FREE prescriptions should not be scrapped despite the soaring bill for obesity and age-related conditions, experts have said.

Tougher price negotiation, cutting waste and extending the sugar tax to cover junk food as well as soft drinks would be more effective in cutting costs for the NHS, they said.

It comes despite calls from some NHS chief executives and doctors for the Scottish Government to rethink the measure amid demand for new drugs, such as immunotherapy cancer medicines, and the record £93.4 million bill for prescribing drugs to treat diabetes.

READ MORE: Price hikes of up to 27 times on everyday prescription drugs 'compromising patient care'

Before it was abolished in 2011, the £3 prescription charge raised £57m. However, former Healthy Secretary Alex Neil said restoring the charge would be a false economy.

He said: “Some of the drugs, particularly the more expensive drugs, actually save the health service money because they stop people having to go into hospital. Given that it costs on average £4,500 per week to keep patients in an acute hospital in Scotland, it’s actually cheaper to keep them at home and give them the drugs to prevent them going into hospital.”

He added that around £150-200m a year could be saved annually through more efficient dispensing.

Recent research highlighting the potential to reverse diabetes through weight loss has also raised questions about what impact tougher action to combat obesity could have on Scotland drugs bill, which is rising by five to 10 per cent annually.

Case Study: 'They said I was a borderline diabetic. That made me sit up and think I really need to do something'

Dr Caroline Whitworth, a specialist in renal medicine and fellow of the Royal College of Physicians Edinburgh said the sugar tax should be extended to food as well as soft drinks.

She said: “It seems illogical to just target beverages. If the reasons behind that are to reduce sugar intake, then it should be the sugar intake however you get it - be it drinks, sweets or high sugar foods. A lot of the so-called low fat products, like low fat yoghurts, have a high sugar content.”

Dr Alex Walker, a Glasgow-based health economist and independent consultant who advises pharmaceutical firms on pricing, said high volume drugs such as those for diabetes, heart and asthma were a bigger driver behind the increasing drugs bill than new medicines. He said the NHS could reduce costs by negotiating money-back deals as demand goes up.

He said: “It’s something that’s popular in France. They say to companies ‘if you provide this much, we’ll pay this price; if more gets prescribed, we expect to get a rebate from you because your costs are spread more thinly and you’re making a bigger profit’.

READ MORE: Price hikes of up to 27 times on everyday prescription drugs 'compromising patient care'

“It’s the classic price and volume trade-off. That’s one avenue that could be explored but there’s probably limits to that.”

CASE STUDY: 'My GP said I was borderline diabetic. That made me sit up and think'

HeraldScotland: George Fleming lost seven stone after being told he was borderline diabeticGeorge Fleming lost seven stone after being told he was borderline diabetic
TAXI driver George Fleming was tipping the scales at 19 stone when he turned up to his first Scottish Slimmers class in January 2014. 

With a height of 5ft 8, it meant that his body mass index came in at just over 40 - meaning he was classed as "obese". 

The wake-up call, however, had been a trip to his GP who warned Mr Fleming, from Bo'ness in West Lothian, that he was on the verge of developing Type 2 diabetes. 

Mr Fleming, 57, said: "My GP said I was a borderline case. That made me sit up and think I really need to do something.

"My dad had type II diabetes later life. He was overweight as well. I lost my mum to a heart attack, and these things make you think you've got to give yourself a chance in life."

"My wife is also a Type 1 diabetic, so I know all about diabetes and it's something I want to avoid like the plague."

"I hate taking tablets - if I don't have to take tablets I won't. I never take painkillers if I can help it. I've always tried to avoid that."

After embarking on a regime of healthy eating and exercise - he took up running and later cycling - he said the weight "fell off". By May 2015, his weight had tumbled to 12st 4. 

HeraldScotland: Mr Fleming before he joined Scottish SlimmersMr Fleming before he joined Scottish Slimmers
Mr Fleming, a married father-of-three and former council building standards surveyor, also saw a major turnaround in his health. 

He said: "I had high blood pressure - I was taking four blood pressure tablets a day. But when I got down to my target weight, the doctor took me off them all. I've started back on one tablet because I've still got a wee bit of blood pressure, but I only take that one tablet now. 

"I'm tested yearly for Type 2 diabetes but I've been fine. I used to have gout as well - that's disappeared completely. I don't take any tablets for gout either. I did have a duodenal ulcer at one point too but I don't have that anymore so I'm not taking anything for it." 

The NHS spends £22 million a day across the UK on anti-diabetes drugs, and around 10 per cent of total NHS expenditure goes on treating Type 2 diabetes. However, Mr Fleming's example chimes with research showing that weight loss of around 15kg (33 Ibs) is often enough to trigger total remission of the disease, but many GPs and patients are unaware of the link.

A ongoing study of more than 300 Type 2 diabetics between Glasgow and Newcastle is Universities is testing whether more than one in five patients can reverse their condition, and for how long, through weight loss. 

If successful, Professor Mike Lean, chair of Human Nutrition at Glasgow University, said it would have "massive implications for healthcare spending". 

More than two years since hitting his target weight, Mr Fleming says he "feels great". 

He added: "I was a serial dieter before. I had tried so many diets and I never stuck to them for any length of time. I found at Scottish Slimmers you had great support from the class manager and the other members of the group. I suppose it becomes a wee bit of a competition. To me it's not really a diet though - it's just healthy eating. 

"I probably eat more now than I ever did, but I just eat the right stuff. I don't eat fatty things, I don't eat sweet stuff very often."