Spending on medicine in Scotland was 11% less in 2011–2012 compared to spending in 2004–2005. This is despite the volume of prescriptions increasing by 33% during that time, according to a new report by Audit Scotland.

Total spending by the National Health Service (NHS) in Scotland in 2011–2012 reached £11.7 billion. Prescribing by general practitioners (GPs) accounts for 70% of all NHS spending on drugs in Scotland. This amounted to £974 million in 2011–2012, with GPs issuing 91 million prescriptions during this period.

The reduction in costs has been partly attributed to an increase in the use of generic drugs and the fact that family doctors are now getting more support and guidance from the NHS with respect to prescribing practices. In the seven years prior to 2004–2005, Scottish prescribing costs had risen 50%.

The NHS spent an estimated £10.5 million on prescribing support staff in 2011–2012, who use good quality data about GPs’ prescribing patterns to support GPs in making good quality and cost-effective decisions about prescribing. GPs in Scotland also get regular feedback on their prescribing and most GP practices have in-house support from pharmacists which is funded by their NHS board.

Audit Scotland believe there is still scope to make potential annual savings of up to £26 million without affecting patient care and propose the following measures to increase savings:

• reducing drug wastage (£12 million)
• reducing the use of drugs considered less suitable for prescribing (£8 million)
• increasing generic prescribing (£2 million)
• only prescribing more expensive versions of drugs to those patients with a clinical need (£2 million)
• achieving the targets in the national therapeutic indicators* (£2 million).

Other recommendations made by Audit Scotland in order to reduce spending were that NHS boards consider employing additional prescribing support staff, work with GPs to implement the national guidelines on prescribing multiple drugs (polypharmacy) and support GPs in reviewing the medication of patients taking multiple drugs.

* The Scottish Government has introduced national therapeutic indicators that provide financial incentives for GPs to improve the quality and cost-effectiveness of their prescribing, for example, by increasing use of lower cost statins.

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Source: www.gabionline.net