110 Million Unnecessary Medicines Prescribed in England Each Year: Review Estimates

110 Million Unnecessary Medicines Prescribed in England Each Year: Review Estimates
File photo showing a doctor writing a prescription. PA
Lily Zhou
Updated:

An estimated 110 million medicine items prescribed by doctors in England each year are not needed, a government-commissioned review into overprescribing has found.

The government vowed to tackle the problem after the new review was published on Wednesday.

The review (pdf), led by the Chief Pharmaceutical Officer for England Dr. Keith Ridge, estimated that one-tenth of the prescription medicines (about 110 million items), are either inappropriate for that patients’ circumstances and wishes, or could be better served with alternative treatments.

According to the Department of Health and Social Care (DHSC), prescriptions are deemed unnecessary when a better alternative is available but not prescribed, the medicine is appropriate for a condition but not the individual patient, a condition changes and the medicine is no longer appropriate, or the patient no longer needs the medicine but continues to be prescribed it.

Official figures show that the number of prescription items dispensed in primary care and the community in England was 10 per head in 1996, and the number has doubled by 2016.

More people have been taking the same medicine for longer without having their prescriptions reviewed. There are also more people taking multiple medications.

Around 15 percent of people in England are currently taking five or more medicines a day, with 7 percent on eight or more medicines a day, the review found.

Apart from the cost of wasted medicines, overprescribing can increase the risk of adverse drug reactions (ADR), leading to more hospital visits and admissions, and premature deaths.

The report found that one in five hospitalisations in over 65s are caused by adverse effects of medicines. Across all hospital admissions, the percentage of ADR-related hospitalisations is around 6.5 percent, two-thirds of which are considered preventable.

It also said that overprescribing may disproportionately affect people with disabilities and ethnic minorities.

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; and a new national clinical director for prescribing to lead reform.

The authors said they believe it’s realistic to reduce the volume of prescription medicines by 10 percent.

The DHSC said ministers have accepted all recommendations laid out in the review.

Health and Social Care Secretary Sajid Javid said the review is “incredibly important” and will “have a lasting impact on people’s lives and improve the way medicines are prescribed.”

“With 15 [percent] of people taking 5 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,” Javid said in a statement.

“I look forward to working with Dr. Keith Ridge and our dedicated NHS teams to deliver on these recommendations,” he added.

PA contributed to this report.
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