Do we need a pill for every ill?

Date published: 27 June 2023


Northern Ireland’s Chief Pharmaceutical Officer Professor Cathy Harrison said that our use of prescribed medicines and the associated costs remains too high, exceeding £800 million a year.

Chief Pharmaceutical Officer Cathy Harrison
Chief Pharmaceutical Officer Cathy Harrison

In a blog to reflect on the 75th anniversary of the NHS Professor Harrison said:-

“I am a huge advocate for the appropriate use of medicines and their role in helping to prevent, treat, and cure disease. Medicines are the most common medical intervention, and in all their forms, they play a vital role in health and wellbeing throughout our lives.

“However, advances in therapies and medicines are expensive. Some new medicines can be hugely costly with many examples of treatments costing tens or hundreds of thousands of pounds per patient. In a service that is free at the point of access, this is why we need to start thinking and talking more about our approach to medicines going forward.

“As we reach the 75th anniversary of the NHS, medicines costs in Northern Ireland are exceeding £800m per year and are the second largest single investment we make in the health service, after staff.  The average number of prescription items a year is 21 per person, at a cost of £227. This cost is the highest in the UK and the volume of prescription items is still rising each year.

“There are a range of factors contributing to this situation, including our ageing population with more complex needs and deprivation levels. The underlying issues are multi-factorial. Recent research conducted by the Community Development & Health Network (CDHN) ‘Our Lives, Our Meds, Our Health: Exploring Medication Safety through a Social Lens’ found a clear link between the social determinants of health and health literacy, and the ability for people to take their medicines safely. The evidence in this research provides the opportunity to learn about how people’s everyday lives and social circumstances can impact on their ability to take medication as prescribed and inspire us to drive improvements in medication safety.

We need a variety of solutions but in terms of prescribing, work has been undertaken to promote improved clinical and cost-effectiveness. Some progress has been made. We have an efficient and cost-effective approach to the procurement of medicines in our hospitals, good compliance with the Northern Ireland Drug Formulary and a generic prescribing rate of over 80% in primary care.

“However, more needs to be done. Our use of medicines and associated costs remains too high. There is an uncomfortable truth that manifests in the prescribing data for medicines.  In Northern Ireland, we continue to use more of almost every type of medicine than other parts of the UK. That includes more antibiotics, more painkillers, more baby milks, more nutritional supplements, even more oxygen.

“This demand for medicines creates a huge burden on our services, with pharmacies and general practices struggling to meet patient expectations. Our community pharmacies currently dispense over 43 million prescription items a year..

“Considering environmental impact, medicines account for about 25% of carbon emissions within the NHS.  This is understandable if we consider the life cycle of a medicine, from assembly of ingredients, production, packaging, prescription, dispensing and consumption and finally waste disposal.  There is a need for more sustainable use of medicines and to decrease the carbon footprint and environmental risk that medicines currently create.

“So where do we start? You may remember the old ad campaign ‘You don’t need a pill for every ill’. That is still very true today. A proportion of GP consultations and prescriptions could be avoided by the safe management of common, self-limiting conditions by individuals either at home or, if needed, with advice and/or treatment from a community pharmacy.  This is just one small change in behaviour that could start to make a big difference.”


Notes to editors: 

  1. The ‘Our Lives, Our Meds, Our Health: Exploring Medication Safety through a Social Lens’ final report can be accessed via the Community Development & Health Network website.
  2. Chief Pharmaceutical Officer Professor Cathy Harrisons NHS 75 Blog can be accessed via the Department website.
  3. For media enquiries please contact the DoH Press Office by email
  4. Follow us on Twitter @healthdpt.
  5. The Executive Information Service operates an out of hours service For Media Enquiries Only between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The duty press officer can be contacted on 028 9037 8110.

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