The net cost of dispensing items and providing services in the community in Scotland has increased by nearly 30% in the last 10 years, according to official figures.
Public Health Scotland’s annual report on dispenser payments and prescription costs, published September 29, showed that the net cost of item costs, service remuneration, advance payments and patient charges to the Scottish government in 2025/26 was £1.67bn.
Read more: Cost of diabetes medication doubled over the last decade
This is up 27.9% since 2016/17, it said, following marginal increases of 0.8% year-on-year.
The cost of NHS items reimbursed grew by 19.3% over the last decade, despite a decreased of 0.4% between 2024/25 and 2025/26.
The number of items reimbursed rose by 1.3% between 2024/25 and 2025/26, and grew from 103.4 million to 118.5 million items over the 10-year period.
Community services
Remuneration of services grew by 6.4% to £369.4m in 2025/26, while the number of Pharmacy First Scotland consultation claims increased by 3% to over 5.7 million.
Around 75% of the Pharmacy First Scotland claims related to a consultation where an item was supplied, with the rest consisting of a pharmacy either giving advice or referring onto another pathway.
It cost £36.39m to remunerate the Pharmacy First Scotland service in 2025/26, with the medicines care and review service similarly remunerating community pharmacies at £35.82m.
Read more: Nine million people prescribed antidepressants in England
The cost of remunerating the smoking cessation service was down from £1.27m to £1.19m in 2025/26, with the number of items dispensed and reimbursed also dropping from 206,761 to 184,041.
And the reimbursement cost for the emergency hormonal contraception services fell from £3.11m in 2024/25 to £2.46m.
GLP-1 growth
Eight of Scotland’s 14 NHS boards had an average cost per person above the national average of £301.24, with NHS Ayrshire & Arran having the highest at £338.30 per person and NHS Orkney the lowest at £258.69.
And 10 of the NHS boards dispensed more than the 21.4 average of prescription items reimbursed per person.
Omeprazole has been the most commonly prescribed drug for the last ten years, accounting for 4.23m items in 2025/26.
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Of the top 10 items by gross ingredient cost of medicines dispensed and reimbursed by NHS Scotland in 2025/26, six were for the treatment diabetes, with glucose interstitial fluid detection sensors costing £39.98m - an increase of over £5m from the previous year.
Semaglutide was the second-most costly item at £26.72m, with its gross ingredient cost increasing by over £8m – around 43.2% - in 2025/26.
But tirzepatide’s gross ingredient cost rose the most over the last year, rising 861.6% to £18.3m, while the drug also saw a 429.6% increase in volume growth.
Read more: ‘Lower than hoped’: Scottish pharmacies get 3.5% uplift
The report said the increase was driven by “market penetration”, with 78,763 more tirzepatide items prescribed in 2025/26 than the year before, as well as a “significant price increase” that saw the cost of a 10mg tirzepatide pen rise from £107 to £255 last September.
It comes after the NHS Business Services Authority (NHSBSA) revealed in August that the cost of medication used to treat diabetes has more than doubled over the last decade.
And it follows the NHSBSA announcing in July that more than nine million people in England were prescribed antidepressants over the last year.
