Your editorial (August 18) and subsequent correspondence about drug-pricing and cost to the NHS seek to cover wide territory. The chairman of the National Institute for Clinical Excellence (Nice) has criticised some of the prices set by pharmaceutical companies for low-volume, high-cost items such as new drugs to treat cancer.

Your editorial (August 18) and subsequent correspondence about drug-pricing and cost to the NHS seek to cover wide territory. The chairman of the National Institute for Clinical Excellence (Nice) has criticised some of the prices set by pharmaceutical companies for low-volume, high-cost items such as new drugs to treat cancer.

In general practice, high volume, lower cost is the general rule, and costs have tended to rise by between 6% and12% per year. This is not an insignificant sum when, as you state, the total budget is approaching £1bn (nearly £200 per head of population). However, the cost is not "soaring" in primary care. Year-on-year change in gross ingredient cost in 2006/07 fell by 0.6% compared to a 2.4% increase in the previous financial year, due to the reduction in price of certain commonly prescribed drugs.

Fluoxetine capsules (Prozac) now cost just 69p for a month and the other most popular antidepressant is barely double that cost. The popular and effective omeprazole (Losec) for heartburn and gastritis cost only £2.25 for a month - its high use and branded cost was thought capable of busting the drug budget when introduced 20 years ago.

GPs in Scotland are generally careful and prudent prescribers, making sound use of generic products (off-patent) and limiting antibiotic use sensibly where possible.

We are fortunate in having such a range of high-quality medicines, many of which are used to prevent strokes, heart attacks and the ravages of diabetes in an ageing population. That is one reason why the costs will continue to increase but appropriately and modestly.

Dr Philip Gaskell, Allan Park Medical Practice, 19 Allan Park, Stirling.