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Research focuses on dependency-forming medicines waste

Experts call for deprescribing support

October 22nd 2021

Tagged: Clinical Zone news England

By Ailsa Colquhoun

New research estimates that around half a billion pounds is wasted each year in England on medicines that can cause dependency, including antidepressants, painkillers and sleeping pills.

The research is released by the All-Party Parliamentary Group for Prescribed Drug Dependence, in conjunction with the universities of Roehampton, Greenwich and University College London (UCL).

The study, the estimated costs incurred by the NHS in England due to the unnecessary prescribing of dependency-forming medications, estimates that, over the period April 2015 to March 2018, up to 21.3 per cent of the costs of prescriptions of antidepressants, up to 72 per cent of benzodiazepines, up to 76 per cent of z-drugs and up to 53 per cent of opioids were unnecessary. In addition, up to 54.4 per cent of the costs of gabapentinoid prescriptions for pain and up to 12.6 per cent of gabapentinoids prescriptions for psychiatric conditions were unnecessary.

This led to estimates of unnecessary annual prescription costs of up to £43.2m for benzodiazepines, up to £28.5m for Z-drugs, up to £288m for opioids, up to £158.5m for gabapentinoids and up to £65.1m for antidepressants. The estimated annual unnecessary costs of prescribing for all five classes of medicines ranged between £493m to £564m, when unnecessary consultation and dispensing costs were included.

Researchers define unnecessary prescribing as prescribing that either contravenes current NICE guidelines, or where no evidence exists for efficacy or continued clinical need, despite long-term use.

In addition to identifying substantial unnecessary prescription waste (including costs incurred through unnecessary consultations and pharmacy dispensing), the research notes that the harms caused by dependency-forming drugs may also lead to other significant costs that the study did not estimate, including higher disability costs, lost tax revenues as well as rising workplace absenteeism and low-productivity costs.

Dr Ruth Cooper, co-lead author of the new research, said: “To help reduce waste, we must engage in careful deprescribing programmes, freeing up resources for more investment in psycho-social alternatives of proven efficacy.”

Professor Joanna Moncrieff, one of the article’s authors, added: “We need a cultural shift in our approach to helping people deal with pain, anxiety and depression, so that it is no longer centred on the use of medication.”

This research follows the publication in 2019 of Public Health England’s Prescribed Medicines Review, which established that over a quarter of the adult population in England (26.3 per cent) had been prescribed a dependency-forming medicine in the previous year.