Common Medicines in Europe: Reading the Numbers

Sixty-five million atorvastatin items in one year. Someone shares it, someone else shares that, and by the third post it’s “65 million people on statins”.

Numbers about medicine use get bent like this all the time, usually without anyone lying. Three questions keep them straight: what exactly was counted, where, and when? Even with all three answered, the number still can’t pick the medicine for you.

The England and Norway figures below come from 2023–24 and stay in separate boxes, because they measure different things. No Europe-wide top 20 here, sorry.

Big headline. What did they actually count?

Units first. Swap “items” for “people” and a perfectly true number turns into a false one.

What’s counted	What it can tell you	What it can’t tell you on its own
Prescription items dispensed	How many items were handed out within that dataset	How many different people, whether they took them, or how many tablets
People receiving a medicine	How many people had at least one supply recorded	Whether they took it daily or whether it helped
Defined daily doses (DDD)	A standard estimate of how much medicine was used	The dose any one person was prescribed
Spending	Money spent, under a stated price definition	Value for money, health benefit or what patients paid
Approvals	New products or uses that regulators assessed	How often anything was actually prescribed

The WHO Collaborating Centre defines a DDD as the assumed average daily dose for an adult taking a medicine for its main use. It’s a unit for statistics, not a recommended dose, and real doses vary with the condition and the person. The Centre itself says DDD figures only give a rough picture of use. DDD definition

A quick example: one person on a long-term medicine might collect several separate supplies over a year. That’s several records, not several people. Change how often supplies are handed out, and the item count moves even if the number of people treated barely changes. That’s just an illustration of the counting problem, not a claim about any country’s rules.

England: 65 million atorvastatin items, not people

The NHS Business Services Authority’s Prescription Cost Analysis, England 2023/24 counted 1.21 billion prescription items dispensed in the community. Atorvastatin made up 65 million of them, more than any other substance in that release. NHSBSA release

So the fair reading is narrow: atorvastatin was handed out a lot in that community-pharmacy dataset. It doesn’t mean 65 million people took it, that it topped prescribing across Europe, or that hospital medicines were counted.

For what those atorvastatin numbers mean if you take it, see Lipitor and atorvastatin explained and choosing between statins.

Norway: different data, different unit

The Norwegian Institute of Public Health’s Drug Consumption in Norway 2019–2023 uses wholesale figures and standard doses. It reports that sales of human medicines, measured in DDD, rose 3.3% in 2023 compared with 2022, and that total includes medicines bought without a prescription. So it isn’t a count of prescription items like the England figure. NIPH report

Most used, most expensive, most helpful: three different lists

Back in England, the same NHSBSA release names beclometasone dipropionate as the substance with the highest cost: £320 million. So the most-dispensed and the most expensive substances weren’t the same. Neither list ranks how well medicines work.

In Norway, cancer and immune-system medicines made up 21% of human-medicine costs in 2023. Many of them have no DDD, so their rising sales don’t show up as more standard doses.

That’s a useful lesson even without a European league table. An expensive group of medicines can loom large in a health budget while a cheap, long-term tablet dominates the dispensing counts. The two countries stay separate here because they count different things in different ways.

And neither chart can tell you which treatment would help a particular person most. That takes evidence about the condition and the person, not a bigger number in a national report.

A familiar name isn’t automatically your medicine

Seeing the name on your own box in a national chart makes it feel personal. The nine groups below explain some familiar names. They’re examples, not a ranking, and being listed doesn’t mean a medicine is available everywhere in Europe.

Group	Examples	Worth knowing
Cholesterol lowering	Atorvastatin, simvastatin	Dose strength and your heart risk matter more than which brand is popular
Blood pressure	Amlodipine and medicines from other classes	A normal reading while you’re treated doesn’t mean you can stop
Type 2 diabetes	Metformin, semaglutide and others	Each comes with its own uses, checks and day-to-day demands
Stomach acid	Lansoprazole and other PPIs	Why you take it and what it interacts with still matter
Thyroid replacement	Levothyroxine, for example Synthroid	Regular blood tests and taking it the same way each day are the main jobs
Clot prevention	Clopidogrel, anticoagulants such as warfarin (Coumadin)	Antiplatelets and anticoagulants are different kinds of treatment
Fluid build-up	Furosemide and other diuretics	Used for fluid retention, including in heart failure; kidneys and blood salts get checked
Depression and anxiety	Citalopram, sertraline and other antidepressants	It can take several weeks to judge, and stopping should be planned with your prescriber
Bacterial infections	Amoxicillin and other antibiotics	Antibiotics treat bacteria; they don’t help colds or flu

For treatment decisions, see Lipitor and atorvastatin, choosing a statin, five heart medicines and semaglutide in everyday life. Each one says which country’s advice it follows.

Generics and biosimilars aren’t the same idea

An authorized generic has the same active ingredient as the original medicine and has to meet the same quality and equivalence standards. The box and some inactive ingredients can differ. Generics can cut costs, but how much depends on the actual product, how it’s bought and what’s reimbursed. One unsourced market-share percentage can’t tell you what your prescription will cost. EMA generic-medicine explanation

A biosimilar is a biological medicine that’s highly similar to the original, not just a generic tablet with another name. The EMA requires no meaningful differences in quality, safety or how well it works. Whether a pharmacy can swap one in, and who pays, is decided separately by each country. EMA biosimilar overview

Counting approvals is different again

The EMA’s 2024 report lists the medicines it recommended, including new active substances and biosimilars. Great for seeing what’s new. Useless as a prescription count. EMA medicines in 2024

ClinCalc DrugStats, meanwhile, uses estimates from the US Medical Expenditure Panel Survey. Handy for US questions; no help for European totals. ClinCalc methodology

Before you believe “the most prescribed medicine”, look for:

Which country or countries it covers.
The year, and whether it’s community pharmacies, hospitals or both.
The unit: items, people, DDD or money.
The original dataset and how it was calculated.
What’s left out, such as hospital supply or over-the-counter sales.

For your own treatment, ask something else entirely: what is this medicine meant to do for me, and what would make us rethink it? Popularity describes a health system. It can’t answer that.

Sources

7 sources

Checked in October 2026.

NHSBSA Prescription Cost Analysis, England 2023/24. Community items and costs
NIPH Drug Consumption in Norway 2019–2023. Wholesale use and costs
WHO Collaborating Centre DDD definition
Generic and hybrid medicines — EMA
Biosimilars — EMA
Medicines in 2024 — EMA
ClinCalc's US methodology