Angus health chiefs are looking to cut the cost of chronic pain prescribing as bills continue to rise.
The Angus Health and Social Care Partnership is braced for a £1.9 million overspend for this year.
One of the biggest reasons for this was a local prescribing bill of around 10% more than the national average in September last year – rising to around 12% in May this year.
A meeting of the Angus integrated joint board heard the wider Tayside cost is running at around 9.4%.
It heard prescribers are being told to reassess patients who are given medications including the painkillers lidocaine and pregabalin, and the cardiovascular drug rosuvastatin.
In Tayside, a new “prescribing formulary” to standardise what medicines are given for ailments was launched in April this year.
Seven of 15 Tayside “quality prescribing visits” were also made to Angus healthcare practises.
Angus Partnership clinical director Dr Alison Clement said Angus is spending “considerably more” than other partnership areas.
“There’s an increase in long-term illness,” she said.
“We are limited by the resources we have — General Practice and pharmacy are both under considerable strain.”
The IJB discussed a report by Dr Clement and primary care manager Rhona Guild, which said the reasons for the higher “family health” spend in Tayside and in Angus are “complex and multifaceted”.
The report added: “It is in part due to higher than average prevalence of a variety of chronic diseases and the regional adoption of clinical pathways aimed at providing patients with the best possible care.
“There is evidence to support that investing in prescribing for some care pathways reduces mortality and morbidity and provide good examples of positive variation and reduced spend in other parts of the system.
“There are however a number of areas of unexplained variation which are undergoing further investigation and action.”
The board’s director of public health, Dr Drew Walker said he believed there is “significant waste” at the point of prescription.
He said: “Right across the world there are issues around the prescription pad being reached for, when other ways of support can be found.
“There are huge issues around compliance; of people not using the medication they are prescribed.
“There is significant waste, significant variation and huge potential for harm.”