Access to weight loss drugs in Scotland can “vary widely between NHS boards”, new research from the the Association of the British Pharmaceutical Industry (ABPI) has revealed.
In a report published yesterday, the body found “substantial variation in the pace and scale of recorded prescribing between NHS boards” across medicine classes, with the “greatest variation in access in GLP-1 medicines” used to treat type 2 diabetes and for weight management.
“Clear variation”
The report analysed community and hospital prescribing data across Scotland’s NHS boards between September 2020 and August 2025, and found that while there was clear variation in the adoption of medicines across each board, “available measures of population need did not fully explain the patterns observed”.
At the end of the study period, the Western Isles NHS Board - which had the highest prescribing rates of all - was dispensing around 10 times as many GLP-1 medicines as the lowest-prescribing NHS Board, Shetland.
But the report noted that “diabetes and obesity levels in each area did not fully explain this gap”, with some areas taking over a year to add GLP-1 medicines to local formularies.
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The report did identify several mitigating factors relevant to data interpretation, for example, that “boards at either end of the range [may] serve small island populations, where a few prescriptions can make a big difference to prescribing rates”.
Private prescriptions were also excluded from the findings and data did not distinguish between medicines prescribed for diabetes and weight management.
A similar pattern of variable access was observed in the provision of non-statin cholesterol-lowering medicines.
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According to the report, “prescribing rates differed eight- to 10-fold” between the highest-prescribing board, Highland, and the lowest-prescribing, Forth Valley, in August 2025.
Analysis revealed that boards with “clearer links” to specialist lipid clinics and GPs “generally recorded higher prescribing”.
But the report emphasised that “the analysis did not adjust for differences in patient need or local services”.
Recommendations
The ABPI made seven recommendations for NHS Scotland and the Scottish government, including “earlier planning” and “more openness about local formulary decisions and how quickly accepted medicines are being introduced”.
It also called for “extra support and checks for complex medicines that rely on specialist service”, and the implementation of a “learning system” that could measure whether early planning results in the quicker provision of new medicines.
The report recommended a change to medicine tracking systems, suggesting that they instead look at “where patients live, not only where they are treated”, and called for “closer working between government, the NHS, academia and industry”.
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It also said there should be “a pilot of protected funding for a small number of high-impact medicines, where local budget pressures could cause delays”.
The pilot would “assess whether dedicated implementation funding accelerates formulary inclusion and adoption, reduces geographical variation and supports earlier patient and system benefits”, it added.
“Avoidable barriers”
ABPI executive director of patient access Victoria Jordan said the report demonstrated that “the use of some accepted medicines can vary widely between NHS boards, and that differences in patient need do not fully explain this”.
“While the data we have does not tell us everything, it does show we need to look more closely at this issue,” she added.
“When avoidable barriers slow things down, patients can wait longer than they should for medicines already judged effective and good value.”
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It comes after a new report by the parliamentary Health and Social Care Select Committee said the English government’s approach to weight loss management needs to be “fundamentally reimagined”.
And it follows an annual report by Public Health Scotland revealing that the net cost of dispensing items and providing services in the community in Scotland has increased by nearly 30% in the last 10 years.
