A pattern runs through PharmSee's city-by-city dispensing revenue data that inverts the assumptions many pharmacy professionals carry: the most deprived areas in England tend to generate the highest per-pharmacy dispensing income.
Sunderland, with large areas falling in the most deprived IMD deciles in England, records average dispensing revenue of approximately £158,092 per active pharmacy — the highest of any city PharmSee has measured. Oxford, one of the least deprived cities in England by the same index, averages roughly £88,645.
The relationship is not linear, and other factors contribute. But across 13 English cities now fully measured, the correlation between area deprivation and dispensing revenue per active branch is the strongest single predictor in the dataset.
Revenue by city: the deprivation gradient
| City | Revenue per active pharmacy | IMD profile | GP-to-pharmacy ratio |
|---|---|---|---|
| Sunderland | £158,092 | Decile 1-2 (most deprived) | 0.78:1 |
| Exeter | £151,513 | Mixed (3-6) | 1.42:1 |
| Newcastle | £141,431 | Decile 2-4 | 0.79:1 |
| Sheffield | £117,315 | Decile 3-5 | 0.78:1 |
| Liverpool | £116,291 | Decile 1-3 | 1.42:1 |
| Stoke-on-Trent | £111,559 | Decile 2-4 | 0.89:1 |
| Norwich | £110,459 | Decile 3-5 | 0.88:1 |
| Manchester | £108,550 | Decile 1-4 | 0.93:1 |
| Oxford | £88,645 | Decile 6-9 (least deprived) | 0.66:1 |
| Birmingham | £86,289 | Decile 1-3 | 1.26:1 |
| Bath | £71,766 | Decile 6-8 | 1.22:1 |
Source: PharmSee analysis of NHSBSA dispensing data. Revenue figures are annual NHS dispensing income only. IMD decile reflects the predominant deprivation band of the 3-mile catchment. Active pharmacies exclude branches with zero dispensing revenue in the most recent NHSBSA quarter, which may reflect reporting lag.
Why deprivation drives dispensing income
The mechanism is well-documented in public health literature. More deprived populations tend to have higher rates of chronic disease — diabetes, cardiovascular conditions, respiratory illness, mental health conditions — all of which generate repeat prescriptions. A pharmacy serving a population with multiple long-term conditions dispenses more items per patient than one serving a younger, healthier catchment.
NHSBSA data bears this out nationally. The dispensing fee of £1.29 per item compounds quickly: a pharmacy dispensing 120,000 items per year earns £154,800 in dispensing fees alone, before enhanced services. In areas with high chronic-disease prevalence, those volumes are achievable for a single busy branch.
Exeter: the outlier that proves the rule
Exeter appears to break the pattern — a relatively affluent city averaging £151,513 per active pharmacy. But Exeter's figure is driven by a different mechanism: market structure. Only 18 of 26 registered pharmacies show dispensing activity (five former Lloyds branches sit at zero revenue), and a GP-to-pharmacy ratio of 1.42:1 funnels more prescriptions per branch. Fewer active pharmacies sharing a moderate revenue base produces a high per-branch average without requiring Sunderland-level prescribing volumes.
Birmingham presents the opposite puzzle: a deprived city averaging only £86,289 per active pharmacy. Here, sheer pharmacy density dilutes revenue — 82 active branches splitting the NHS dispensing income across a wide market, plus 14 zero-revenue entries that may be in transition.
What this means for pharmacy planning
For operators and location planners, the data suggests that per-pharmacy dispensing income is a function of three interacting variables: area deprivation (which drives prescribing volume), the GP-to-pharmacy ratio (which determines how that volume is distributed), and the number of active competitors.
A high-deprivation area with a low GP-to-pharmacy ratio — Sheffield at 0.78:1, for instance — still produces strong per-branch revenue (£117,315) because the prescribing volume is high enough to support many pharmacies. A low-deprivation area with a high ratio, like Bath at 1.22:1, can still underperform (£71,766) because the underlying prescribing volume is modest.
Explore deprivation data and pharmacy density for any English postcode using PharmSee's location analysis tool, or compare specific pharmacies using the pharmacy search.
Caveats
Revenue figures represent NHS dispensing income only. They do not capture retail sales, private prescriptions, Pharmacy First consultations, vaccination income, or other enhanced service revenue — all of which can materially alter a branch's commercial picture. Zero-revenue entries are excluded from per-active-pharmacy calculations; these entries may reflect data-reporting lag rather than permanent closure. IMD decile assignments are based on the predominant LSOA profile within a 3-mile radius and are approximate.
Data: PharmSee analysis of NHSBSA dispensing contractor records and Index of Multiple Deprivation 2025. Snapshot: April 2026.