Patients in the Western Isles are being prescribed drugs used for weight loss and diabetes at almost three times the rate of any other health board in Scotland. A new report from the Association of the British Pharmaceutical Industry (ABPI) found "significant variation" between Scotland's health boards prescribing new medicines, including drugs for heart attacks and strokes. The biggest variation was seen in access to GLP-1 medication, which is widely used to treat type 2 diabetes but was approved for weight management in 2023.
NHS Western Isles said it was seeing "significant clinical benefit". The ABPI said there were limitations to the data, but better planning could help overcome inequalities in access. The Scottish government said it would "carefully consider" the findings of the report.
It said its health board reforms were intended to "improve equity of access to services and reduce the unwarranted variation and bureaucratic barriers we currently have in place". These reforms include plans to reduce the number of mainland health boards from 14 to two, which leading doctors have opposed. This first-of-a-kind report from the body that represents pharmaceutical companies, compared access to several new medicines approved by the Scottish Medicines Consortium (SMC) as safe to use and value for money on the health service.
The analysis looked at NHS prescribing across all Scottish boards from September 2020 to August 2025. The biggest variation for patients was in access to GLP-1medications which showed "substantial geographic variation". The report sets out a three-month average quantity of the drug prescribed per head of population for each health board in Scotland, between June to August 2025.
NHS Western Isles prescribed the highest rate (1,086.54) followed by NHS Greater Glasgow and Clyde (392.97). NHS Shetland had the lowest rate (100.31). The report authors say there are limitations to the data with both boards at the end of the range serving small island populations, where a few prescriptions can make a big difference to prescribing rates.
It also highlighted that this data does not identify which were prescribed for diabetes and which for weight loss. Earlier this month, BBC Scotland News revealed that fewer than half of Scotland's 14 territorial health boards were currently prescribing GLP-1s specifically for weight loss, and fewer than 800 Scots had received the jabs so far for this purpose. The Royal College of Physicians described the lack of access to the "safe and cost-effective medicines" as "discriminatory against obese people", and argued the NHS could save millions in obesity-related illness.
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