Options to restrict or stop the routine prescribing of selected medicines in primary care

Overview

Medicines have a vital role in helping to prevent, treat, and cure disease. They are Northern Ireland’s most common medical intervention and are relied upon to support health and wellbeing throughout life. However, medicines costs in Northern Ireland (NI) are increasing annually and have now reached over £870 million per year, an increase of 43% over the last decade. Despite on-going efforts to improve the efficient use of medicines in NI, prescribing rates and costs per person remain consistently higher than in other regions within the United Kingdom (UK). Without further action, the Health and Social Care (HSC) service will face increasing difficulty in funding new and often high-cost treatments while meeting the needs of a growing and ageing population.

Alongside financial pressures, there are wider sustainability challenges. Once dispensed, prescription medicines cannot be reused, contributing to avoidable waste and unnecessary environmental harm. Reducing inappropriate prescribing and medicines waste is therefore essential not only for financial sustainability, but also for reducing the carbon footprint of healthcare in NI.

In response to these challenges, the Department of Health (DoH) published “Valuing Medicines: A strategy for the sustainable use of medicines in Northern Ireland” in September 2025. The Valuing Medicines Strategy (VMS) sets out a framework to ensure medicines are used in a way that is clinically effective, environmentally sustainable, and delivers the best outcomes for patients and the health service.

This consultation focuses on the implementation of VMS Recommendation 1.2, identified as a priority for year one of implementation. This recommendation commits the Department to consult on actions to restrict or stop the prescribing of selected medicines, which Departmental guidance considers having low and limited clinical value.

The DoH does not support HSC prescribing of products where there is insufficient evidence of effectiveness. Although existing guidance, such as formulary controls and “Limited Evidence” and “Stop” lists, supports clinicians in identifying such medicines, these measures are non-statutory and allow for clinical discretion. As a result, variation in prescribing practice continues. In 2024/25, approximately £7.3 million was spent in primary care in NI on items included on these lists, in addition to the wider costs associated with prescribing, including GP and practice staff time. This expenditure may represent a low and limited clinical value for public funding, particularly where resources could be redirected towards treatments with stronger evidence of clinical benefit.

The purpose of this consultation is to seek views on proposed options to strengthen current arrangements. These include potential measures to restrict or stop the prescribing of selected medicines, which Departmental guidance considers having low and limited clinical value, by those operating under General Medical Services (GMS) contractual arrangements, including consideration of legislative change. This includes ‘Limited Evidence’ and ‘Stop’ list medicines:

• with limited evidence of clinical effectiveness, and
• that are readily available over the counter, meaning they can be purchased without a prescription from community pharmacies and other retail outlets.

Please note that it is advised that respondents should first read the consultation document before attempting to respond to these consultation questions.

Why your views matter

Your voice matters, and your perspective is invaluable in helping to shape a policy to ensure the sustainable use of medicines in NI. It is also crucially important to have your say in how public services are shaped.

The Department is seeking views from all those who may be directly affected by these proposals, as well as those who have direct or indirect influence on prescribing decisions, such as general practitioners, community pharmacy teams, other healthcare professionals, health and social care providers, those working across the HSC sector, community and voluntary organisations, and members of the public.

Please submit your responses by 2 October 2026

Privacy.

We respect your privacy. Any personal information you provide will be handled in accordance with data protection laws. We will not publish your personal details.

Being transparent and providing accessible information to individuals about how we may use personal data is a key element of the Data Protection Act (DPA) and the EU General Data Protection Regulation (GDPR). The DoH is committed to building trust and confidence in our ability to process your personal information and protect your privacy.

For information on how we process your information, please see the privacy notice in the main consultation document.