is fluticasone/umeclidinium/vilanterol prescribing rising or falling in the NHS?

Rising. England dispensed 1,617,186 items of Fluticasone/umeclidinium/vilanterol in the 12 months to May 2026, up 4.5% 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 fluticasone/umeclidinium/vilanterol?

£78.7m 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 fluticasone/umeclidinium/vilanterol prescribed most?

By raw volume, NHS North East and North Cumbria ICB dispensed the most fluticasone/umeclidinium/vilanterol 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.

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See the full picture for Fluticasone/umeclidinium/vilanterol.

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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