GLP 1 Prescribing: Improving Safety, Reducing Waste and Tackling Overprescribing

NAME OF ORGANISATION

Project summary

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 agents are increasingly prescribed for type 2 diabetes and obesity, but present key challenges including high cost, national supply shortages, and emerging misuse for non-licensed indications such as cosmetic weight loss. Within Aneurin Bevan University Health Board (ABUHB), variation in prescribing practices created risks to patient safety, medicines waste, and financial sustainability.

A health board-wide project was undertaken to optimise prescribing of injectable GLP-1 therapies in primary care. A standard operating procedure (SOP) was developed and implemented across GP practices, supported by EMIS and Vision searches to identify all adult patients receiving these agents. A structured audit of 3,555 patient records was completed using a standardised template capturing drug, dose, formulary compliance, and prescribing quantity.

Prescriptions were reviewed against national guidance, including Chief Pharmaceutical Officer recommendations to issue monthly supplies. Where overprescribing was identified, quantities were rationalised to reduce excess supply and minimise misuse risk. Inappropriate prescribing (e.g. non-formulary use, unlicensed indications, or generic prescribing risks) was addressed, with cases escalated where required. Secondary care prescribing concerns were resolved through engagement with specialist clinicians.

The project identified 64 patients with incorrect prescribing quantities, representing avoidable waste and potential contribution to national shortages. Interventions improved prescribing consistency, reduced the risk of inappropriate supply, and generated financial savings of £144,500. Alongside optimisation work, education and safety messages were widely disseminated, including MHRA alerts and risks associated with misuse.

Overall, the project improved patient safety, reduced overprescribing and medicines waste, and strengthened system-wide governance for high-cost medicines.