Scotland health and social care correspondentPublished31 minutes agoPatients 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.
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.
According to freedom of information requests sent by BBC Scotland News, NHS Western Isles has 340 patients on medication for weight loss – the highest number of any board involved in the pilots.
NHS Western Isles is one of six health boards taking part in pilot programmes to improve access to weight loss medication.
The others are NHS Forth Valley, NHS Borders, NHS Lothian, NHS Lanarkshire, and the NHS State Hospital known as Carstairs.
NHS Western Isles said it established a "structured pathway" for access to GLP-1 medicines earlier than any other NHS board in Scotland.
It added: "Our prescribing rates reflect that early implementation, as well as local clinical need, rather than participation in a pilot scheme."
"These medicines are prescribed following clinical assessment and form part of a wider dietetic-led programme supporting long-term behaviour change and healthier lifestyles. Patients are reporting and we are seeing significant clinical benefit."
The report also looked at access to certain medicines prescribed to patients with cardiovascular disease.
Cardiovascular disease, which includes conditions such as heart disease or stroke, is a leading cause of death and affects around 800,000 people in Scotland.
The study looked at prescribing data for non-statin low-density lipoprotein (LDL)-lowering medicines accepted by the SMC.
Prescribing rates differed eight-to-10-fold between the highest-prescribing (Highland) and lowest-prescribing (Forth Valley) boards.
Authors say health boards with closer links between specialists and GPs generally recorded higher prescribing.
The ABPI made seven recommendations, including better planning and co-operation alongside more transparency by health boards about decisions on what medicines to use locally, and how quickly accepted medicines are being introduced.
Victoria Jordan, ABPI executive director of patient access, said: "Scotland has a strong and respected system for assessing new medicines.
"But this report shows that the use of some accepted medicines can vary widely between NHS boards, and that differences in patient need do not fully explain this.
"While the data we have does not tell us everything, it does show we need to look more closely at this issue. When avoidable barriers slow things down, patients can wait longer than they should for medicines already judged effective and good value.
"We need to plan and work together across government, the NHS, clinicians, patients, academia and industry. That way, we can help make sure national SMC decisions have benefit to patients, wherever they live."
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