Patients face an NHS postcode lottery for Ozempic-style drugs, with prescribing rates varying tenfold between Scottish health boards, according to a report.

The first study of its kind found ‘substantial geographical variation’ in prescribing, despite strong growth in NHS use of the drugs.

The Association of the British Pharmaceutical Industry (ABPI) trade body analysed how widely medicines were prescribed after being approved for NHS use by the Scottish Medicines Consortium.

It found prescribing activity in the Western Isles was ten times higher than in Shetland, Scotland’s lowest-prescribing area.

Across all the medicines looked at, the research found ‘there was substantial variation in the pace and scale of recorded prescribing between NHS boards’.

It recommended ‘a more co-ordinated approach to implementation across NHS Scotland’.

To achieve this, the ABPI put forward seven priority areas for action, saying health board bosses and the Scottish Government should ‘lead the work’ on implementing these with the boards and other parties.

Ozempic is one of a new generation of so-called weight-loss jabs that help curb appetite and promote weight loss.

Originally developed to treat type 2 diabetes, the drugs have become widely known as obesity treatments, with Wegovy and Mounjaro among the best-known alternatives.

While these medications have been approved for NHS use for weight loss in eligible patients and for treating inadequately controlled type 2 diabetes, the report pointed out that most NHS prescriptions come under the latter category.

Use of such drugs to help tackle obesity has ‘remained substantially more limited than use for type 2 diabetes’, it noted, with 71 per cent of Scottish respondents taking weight-loss medication in the last 12 months obtaining it privately, rather than on the health service.

As such it stressed the findings of the report ‘should not be interpreted as evidence of widespread NHS adoption for obesity’, adding the data was ‘likely to predominantly reflect prescribing for type 2 diabetes’.

The report went on to note that the two areas with the highest prescribing rates, Western Isles and NHS Greater Glasgow and Clyde, were ‘substantially’ different in terms of recorded population need.

It pointed out that Greater Glasgow and Clyde had ‘the second-lowest prevalence of overweight and obesity across NHS boards’, while the Western Isles had the second-highest prevalence.

Meanwhile, Shetland ‘recorded the lowest per capita prescribing despite relatively high overweight and obesity prevalence’, the report added.

Victoria Jordan, ABPI executive director of patient access, said that while ‘Scotland has a strong and respected system for assessing new medicines’, the report showed ‘that the use of some accepted medicines can vary widely between NHS boards and that differences in patient need do not fully explain this’.

Ms Jordan said: ‘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.’

Meanwhile, doctors have warned of a ‘two-tier system’ for weight loss treatment after it emerged only 700 Scottish people had received fat jabs on the NHS over the past three years.

The injections have been prescribed to just 705 patients in pilot schemes and are unavailable to the majority who need them.

Professor Mark Strachan, President of the Royal College of Physicians of Edinburgh, said: ‘The advent of weight loss medicines is a monumental development in the management of obesity, type 2 diabetes and the associated health conditions.

‘For example, research indicates a reduced risk of major cardiovascular events - such as heart attacks, strokes, and cardiovascular death - by around 20 per cent or more in eligible patients.

‘As a diabetologist, I see the positive physical and mental health impacts of these medicines in my patients.

‘Some of my patients have lost over 20kgs [more than three stones] in weight because of weight loss medicines.

‘But at the moment, many of the people who would benefit from these medicines cannot access them for weight management through the NHS in Scotland.

‘Public health data indicate that people living in our most deprived communities may carry a disproportionate burden of obesity and type 2 diabetes.

‘Meanwhile, those who are well-off financially are often able to afford weight loss medicines through private prescriptions.

‘This may effectively create a two-tier system whereby the financially well-off have fewer barriers to access these medicines.’

The Simple Online Pharmacy estimates that 300,000 Scottish people pay for private prescriptions of the drugs, which can cost more than £4,000 every year.

The Scottish Government insisted it was working to reduce regional differences in healthcare.

A spokesman said: ‘We will carefully consider the findings of this report and have been clear our reforms to NHS boards are intended to improve equity of access to services and reduce the unwarranted variation and bureaucratic barriers we currently have in place.’