Scottish GPs could save £26m by changes in prescribing

An inquiry into prescribing patterns among family doctors in Scotland has concluded that £26m ($42m) could be saved every year through greater efforts to ensure that the most appropriate drugs are given to patients.

A report from the Accounts Commission for Scotland acknowledges that the quality and cost effectiveness of prescribing has improved in recent years, but it adds that there is still great potential for further improvements.

In particular it highlights the continuing use of drugs categorised by the British National Formulary as "less suitable for prescribing" or of "limited value." These are still prescribed in considerable quantities and are costing the Scottish health service almost £20m a year.

The report also says that replacing half of all premium priced preparations--such as slow release drugs, expensive inhalers, and skin patches--with standard formulations would save about £11m a year. How-ever, it recognises that the more expensive versions may be more suitable for certain patients.

The Accounts Commission found considerable variation in prescribing patterns between different practices even when they seemed to have similar patient populations. "This variation is often caused by characteristics of doctors themselves such as differences in diagnostic behaviour and different approaches to managing particular health problems," it adds.

The report says doctors should stop prescribing unnecessary drugs and recommends that they carry out regular reviews of prescribing patterns to ensure optimum use.

Bryan Christie, Edinburgh


studentBMJ 1999;07:394-436 November ISSN 0966-6494