James Davies, associate professor of medical anthropology and psychology at University of Roehampton, explains why the NHS’s £1.6 billion on prescriptions is a problem.
The NHS 2025/2026 Operational Planning Guidance, published on 30 January 2025, controversially empowered local NHS leaders to “reduce or stop lower value activity to enable the service to live within its means and deliver value to taxpayers”. While many would support the removal of treatments such as homoeopathy, they may be less enthusiastic about the implied drive to reduce unnecessary medication, given that medications are deemed a lifeline for so many people.
A staggering £1.37 billion to £1.56 billion, however, was spent by the NHS between April 2015 and March 2018 on drugs that were either inappropriate or unnecessary, according to research by the University of Roehampton.
An average of £45.9 million is wasted every year on unnecessary prescriptions for antidepressants. A further half a billion pounds is spent annually on unnecessary prescriptions for dependency-forming drugs, including opioids, gabapentinoids, benzodiazepines and Z-drugs.
The issue may be even more pervasive: a 2021 UK Government-commissioned review found that 10% of items dispensed in NHS primary care are overprescribed and, therefore, unnecessary.
A drain on resources
Many of these drugs carry risks, including overdose and dependency, with questionable effectiveness for mild and moderate depression, anxiety and long-term chronic pain.
It is worth noting that while antidepressant prescriptions in England have nearly doubled over the last decade, rising from 47 million in 2011 to more than 85 million in 2022/23, there has not been a reduction in mental health issues.
Evidence suggests that alternatives such as psychological therapies, physical activity, and pain management programmes can better improve outcomes.
The rise in mental health struggles is inextricably linked to broader social and economic problems, such as unmanageable workloads, job insecurity, rising economic strain, to inadequate social care and community support. When distress is viewed solely through a medical lens, we risk reducing human suffering to a problem of individual biology, rather than recognising (and tackling) its social determinants.
Over-medicalisation does not just drain NHS resources; it diverts attention away from the deeper social reforms needed to address the rising social burden of poor health.
Reducing unnecessary prescriptions is important, but blunt cuts to services are not the answer. We must rather invest further in social and psychological interventions that address suffering at its root. While the government’s Autumn Budget pledged additional funding for social care, organisations such as Care England have already warned that these commitments are but a drop in the ocean.
If we are truly to reduce unnecessary prescriptions, we must first ensure that individuals have access to the social support, therapy, and drug withdrawal and community resources that can offer real, long-term relief. Otherwise, we risk not only failing patients but deepening the very crises we aim to address.
