Medicines optimisation: key therapeutic topics summarise the evidence-base on topics identified to support medicines optimisation, but are not formal NICE guidance.

These topics are selected and prioritised therapeutic areas where there are potential opportunities for maintaining or improving quality and improving value from our use of medicines. Releasing resources from one area of health care while maintaining or improving quality of care means those resources are available for use elsewhere, for example - the prescribing of innovative medicines.

The selection of metrics to support these topics is overseen by the NHS England Medicines Optimisation Intelligence Group, and work is ongoing in this area.

The 2018 update of 'medicines optimisation: key therapeutic topics' has been published.

Individual therapeutic topics can be accessed via the ‘view the key therapeutic topics’ link on the right hand side of this page.

This update has retained 14 topics from 2017: 

  • multimorbidity and polypharmacy
  • psychotropic medicines in people with learning disabilities whose behaviour challenges
  • safer insulin prescribing
  • medicines optimisation in long-term pain
  • biosimilar medicines
  • acute kidney injury (AKI): use of medicines in people with or at increased risk of AKI
  • anticoagulants, including non-vitamin K antagonist oral anticoagulants (NOACs)
  • asthma: medicines safety priorities
  • hypnotics
  • antipsychotics in people with dementia
  • antimicrobial stewardship: prescribing antibiotics
  • type 2 diabetes mellitus: medicines optimisation priorities
  • non-steroidal anti-inflammatory drugs
  • wound care products.

One topic has been retired:

  • lipid-modifying drugs.

One topic has been added:

  • chemotherapy dose standardisation.

The evidence context for all the current topics has been updated in the light of new guidance and important new evidence. Historical content for retired topics is available for reference but has not been updated.

I am delighted to welcome the latest update of medicines optimisation: key therapeutic topics, which continue to be developed in collaboration with the Medicines Value/Medicines Optimisation Programme and inform the medicines optimisation dashboard.


The appropriate use of medicines has never been so high profile, as highlighted in the Carter Review, Operational productivity and performance in English NHS acute hospitals: unwarranted variations. With the annual medicines bill now standing at over £16 billion and rising, it is vitally important that we maintain momentum through medicines optimisation becoming embedded into the NHS RightCare programme and the availability of the medicines optimisation dashboard.

Dr Bruce Warner, Deputy Chief Pharmaceutical Officer NHS England

More information

Our integrated process statement sets out how we select topics and prepare the documents.

Past consultations