Medication Costs: US vs UK
A side-by-side of two real government figures: the average US Medicare Part D spending per dose (CMS open data, calendar year 2024) and the flat NHS England prescription charge of £9.90 per item (2026/27 (from 1 April 2026)). They measure different things, in different currencies, so we never convert one into the other — we show both, honestly, so the genuine difference is visible.
How do medication costs compare between the US and the UK?
They are measured very differently. In the US, average Medicare Part D spending per dosage unit (calendar year 2024, CMS open data) ranges from $0.0564 (Metformin HCl) to $511.63 (Mounjaro) across the 100 highest-volume drugs. In England, an NHS patient pays a flat £9.90 per prescription item for any of them (2026/27 (from 1 April 2026)) — or nothing with a Prepayment Certificate or exemption. The US per-dose spend varies hugely; the England patient charge does not. Information only, not medical advice.
Not medical advice. The figures on this page are drawn unchanged from public government datasets for general information only. They are not price quotes and not a substitute for professional advice. What you actually pay depends on your country, pharmacy, insurance, manufacturer, dose and region. Never start, stop or switch a medication on cost grounds without a licensed pharmacist or clinician.
The US figure is Medicare Part D PROGRAM spending per dosage unit (in US dollars), not a cash price; the UK figure is the patient's flat NHS charge per item (in pounds). They measure different things in different currencies and are shown side by side, never converted into one another.
United States
Average Medicare Part D spending per dosage unit, calendar year 2024. Varies by drug — from $0.0564 (Metformin HCl) to $511.63 (Mounjaro). Program spending, not a cash price.
England (NHS)
In England, an NHS patient pays a flat £9.90 per dispensed prescription item (2026/27 (from 1 April 2026), frozen) — the same charge for any drug, whatever it costs the NHS — or nothing at all with a Prescription Prepayment Certificate (£114.50/year cap, worth it above 11 items/year) or an exemption. NHS prescriptions are free outright in Scotland, Wales and Northern Ireland.
Three ways to explore
Where the US per-dose gap is widest
In England, every one of these costs the patient the same £9.90 per item. In the US, Medicare’s average spend per dose runs from fractions of a cent to hundreds of dollars.
| Drug | US per dose | England patient |
|---|---|---|
| Mounjaro | $511.63 | £9.90 |
| Trulicity | $467.75 | £9.90 |
| Ozempic | $306.48 | £9.90 |
| Shingrix | $196.56 | £9.90 |
| Jardiance | $18.94 | £9.90 |
| Drug | US per dose | England patient |
|---|---|---|
| Metformin HCl | $0.0564 | £9.90 |
| Hydrochlorothiazide | $0.0584 | £9.90 |
| Metoprolol Tartrate | $0.0591 | £9.90 |
| Metformin HCl ER | $0.06 | £9.90 |
| Carvedilol | $0.065 | £9.90 |
Most-claimed Part D drug calendar year 2024: Atorvastatin Calcium at $0.1452 per dose over 73,349,032 claims.
Frequently asked questions
- Why is there no single "US price vs UK price" per drug?
- Because the two countries publish different things. The US (CMS) figure is average Medicare Part D PROGRAM spending per dosage unit, in US dollars. The UK figure is the patient's flat NHS charge per item, in pounds — the NHS does not publish a comparable per-drug patient price. We show both real numbers side by side and never convert one into the other.
- What is the NHS prescription charge?
- In England, an NHS patient pays a flat £9.90 per dispensed prescription item (2026/27 (from 1 April 2026), frozen) — the same charge for any drug, whatever it costs the NHS — or nothing at all with a Prescription Prepayment Certificate (£114.50/year cap, worth it above 11 items/year) or an exemption. NHS prescriptions are free outright in Scotland, Wales and Northern Ireland.
- Does the England charge really not depend on the drug?
- Correct. England charges a flat £9.90 per dispensed item (2026/27 (from 1 April 2026)) whether it is a few-pence generic or an expensive branded drug. So a US cost gap that runs from cents to hundreds of dollars per dose is invisible to the England patient at the pharmacy counter.
- Is this medical advice or a price quote?
- No. These are general-information figures taken unchanged from public US and UK government datasets. They are not price quotes and not medical advice. Never start, stop or switch a medication on cost grounds without a licensed pharmacist or clinician.
Questions about your medication?
A GeraClinic clinician can review your medication, explain lower-cost options where clinically appropriate, and issue or renew a prescription online — without travelling to a clinic.
Contains public sector information published by U.S. Centers for Medicare & Medicaid Services (CMS) and licensed under the U.S. Government Works / Public Domain. Source: CMS Medicare Part D Spending by Drug (calendar year 2024, published 2026-06-25).
Contains public sector information published by NHS Business Services Authority (NHSBSA), NHS England & DHSC and licensed under the Open Government Licence v3.0. Source: NHS prescription charges (England) — NHSBSA / NHS England / DHSC (2026/27 (from 1 April 2026), published 2026-04-01).