The figures obtained by Scotland on Sunday through a Freedom of Information (FoI) request lay bare the true cost of the flagship policy to provide over-the-counter drugs on the NHS.
At present the average cost of a pack of 16 paracetamol tablets is around 30p, and around three billion tablets have been dispensed for free.
NHS Greater Glasgow and Clyde spent more than any other health board in Scotland in the seven-year period – forking out more than £12m.
The figures relate specifically to primary care costs including GP prescriptions, with secondary care provision, provided in hospital settings, not included.
The next highest spenders were NHS Lothian, who racked up an £8.2m bill for paracetamol, and NHS Lanarkshire, who spent £7.5m prescribing the drug.
Before it was abolished in 2011, the £3 prescription charge raised £57m for the health service in Scotland.
Dr John McAnaw, chair of the Scottish Pharmacy Board, who represent the Royal Pharmaceutical Society in Scotland, said the prescribing of paracetamol needed to be looked at in the context of treating longer-term conditions such as osteoarthritis.
He said: “It is very difficult to comment on the cost of one medicine in isolation.
“This must be looked at in the context of the total amount spent on prescription medicines, and in an era of an ageing population, living longer sometimes with several long-term conditions.
“Paracetamol is an inexpensive but safe and efficient option which is used to treat many different kinds of pain, including the chronic pain of long-term conditions.”
He added: “Any increase might reflect that paracetamol is used as a first choice and frequently reduces the need for more expensive painkillers which might not have such a good safety profile, particularly in our frail and elderly population.”
At present a charge of £8.80 is made for each item on the NHS in England, although some people are exempt because of their age, income or medical condition.
The NHS in England has spent almost £400m prescribing paracetamol in the past five years at a cost of £3.23 per item, despite the pills being sold over the counter at a fraction of the cost.
James Price, campaign manager at the TaxPayers’ Alliance, said: “It’s completely baffling how trusts have spent so much on paracetamol, which can be purchased for mere pennies in commercial shops. But poor NHS procurement means that it is much more expensive to both purchase and give to patients. Taxpayers should not be subsidising paracetamol when it is much cheaper in the shops.”
Free prescriptions are seen as a tool to reduce health inequalities and a way to ensure people with long-term conditions are able to keep taking their medicines.
Under devolution, Wales was the first part of the UK to make prescriptions free, in 2007. Northern Ireland followed in 2010.
However, the policy has come in for criticism, with doctors calling for means-testing to be brought in. This was dismissed by health secretary Shona Robison as a “tax on ill health”.
More recently, trouble-torn NHS Tayside decided to cut back on paracetamol handouts in a bid to sort out their dire finances after it was revealed that £2.7m of its endowment fund, which takes donations from the public, was used for routine spending.
NHS Tayside has spent more than £6m on prescribing paracetamol since prescription charges were abolished.
Scottish Conservatives health spokesman Miles Briggs said: “Almost £58m is a huge amount of money for health boards across Scotland to be spending on a drug that is relatively cheap.
“Prescribing paracetamol costs significantly more than the actual drug costs, so we need to try to encourage people to purchase paracetamol from pharmacies and supermarkets instead of costly NHS prescriptions.
“Every NHS tax pound is vital to help improve and invest in our Scottish NHS and the nation’s health – we need to see the better utilisation and spending of NHS resources.”
According to the latest prescription cost analysis from the Scottish Government’s Information Services Division going back to 2015/16 – the total number of items dispensed was 102.61 million, with a gross ingredient cost of £1.10 billion.
Scottish Liberal Democrats health spokesperson Alex Cole-Hamilton MSP said: “With health board budgets under huge pressure, it’s important that all expenditure is rigorously assessed to ensure that they provide value for taxpayers’ money.
“The intention of free prescriptions was to ensure that everyone had access to the essential medicine they needed.
“Health boards should be ensuring that the prescriptions distributed reflect this intent.”
A Scottish Government spokesperson said: “Our policy of free prescriptions removed what was effectively a tax on ill health, and is one we remain firmly committed to. The best people to make judgments on when particular prescriptions are needed are medical professionals. Paracetamol provides effective pain relief, and the majority of its use in Scotland is to support the management of chronic disease.
“The spending on paracetamol prescriptions represents approximately 0.5 per cent of the total drug expenditure across NHS Scotland over the same seven-year period. When it comes to procurement of medicines, we work with partners to ensure that they are provided in the most cost-effective way.”
Dumfries & Galloway £1,966,904
Ayrshire & Arran £274,763
Gtr Glasgow & Clyde £12,758,520
Western Isles £362,566
Forth Valley £3,674,250