GPs have been told to prescribe expensive drugs

This could divert cash away from other vital areas, says the Audit Commission.

However, ministers insist that big spending on the latest drugs can actually end up saving the NHS money as patients require less additional help.

The commission says it has found ways in which GPs could get a grip on their spiralling drugs budgets.

Statins, which lower cholesterol levels, and modern blood pressure medications are some of the most widely prescribed drugs in the UK, but are more expensive than older alternative treatment regimes.

As prescribing costs rise rapidly, it is vital that every penny is spent well James Strachan, Chairman, Audit Commission

The government has said that these new drugs have to be prescribed, which means that primary care trusts (PCTs) - groups of GPs and other primary care organisations covering a town - must find the money to pay for them, even if they have tight budgets.

No specific extra government funding is made available to pick up the cost of swapping an expensive, new drug for an old, cheaper one in many hundreds of patients per PCT, although the overall funding of general practice has risen beyond inflation in recent years.

New record

The overall cost of drugs prescribed by family doctors rose by 29% between 1998/9 and 2001/02 to an all-time high of �5.5 billion.

This rise far outstripped a substantial increase in the amount of money made available in primary care over that period.

Increased prescribing of the best drugs saves lives. It is money well spent. David Lammy MP, Health Minister

A further 12% increase in drug spend in 2002/03, predicts the Audit Commission, could leave PCTs facing an �110m shortfall.

However, the commission says it has found a way for doctors to claw back some of this money.

Its national "prescribing savings database", it claims, could help GPs spot "wasteful" prescribing.

Antibiotic waste

Many doctors still give out antibiotics for viral infections, even though they will have no effect.

The commission said that just by halting this, the average PCT could save �59,000 a year.

James Strachan, its chairman, said: "As prescribing costs rise rapidly, it is vital that every penny is spent well.

Funding for these drugs is a huge upfront cost for the NHS. Dr Jim Kennedy, Royal College of General Practitioners

"New drugs are now available which can have a tremendous impact on people's health, provided that they are given to the right patients.

"All PCTs should review their performance to see how they, too, can free up the funds to ensure people get the medicines they need."

Dr Jim Kennedy, chairman of the prescribing committee of the Royal College of General Practitioners said: "There is no doubt that such medication saves lives and improves the quality of life.

"However, funding for these drugs is a huge upfront cost for the NHS.

"While it is a valid investment, it should not be at the expense of other primary care treatments."

However, Health Minister David Lammy said that investing in the best drugs was the best policy for PCTs.

He said: "Increased prescribing of the best drugs saves lives. It is money well spent.

"The Audit Commission's conclusions about prescribing do not reflect PCTs overall financial picture.

"This year PCTs got an average 10% increase. This is an increase in their total budgets.

"Within that, some spending will rise by more than 10% - for example on the best drugs - and some spending will be well below 10%. It is a matter for each PCT."

Liberal Democrat health spokesman Dr Evan Harris said: "GPs are having to prescribe more drugs than their budgets allow. Other services are having to be cut because of this.

"The problem is that the government is expecting the money spent on drugs to pay for other things, such as Whitehall targets."

Shadow Health Secretary Dr Liam Fox said: "It is clear that Primary Care Trusts face a big funding gap next year.