Record NHS Spending on Weight Loss Drugs Raises Long Term Cost Debate in Scotland

Scotland’s National Health Service saw a dramatic increase in the prescription of semaglutide, known commercially as Ozempic and Wegovy, as the annual number of prescriptions rose to 168,486 in 2024 and 2025. This represents an increase of more than 112 percent from the 79,182 prescriptions recorded in the prior year and marks the single largest rise for any drug prescribed last year. Concurrently, the public expenditure on semaglutide has surged from £8.7 million to almost £18.7 million within the same period. Each prescription now averages over £110 in cost to the NHS, though patients themselves pay nothing due to the existing free prescription policy.

This rise in pharmaceutical intervention comes in the context of Scotland’s severe obesity crisis. Around two thirds of adults in the country are overweight, with one third classified as obese. These rates surpass those found in the rest of the United Kingdom and most EU nations. Recent analysis by Public Health Scotland estimates that obesity costs the nation approximately £5.3 billion per year, though the agency warns that without effective intervention, over half of all Scots could be overweight by 2040, intensifying pressure on public health services.

The surge in prescriptions can be attributed in part to new government guidance, which now allows weight loss drugs to be prescribed for a broader range of obesity-linked conditions including heart disease. This move contrasts with the more restrictive policies currently in place in England and signals an increased recognition among Scottish authorities of the severe health, social, and economic consequences attached to rising levels of obesity.

Alongside semaglutide, use of tirzepatide—sold under the brand names Mounjaro and Zepbound—has also increased, moving from zero to over two million pounds in public spending in just two years, spread across 18,332 prescriptions. Many Scots are also choosing to pay privately for these drugs, with estimates suggesting nearly five percent of the population are making such purchases outside of the public system.

Specialists note that while these drugs entail high initial costs, there is significant potential for long term savings by averting more serious and costly health outcomes that result from untreated obesity. The escalation in drug spending has elicited concern from some policy makers and commentators, who warn of exponential growth in the public bill and raise questions about cost effectiveness and sustainability.

The Scottish Government has emphasised that all approved medicines, including those for obesity, undergo a standard cost and clinical effectiveness evaluation by the Scottish Medicines Consortium. While prescription data does not account for any undisclosed price concessions agreed by the NHS, the intention remains to balance value to both patients and the health service as a whole.