Methotrexate prescribing across the NHS.
Methotrexate is the anchor drug of rheumatology, 2.2m items a year of once-weekly dosing delivered through shared care. It is also the classic never-event drug, where daily dispensing in error can kill, which makes its steady, boring line a small monument to system safety.
The NHS in England dispensed 2,178,185 prescription items of Methotrexate in the 12 months to May 2026, across primary care and hospitals.
Spending on Methotrexate over those 12 months was £25.1m at net ingredient cost, the list price of what was dispensed before any discounts.
Items were up 1.7% on the previous 12 months.
41% of Methotrexate volume moved through primary care and 59% through hospital pharmacies.
Methotrexate is the largest of 11 chemical substances in Rheumatic disease suppressant drugs (BNF 10.1.3), by items dispensed.
Among Integrated Care Boards, NHS Central East ICB dispensed the highest volume of Methotrexate.
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 | 178,165 | £2.1m |
| April 2026 | 182,741 | £2.2m |
| March 2026 | 184,991 | £2.1m |
| February 2026 | 168,217 | £1.9m |
| January 2026 | 182,931 | £2.1m |
| December 2025 | 193,180 | £2.2m |
| November 2025 | 173,323 | £2.0m |
| October 2025 | 187,945 | £2.1m |
| September 2025 | 183,352 | £2.1m |
| August 2025 | 175,826 | £2.0m |
| July 2025 | 189,878 | £2.2m |
| June 2025 | 177,636 | £2.0m |
The same series as the chart, most recent month first. The full monthly history, as CSV, sits behind Apply.
59.4% of its class.
Methotrexate is the largest of 11 chemical substances in Rheumatic disease suppressant drugs (BNF 10.1.3), 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.
Methotrexate across all 36 ICBs.
Every Integrated Care Board in England, shaded by how much methotrexate 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 Methotrexate 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 Central East ICB 128k
- 2 NHS Surrey and Sussex ICB 121k
- 3 NHS Cheshire and Merseyside ICB 109k
- – + 33 more. Unlock the full 36-ICB table. Unlock →
- 1 NHS Coventry and Warwickshire ICB +19.4%
- 2 NHS Leicester, Leicestershire and Rutland ICB +5.4%
- 3 NHS Bristol, North Somerset and South Gloucestershire ICB +5.1%
- – + 33 more. Unlock every ICB, ranked. Unlock →
- 1 Methotrexate 2.5mg tablets 84%
- 2 Metoject PEN 20mg/0.4ml inj pre-filled pens 4%
- 3 Metoject PEN 25mg/0.5ml inj pre-filled pens 3%
- – + 3 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 | 2.2m | May 2026 |
| Northern Ireland | 103k | May 2026 |
| Scotland | 320k | April 2026 |
| Wales | 39k | 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 methotrexate.
The monitoring blood tests that make methotrexate safe are the real workload and cost, and none of them appear in prescribing data.
Asked and answered.
Is methotrexate prescribing rising or falling in the NHS?
Rising. England dispensed 2,178,185 items of Methotrexate in the 12 months to May 2026, up 1.7% 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 methotrexate?
£25.1m 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 methotrexate prescribed most?
By raw volume, NHS Central East ICB dispensed the most methotrexate 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.
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