Scottish GPs have been urged to continue increasing their generic prescribing levels, despite achieving a double-digit reduction in costs last year.
A report from Audit Scotland commended GPs for cutting real terms spend on prescribing by 11% in 2011/12, compared with 2004, when spending was last reviewed.
This was despite the volume of prescriptions rising by a third since its last audit in 2004 – with 900,000 Scottish people over the age of 50 now taking four or more drugs.
The improvement, it said, stems from better management of GP prescribing by the health service and GPs receiving more support and guidance on their prescribing, but concluded that despite this there is still money to save.
In 2011/12 there were 91 million prescriptions issued by around 1,000 GP practices in Scotland, costing £974 million in total and accounting for 11% of Scottish health boards’ total annual spend on all aspects of health services.
The report said: ‘There is scope to make potential annual savings of up to £26 million without affecting patient care. NHS boards can achieve this by reducing unnecessary waste; reducing the use of drugs considered less suitable for prescribing; increasing generic prescribing; and only prescribing more expensive versions of drugs to those patients with a clinical need for them.’
Commenting on the report, Scottish GPC chair Dr Alan McDevitt said that while there is a lot of money to be saved by reducing prescribing spend, many health conditions are best managed by prescribing effective drugs, which relieves pressure in other parts of the health service. He also cautioned that generic alternatives may be good but not the answer for all patients. However, he welcomed the recommendation to increase the number of prescribing support staff.
He said: ‘Prescribing costs in the NHS are second only to workforce costs in the health budget and therefore opportunities to make savings here can have a significant impact on health spending.
‘However, when considering prescribing of medicine by GPs it is important to look at the wider impact on the NHS, rather than simply seeking to reduce the number of prescriptions issued.’
‘As well as improving our own performance, it is important that patients do not waste drugs and request repeat prescriptions only when they are needed.’
Auditor General for Scotland, Caroline Gardner, said: ‘Since we last looked at GP prescribing, the volume of drugs prescribed has continued to rise but the NHS has significantly improved how it manages spending.
‘This was during a period when there have been considerable pressures and constraints on the health service. It has achieved this through providing doctors with more support and guidance and using better information about what GPs are prescribing. Demand for prescriptions is likely to increase further and it’s important that the NHS continues to work with GPs to make sure patients get the drugs they need and spending is well managed.’
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