“Low-value” prescription items are costing the NHS £128m a year. Sky News looks at some of the treatments under review
NHS England is working on new guidelines to stop GPs from prescribing medicines which can be purchased over the counter for a fraction of the cost.
Here is a look at some of the items available on prescription that are being considered as part of the consultation and their annual cost to the NHS:
Travel vaccines
Only a small number of vaccines are allowed on the NHS, but many practices still prescribe them.
Vaccines for typhoid, hepatitis A and cholera and a combined jab for diphtheria, polio and tetanus are usually available free on the health service because they protect against diseases deemed to present the greatest risk to public health if brought into the country by travellers.
Some countries require visitors to be vaccinated against diseases such as yellow fever, meningitis, tuberculosis, hepatitis B, Japanese encephalitis and tick-borne encephalitis.
These are not usually available on the NHS and can cost around £50 for each dose.
Co-proxamol
Used for mild to moderate pain relief, it is a combination of two active ingredients, dextropropoxyphene and paracetamol. The latter is typically included as a lower 350mg dose compared with the standard 500mg dose when taken alone.
The evidence is weak on whether co-proxamol is more effective at treating pain than a regular dose of paracetamol.
Omega-3 and fish oils
Natural oils from certain breeds of fish such as salmon and mackerel are prescribed for patients at risk of heart disease.
The fatty acid omega-3 usually comes in capsule form and has been used to help prevent irregular heartbeats and reduce the risk of clotting by making the blood less sticky.
Tadalafil
It is an expensive alternative to Sildenafil (Viagra) and there is no evidence to suggest its effectiveness is superior.
Doxazosin MR
It is used to treat hypertension, but doxazosin modified release (MR) tablets are only believed to be effective for a very small number of patients.