Report finds ‘substantial variation’ in health board prescribing of GLP-1 drugs

A new report has highlighted “substantial geographical variation” in prescribing of drugs such as Ozempic and Mounjaro on the NHS in Scotland.

The first study of its kind by the Association of the British Pharmaceutical Industry (ABPI) found that while there had been “strong growth in NHS prescribing” of such drugs, there were differences between health boards which could not fully be explained by patient need.

GLP-1 and GIP/GLP-1 drugs – such as Ozempic and Mounjaro – were one of the types of medications considered in the study, which looked at how widely drugs were prescribed to patients after being approved for NHS use by the Scottish Medicines Consortium (SMC).

Across all the medicines looked at, the research found “there was substantial variation in the pace and scale of recorded prescribing between NHS boards”.

It recommended “a more co-ordinated approach to implementation across NHS Scotland”.

To achieve this, the ABPI put forward seven priority areas for action, saying NHS Scotland bosses and the Scottish Government should “lead the work” on implementing these with NHS boards and other parties.

While GLP-1 medications have been approved for NHS use for weight loss in eligible patients and for treating inadequately controlled type 2 diabetes, the report pointed out that most NHS prescriptions come under the latter category

Use of such drugs to help tackle obesity has “remained substantially more limited than use for type 2 diabetes”, it noted, with 71% of Scottish respondents taking weight-loss medication in the last 12 months obtaining it privately, rather than on the NHS.

As such it stressed the findings of the report “should not be interpreted as evidence of widespread NHS adoption for obesity”, adding the data was “likely to predominantly reflect prescribing for type 2 diabetes”.

However, for NHS prescribing, the study found that NHS Western Isles had the highest three-month average population-standardised level of activity – 10 times higher than in Shetland, which had the lowest.

The report went on to note that the two areas with the highest prescribing rates, Western Isles and NHS Greater Glasgow and Clyde, were “substantially” different in terms of recorded population need.

It pointed out that Greater Glasgow and Clyde had “the second-lowest prevalence of overweight and obesity across NHS boards”, while the Western Isles had the second-highest prevalence.

Meanwhile, “Shetland recorded the lowest per capita prescribing despite relatively high overweight and obesity prevalence”, the report added.

Commenting on the report, Scottish Labour health spokesperson Jackie Baillie insisted: “We cannot have a situation where people across the country face a postcode lottery when it comes to accessing medication.”

She added: “This report has identified an implementation gap between the SMC approving medications and those then being adopted across NHS Scotland.

“The Scottish Government, along with health board bosses, must consider this report and evaluate what more can be done to close that gap and ensure that there is equitable access for patients across Scotland.”

Victoria Jordan, ABPI executive director of patient access, said that while “Scotland has a strong and respected system for assessing new medicines”, the report showed “that the use of some accepted medicines can vary widely between NHS boards and that differences in patient need do not fully explain this”.

Ms Jordan said: “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.”

A Scottish Government spokesperson said: “We will carefully consider the findings of this report and have been clear our reforms to NHS boards are intended to improve equity of access to services and reduce the unwarranted variation and bureaucratic barriers we currently have in place.”

Published: 29/10/2026 by Radio NewsHub