Drug costs are rising worldwide and price controls are set by governments. The United Kingdom has a unique database of prescribing from which practice indicators and audit of prescribing can be derived. FHSAs are funded to provide professional advice to prescribers. Most fundholders have achieved savings on their drug bills; other incentive schemes are needed. Research is needed to measure prescribing outcomes and health gain before new drugs and formulations are used. There are prescribing interface issues between primary and secondary care which may best be resolved by the development of purchasers. Community pharmacies have a developing role to play in improving prescribing.