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A newly released report from the organization representing pharmaceutical companies provides an unprecedented look into the accessibility of various recently approved medicines by the Scottish Medicines Consortium (SMC), which evaluates them for safety and cost-effectiveness within the health service. This study examined NHS prescribing patterns across all Scottish health boards over a five-year period, spanning from September 2020 through August 2025.
One of the most notable findings of the report is the significant geographic disparity in patient access to GLP-1 medications, which varied greatly depending on location. The report details the average amount of these drugs prescribed per capita during a three-month window from June to August of 2025. Among the health boards, NHS Western Isles demonstrated the highest prescribing rate at 1,086.54 prescriptions per head, followed by NHS Greater Glasgow and Clyde with 392.97. Conversely, NHS Shetland recorded the lowest rate, at 100.31. The authors caution that these figures may be skewed by the small populations of some island boards, where even a few prescriptions can disproportionately affect the statistics. Additionally, the data do not differentiate whether the prescriptions were intended for diabetes treatment or weight loss.
Previous coverage from BBC Scotland News earlier this month highlighted that fewer than half of Scotland’s fourteen territorial health boards currently provide GLP-1 drugs specifically for weight management, with under 800 individuals having received injections for this purpose to date. The Royal College of Physicians criticized the limited access, labeling it as “discriminatory against obese people” and pointing out the potential for the NHS to save substantial sums by reducing illness related to obesity. According to freedom of information requests filed by BBC Scotland News, NHS Western Isles leads with 340 patients receiving weight loss medication, the highest figure among boards participating in pilot schemes designed to enhance access. Alongside NHS Western Isles, five other health boards—NHS Forth Valley, NHS Borders, NHS Lothian, NHS Lanarkshire, and the NHS State Hospital at Carstairs—are involved in these pilots. NHS Western Isles noted that it implemented a “structured pathway” facilitating access to GLP-1 medicines earlier than other boards and stated, “Our prescribing rates reflect that early implementation, as well as local clinical need, rather than participation in a pilot scheme.” The board further emphasized that prescriptions are given following clinical assessment and are part of a broader, dietitian-led program aimed at fostering long-term lifestyle changes, with both patient-reported improvements and observed clinical benefits.
The report also examined accessibility to certain cardiovascular medicines for patients diagnosed with cardiovascular diseases, such as heart disease and stroke, which collectively impact approximately 800,000 people across Scotland and are among the leading causes of death. Specifically, it reviewed prescribing patterns for non-statin LDL-lowering medications that the SMC has approved. Variation in prescribing rates was stark, with an eight-to-ten-fold difference observed between the highest prescribing board (Highland) and the lowest (Forth Valley). The authors suggested that closer collaboration between specialists and general practitioners tends to correlate with higher prescribing rates. The Association of the British Pharmaceutical Industry (ABPI) put forward seven recommendations aimed at improving outcomes, which include enhanced planning and collaboration, and greater transparency from health boards concerning decisions on local medicine use and the speed of integrating SMC-approved treatments. Victoria Jordan, the ABPI executive director of patient access, commented, “Scotland has a strong and respected system for assessing new medicines. But this report shows that the use of some accepted medicines can vary widely between NHS boards, and that differences in patient need do not fully explain this.” She added, “While the data we have does not tell us everything, it does show we need to look more closely at this issue. When avoidable barriers slow things down, patients can wait longer than they should for medicines already judged effective and good value. We need to plan and work together across government, the NHS, clinicians, patients, academia and industry. That way, we can help make sure national SMC decisions have benefit to patients, wherever they live.”
Read the full article from The BBC here: Read More
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