After the Christmas excess comes the payback. In the past few weeks, millions of people will have groaned a little, reached for a packet of indigestion tablets and wished they had not eaten that last mince pie. Thousands more will have consulted their GP for a prescription.
Dyspepsia is a nice little earner for the drug companies. Almost seven million prescriptions a year are written for indigestion remedies, most of them for proton pump inhibitors, the strongest and most expensive on chemist's shelves. Yet most patients don't need dyspepsia destroyers, for which the NHS paid 425m in 2006. They would do as well on a packet of Alka Seltzer or on nothing at all.
Unnecessary prescribing is bad for patients there is a small risk of side effects and bad for the NHS. Overuse of proton pump inhibitors costs at least 100m a year, and possibly as much as 300m, according to the British Medical Journal. It is a strange world in which doctors hand out powerful indigestion medicines to anyone who wants them, but deny essential cancer drugs because the NHS cannot "afford" them.
The National Institute of Clinical Excellence has issued advice for the use of proton pump inhibitors, designed to restrict their use to the most severely affected patients, but the guidance has been ignored.
Responsibility for curbing unnecessary prescribing lies with primary care trusts. The next time a trust tries to deny a cancer patient the latest drug, it should be asked what it is doing to reduce its budget for indigestion. It may cause some dyspeptic reactions but it should help focus NHS cash where it is really needed.