Not all pharmacy markets are equal. The amount a pharmacy earns from NHS prescription dispensing varies dramatically depending on where it is — and the pattern is not what most people would expect.
PharmSee has measured dispensing revenue per active pharmacy across 13 English cities using the same methodology: total NHSBSA-recorded dispensing revenue within a three-mile radius of a city-centre postcode, divided by the number of pharmacies with recorded dispensing activity (excluding zero-revenue register entries).
The result is a 2.5:1 spread from the highest-earning city to the lowest.
The Rankings
| Rank | City | Revenue/Active Pharmacy | Active Branches | Total Revenue |
|---|---|---|---|---|
| 1 | Sunderland | £158,092 | 40 | £6,323,672 |
| 2 | Newcastle | £141,431 | 63 | £8,910,162 |
| 3 | Exeter | ~£130,000 | 21 | ~£2,730,000 |
| 4 | Sheffield | £117,315 | 79 | £9,267,873 |
| 5 | Liverpool | £116,291 | 87 | £10,117,284 |
| 6 | Stoke | £111,559 | 60 | £6,693,513 |
| 7 | Norwich | £110,459 | 32 | £3,534,688 |
| 8 | Manchester | £108,550 | 91 | £9,878,063 |
| 9 | Coventry | ~£95,294 | 85 | ~£8,100,000 |
| 10 | Birmingham | £86,289 | 82 | £7,075,693 |
| 11 | Cambridge | ~£74,444 | 27 | ~£2,010,000 |
| 12 | Bath | £71,766 | 22 | £1,578,843 |
| 13 | Oxford | ~£63,590 | 39 | ~£2,480,000 |
All figures from the most recent NHSBSA quarterly dispensing dataset accessed via PharmSee. Active branches are those with recorded dispensing revenue >£0. Revenue captures NHS prescription dispensing only. Approximate figures (~) based on prior PharmSee analyses.
The Pattern: Deprivation Drives Dispensing
The ranking reveals a clear if uncomfortable pattern: pharmacies in more deprived areas earn more from dispensing.
Sunderland (IMD decile 2, "Very High Deprivation") tops the table at £158,000 per active pharmacy. Newcastle (decile 3-4) comes second. At the bottom sit Oxford and Bath — two of the most affluent cities in England — at roughly £64,000 and £72,000 respectively.
This is not a coincidence. Areas with higher deprivation tend to have populations with greater health needs, more chronic conditions, and higher prescription volumes. The NHS dispensing fee structure means that each item dispensed generates revenue regardless of the pharmacy's location, but the number of items dispensed per capita is strongly correlated with deprivation.
The implication for pharmacy owners and investors is significant: a pharmacy in a deprived area may generate substantially more dispensing income than one in an affluent area, even if the retail and private dispensing opportunities are fewer.
Two Ways to Read the Table
There are two competing narratives in this data:
The demand story. High per-pharmacy revenue suggests strong prescription demand — more patients, more items, more income per branch. For professionals, this translates to busier workdays. For owners, higher turnover but potentially higher staffing costs.
The supply story. High per-pharmacy revenue also suggests fewer competitors sharing the market. Sunderland's 40 active pharmacies serve 43 GP practices. Oxford's 39 active pharmacies serve only 27 GP practices. There are proportionally more pharmacies per prescription in Oxford, meaning each branch captures a smaller share.
In most cases, both forces are at work simultaneously. Sunderland has high demand (deprived, ageing population) and moderate supply (many registered branches, but fewer active ones). Oxford has lower demand (healthier, younger population skewed by university demographics) and abundant supply (pharmacy-dense market with a low GP-to-pharmacy ratio).
What the Data Does Not Show
This ranking captures NHS dispensing revenue only. It does not include:
- Retail sales — which may be higher in affluent areas with greater consumer spending
- Private dispensing — including private prescriptions and travel health services
- Enhanced services — such as Pharmacy First consultations, flu vaccinations, or blood pressure checks
- Delivery income — some pharmacies generate significant revenue from prescription delivery services
A pharmacy in Oxford earning £64,000 from dispensing may still be commercially viable if it generates substantial retail and private income. Conversely, a Sunderland pharmacy earning £158,000 from dispensing may face higher costs from longer opening hours and greater staffing requirements to handle the volume.
Revenue per Pharmacy Is Not Profit
Higher revenue does not automatically mean higher profit. Pharmacies in high-dispensing areas often require more staff, longer hours, and higher drug procurement costs. The NHS dispensing margin has been under pressure for several years, and the per-item fee of £1.29 has not kept pace with inflation.
What this ranking does indicate is where dispensing workload — and therefore the core NHS pharmacy function — is most concentrated on a per-branch basis. For workforce planners, it suggests where pharmacist and technician capacity is most stretched.
For Professionals
If you are considering where to work, this data offers one lens on market dynamics. Cities higher in the ranking tend to have busier dispensaries, which can mean more varied clinical experience but also more demanding workloads. Cities lower in the ranking may offer a better work-life balance but fewer dispensing-related career development opportunities.
Explore pharmacy data by location on PharmSee's pharmacy search, compare branches side by side with the comparison tool, or check live vacancies on the job board.
Methodology and Caveats
All figures are derived from PharmSee's aggregation of NHSBSA dispensing data and the NHS England dispensing contractor register. Revenue figures represent the most recent available quarterly dataset. "Active" pharmacies are those with dispensing revenue greater than zero; zero-revenue branches have been excluded to avoid counting non-dispensing register entries.
The three-mile urban radius captures city-centre and inner-suburban pharmacies. Results may differ with larger or smaller radii. Revenue figures are one component of total pharmacy income and should not be interpreted as overall business performance.
Data sources: NHSBSA dispensing data via PharmSee, NHS Digital GP practice list, NHS England dispensing contractor register. Snapshot date: April 2026.