Around 110 million prescription items handed out every year “need not have been issued”, according to new estimates.
A Government-commissioned review into the overprescribing of medicines – where people are given medicines they do not need or want, or which may do them harm – concluded that the issue is a “serious problem” in health systems around the world.
While the NHS has helped stem the growth of overprescribing in England, the problem remains at “unacceptable levels”, according to the report.
The review, led by chief pharmaceutical officer for England Dr Keith Ridge, estimates that 10% of the total number of prescription items issued by GP surgeries “need not have been issued”.
With 1.1 billion prescription items dispensed in the community in England in 2020/21, this suggests that as many as 110 million could have been “overprescribed”.
The authors said that they did not want to set a target for reducing overprescribing, but said that a 10% reduction is “realistic”.
The review adds: “This would be equivalent to a reduction of around 110 million items a year.”
The elderly, those with disabilities and people from black, Asian and minority ethnic backgrounds are “disproportionately affected”, the review states.
Around 15% of people in England are taking five or more medicines a day, with 7% on eight or more.
The review authors warned that overprescribing can affect these groups when different medicines interact negatively with each other.
Indeed some 6.5% of hospital admissions are caused by the adverse effects of medicines, rising to 20% of hospital admissions among people over the age of 65.
The authors also said that repeat prescriptions make up around three-quarters of all prescription items and can be left without review for long periods, increasing the risk of overprescribing.
The review has made a series of recommendations including:
– systemic changes to improve patient records, transfers of care and clinical guidance to support more patient-centred care.
– culture change to reduce the reliance on medicines and support shared decision-making.
– a new national clinical director for prescribing to lead reform.
Ministers have pledged to crack down overprescribing, which is defined as the use of a medicine where there is a better non-medicine alternative, or the use is inappropriate for that patients’ circumstances and wishes.
The Department of Health and Social Care said that all of the recommendations had been accepted.
Health and Social Care Secretary Sajid Javid said: “This is an incredibly important review which will have a lasting impact on people’s lives and improve the way medicines are prescribed.
“With 15% of people taking five or more medicines a day, in some cases to deal with the side effects of another medicine, more needs to be done to listen to patients and help clinical teams tackle overprescribing.
“I look forward to working with Dr Keith Ridge and our dedicated NHS teams to deliver on these recommendations.”
Dr Ridge added: “Medicines do people a lot of good and the practical measures set out in this report will help clinicians ensure people are getting the right type and amount of medication, which is better for patients and also benefits taxpayers, by preventing unnecessary spending on prescriptions.
“Continuing to tackle overprescribing requires a whole system approach involving clinicians and patients, so we can continue to build the change we all wish to see in how medicines are used for the benefit of patients, and with medicines production and use a major driver of greenhouse gas emissions – contributing to the NHS’s net zero ambition.”