The effects of higher service costs, increased demand for healthcare and tighter budgets continue to take their toll on all parts of the health service and are thought to be impacting on patient care. Expenditure on medicines (one of the drivers of higher service costs) is growing in primary and secondary care,1 and has long been targeted as an area for rationalisation. Prescribing-related financial savings plans have been part of the NHS landscape for over 20 years and it is appropriate that the costs associated with the most common therapeutic intervention in the NHS should come under close scrutiny. However, it should be remembered that the UK spends less …