Doctors in Northern Ireland are wasting up to two hours a day writing millions of prescriptions for medicines that could be bought over the counter, it has been claimed.
The comments from the BMA Northern Ireland come as it emerged prescription medicines cost the health service in Northern Ireland millions of pounds more per capita than the rest of the UK.
Dr Terry Maguire of the Health and Social Care Board (HSCB) revealed the annual cost per patient here was £224.
Last year 38.7 million prescription items were dispensed at a cost of £400m. Of this, an estimated £18m's worth were wasted.
Overall, medicines cost the health service in Northern Ireland £70m per year more compared to the rest of the UK.
This has led to calls for the system to be "remodelled" to become more cost-efficient and time-efficient.
Dr Maguire has appealed for people to think about why medicines cost the health service so much more here.
Speaking at the April Local Commissioning Group public meeting, he said: "If everyone played their part by cancelling unwanted repeat prescriptions and only ordering what they need, it would help save the health service millions."
He explained it was recognised we spend significantly more on medicines in primary care.
"Some of the difference may be accounted for by higher levels of need," he added.
He said if Transforming Your Care – the major review of the Northern Ireland healthcare service – was to succeed, the public needed to start thinking what they can do to make the best use of our health service.
"It is important that everyone works to reduce the levels of wasted medicines – patients should tell their doctor or pharmacist if they are no longer taking a medicine so that their medication can be reviewed, and people should stop and check what medicines they have at home before ordering more repeat medicines," he added.
"In Belfast Local Commissioning Group, we are working to reinvest the money saved through prescribing to improve health and social care services for local people and to reduce health inequalities."
Dr Tom Black, chair of the Northern Ireland General Practitioners Committee of the BMA, said: "This money could be spent on more important services without losing care for those vulnerable patients with the greatest need."
Dr Black explained that the LMC conference said the issue of co-payments – such as reintroducing prescription charges in order to control the overwhelming demand for medicines that are available over the counter at low cost– should be examined.
"Examples would be 30 paracetamol tablets worth about 50p that would cost the NHS about £5 to process through a GP prescription with a pharmacist dispensing it," he said.
Dr Black added: "GPs now spend up to two hours per day writing prescriptions for simple items available over the counter.
"This is time that could be used to see patients."
Patients in Northern Ireland receive about 25% more scripts per person per year.
"This money could be spent on more important services without losing care for those vulnerable patients with the greatest need," he added.
He said GPs had offered to work with the HSCB on developing local formulae for practices to cut spending on medicines and we're awaiting a reply.
A spokesman from the Department of Health said: "He (the Health Minister) has noted the recent increase in prescription charges in England. The reintroduction of a small prescription charge in Northern Ireland, which would be directed towards new specialist cancer drugs, would require Executive approval.
"There have been no discussions about a fine for wasting medicines."
Top five scripts in Northern Ireland
The table shows the top five most commonly dispensed prescription items in Northern Ireland over the six-month period between September 2013 and February 2014, and the associated costs.
NUMBER OF PRESCRIPTION ITEMS: 637,520
2. OMEPRAZOLE (USED TO TREAT INDIGESTION OR A SUSPECTED STOMACH ULCER)
NUMBER OF PRESCRIPTION ITEMS: 528,674
NUMBER OF PRESCRIPTION ITEMS: 492,181
4. SIMVASTATIN (CHOLESTEROL LOWERING DRUG)
NUMBER OF PRESCRIPTION ITEMS: 428,332
NUMBER OF PRESCRIPTION ITEMS: 418,868