Hydroxocobalamin prescribing across the NHS.
Hydroxocobalamin is the B12 injection: 3.3m items a year, each one implying a nursing appointment the drug cost never shows. The molecule costs pennies; the delivery model is the expensive part, which is exactly why the oral switch on the cyanocobalamin page is happening.
The NHS in England dispensed 3,337,384 prescription items of Hydroxocobalamin in the 12 months to May 2026, across primary care and hospitals.
Spending on Hydroxocobalamin over those 12 months was £8.7m at net ingredient cost, the list price of what was dispensed before any discounts.
Items were up 3.5% on the previous 12 months.
82% of Hydroxocobalamin volume moved through primary care and 18% through hospital pharmacies.
Hydroxocobalamin ranks #2 of 4 chemical substances in Drugs used in megaloblastic anaemias (BNF 9.1.2), by items dispensed.
Among Integrated Care Boards, NHS North East and North Cumbria ICB dispensed the highest volume of Hydroxocobalamin.
Source: NHS Business Services Authority open data (English Prescribing Data and SCMD), OGL v3.0. Items count prescriptions dispensed, not patients treated.
| Month | Items | Spend (NIC) |
|---|---|---|
| May 2026 | 278,465 | £724k |
| April 2026 | 269,054 | £707k |
| March 2026 | 280,098 | £724k |
| February 2026 | 269,618 | £706k |
| January 2026 | 290,758 | £712k |
| December 2025 | 281,897 | £737k |
| November 2025 | 257,159 | £685k |
| October 2025 | 283,302 | £750k |
| September 2025 | 290,834 | £749k |
| August 2025 | 274,187 | £709k |
| July 2025 | 288,267 | £745k |
| June 2025 | 273,745 | £737k |
The same series as the chart, most recent month first. The full monthly history, as CSV, sits behind Apply.
23.9% of its class.
Hydroxocobalamin ranks #2 of 4 chemical substances in Drugs used in megaloblastic anaemias (BNF 9.1.2), by items dispensed in May 2026. The full class league, who's gaining, and the month-by-month share movement sit behind Apply.
Average items by calendar month across the full history, indexed to the annual mean.
Hydroxocobalamin across all 36 ICBs.
Every Integrated Care Board in England, shaded by how much hydroxocobalamin 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.
Darker shading marks where Hydroxocobalamin is dispensed most per head of population. Exact figures for every ICB, and the drill-down to practice level, are in the full report.
Zoomed out to the 7 NHS regions.
The same 12 months rolled up to NHS England's seven regions, ranked by intensity.
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.
- 1 NHS North East and North Cumbria ICB 266k
- 2 NHS Cheshire and Merseyside ICB 172k
- 3 NHS Kent and Medway ICB 158k
- – + 33 more. Unlock the full 36-ICB table. Unlock →
- 1 NHS West and North London ICB +42.9%
- 2 NHS South East London ICB +24.8%
- 3 NHS South West London ICB +20.5%
- – + 33 more. Unlock every ICB, ranked. Unlock →
- 1 Hydroxocobalamin 1mg/1ml solution for injection ampoules 100%
- 2 Neo-Cytamen 1000micrograms/1ml inj ampoules 0%
- 3 Hydroxocobalamin 10mg/2ml solution for injection ampoules 0%
- – + 1 more. Unlock every strength and pack. Unlock →
Split of items across NHSBSA primary care and SCMD hospital dispensing.
Prescribing by deprivation.
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.
The devolved nations.
| Nation | Items · 12 months | Data to |
|---|---|---|
| England | 3.3m | May 2026 |
| Northern Ireland | 109k | May 2026 |
| Scotland | 313k | April 2026 |
| Wales | 284k | 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.
What open data won't tell you about hydroxocobalamin.
Injection frequency varies by patient and protocol, so items map onto people worse than for most lines.
Asked and answered.
Is hydroxocobalamin prescribing rising or falling in the NHS?
Rising. England dispensed 3,337,384 items of Hydroxocobalamin in the 12 months to May 2026, up 3.5% 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 hydroxocobalamin?
£8.7m 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 hydroxocobalamin prescribed most?
By raw volume, NHS North East and North Cumbria ICB dispensed the most hydroxocobalamin 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.
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.
Related pages.
See the full molecule directory, or read about the data and pricing.
Track hydroxocobalamin like this, every month.
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