National Prescribing Patterns in Stoma Care Across the United Kingdom: A Prescription Cost Analysis with Health Policy Implications

Objectives: The prevalence of stoma formation in the United Kingdom has risen markedly over the past decade, yet comparatively little is known about national prescribing patterns for ostomy products. A retrospective cross-sectional observational study was conducted in which the UK Prescription Cost Analysis (PCA) data for 2023 were examined to assess what information can be extracted from these datasets, to evaluate inter-nation variation in prescribing, and identify areas warranting further health economics and policy investigation. Methods: PCA data for calendar year 2023 were collated from the four devolved UK health services. Data on product type, manufacturer, quantities dispensed, and cost were compared across nations and product categories. Results: Total UK prescription spend on ostomy products in 2023 was £457 million, 3.4% of overall NHS prescription expenditure. Pouches accounted for 72% (£329 million) of spend, with the remainder supporting peristomal skin health and appliance adhesion. Estimated average per-patient spend was modelled and varied substantially by nation, from £1073 in Wales to £2354 in England, against a UK average of £2243. Persistent prescribing of ancillary items no longer recommended for routine use (filters, deodorants, bag covers) accounted for an estimated £ 8 million (>2% of spend). Conclusions: PCA data represent an underutilized resource for population-level analysis of ostomy care. Marked inter-nation variation in expenditure, uncertainty surrounding ostomate population estimates, and the continued prescribing of ancillary items not recommended for routine use identify important evidence gaps and generate hypotheses for future research with direct relevance to prescribing policy, resource allocation, and equitable access to care across the United Kingdom.