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Trends, geographical variation and factors associated with melatonin prescribing in general practices in England: A practice-level analysis

Research output: Contribution to journalArticlepeer-review

Mandy Wan, Rukeya Begum, Asia N. Rashed

Original languageEnglish
JournalBritish Journal of Clinical Pharmacology
Early online date27 Nov 2021
Accepted/In press2021
E-pub ahead of print27 Nov 2021

Bibliographical note

Funding Information: The authors are grateful to Ms Malgorzata Tylek for her support on data extraction. M.W. is a doctoral student supported by a Clinical Doctoral Research Fellowship grant (ICA‐CDRF‐2016‐02‐057) from the UK National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. A.N.R. has received funding from the Neonatal and Paediatric Pharmacists Group (NPPG) for paediatric research. Publisher Copyright: © 2021 British Pharmacological Society

King's Authors


An overview of melatonin prescribing trends and variation in England is described in this study. Prescription reimbursement data for melatonin in England were extracted from publicly available primary care datasets between 2008–2019. Melatonin prescribing rates, cost and product license status were described over time. Potential factors associated with melatonin prescribing were investigated using Poisson regression. Melatonin prescribing increased from 2.0 to 19.9 per 1000 people between 2008 and 2019. While prescriptions for licensed products increased from 6.5% to 88.2%, spending on unlicensed products was £10 million and accounted for 23.3% of the total prescription cost in 2019. Practices with a higher proportion of children and older people and those serving more deprived patient populations were associated with a higher rate of prescribing (rate ratio = 1.51, 1.66 and 1.59, respectively). Melatonin prescribing in England has increased exponentially over the last decade, with substantial spending on unlicensed products of unknown quality. Patient-level analysis research is needed.

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