Britain vs Denmark: How inequality shapes prescription drug use and what it means for public health

Philip Broadbent's analysis compares routine prescribing in Britain and Denmark, showing that overall maintenance meds for aging are similar, but Britain’s excess is driven by drugs for pain, mood and distress concentrated in deprived communities. The article draws on OECD and national data to illustrate how deprivation and policy shape drug volumes, while noting that Denmark’s lower usage extends beyond lifestyle choices to social protections.

• Antidepressants: England dispenses more than OECD average; Denmark reduced consumption in recent years
• Opioids: UK historically highest; Denmark's use fallen since 2010
• Polypharmacy and deprivation: Heaviest prescribing in England's most deprived areas
• Overprescribing: around 10% of items dispensed in English primary care considered overprescribed

Author: Philip Broadbent (University of Glasgow) for The Conversation UK and Videnskab.dk.

Introduction

The Conversation UK and Denmark's Videnskab.dk present a health inequality focused comparison of prescription practices between Britain and Denmark. While it is tempting to attribute Britain’s higher drug use to lifestyle failures and to portray Denmark as a country that prevents illness through prevention, the article shows that routine maintenance medications are similar in both countries. The divergence appears in medicines tied to social hardship, such as pain, mood and sleep disorders, and is closely linked to deprivation and social policy.

Maintenance medications and the overall picture

When looking at routine medications for aging, Britain and Denmark prescribe similar volumes. However, Britain’s excess is concentrated in drugs associated with chronic pain and psychological distress. The UK also exhibits higher opioid use historically, and the data reveal that the heaviest prescribing is increasingly located in England's most deprived communities. In contrast, Denmark has lower consumption in these drug classes, a pattern the authors connect to stronger social protections and less inequality.

What the data actually show

Across several drug classes, the two countries are more alike than stereotypes suggest. For example, statin prescription rates for heart disease are roughly similar (13% in Denmark vs 14-15% in the UK). In terms of polypharmacy among those aged 75 and over, around half of Danes take five or more medicines weekly, compared with about 51% in England for a comparable age group. English primary care dispenses about 1.26 billion prescription items in 2024-25, roughly 22 items per person, a 4% rise from the previous year, whereas Denmark dispenses around 13 items per person. These figures show the scale of prescribing but also hint that the gap between the two nations is driven by the drugs most linked to social adversity rather than cardiovascular or diabetes medicines alone.

Prescribing for despair

The UK’s antidepressant use is well above the OECD average, with nearly 9 million patients receiving antidepressants last year. Denmark, by contrast, has reduced its antidepressant consumption in recent years, marking a notable policy and cultural difference between the countries. Likewise, opioid use in the UK has been high in the past, while Denmark has seen a substantial decline. The article places these patterns in the broader context of social inequality, poverty, housing insecurity and unemployment as drivers of distress and chronic disease.

Autonomy, supply and the public’s role

The authors also discuss everyday life and consumer access to medicines. In Britain, over-the-counter painkillers like paracetamol are ubiquitous, contributing to a culture of self-management that can mask underlying harms. Denmark restricts basic painkillers at the point of sale, with limited access to codeine combinations behind pharmacies. The piece argues that the British framing of over-the-counter analgesics as patient autonomy can obscure who bears the harm, and shows how policy changes can have meaningful health outcomes, as seen in the paracetamol pack size restriction of 1998 that reduced overdose deaths and liver transplants.

The illusion of autonomy and the root cause

The article emphasizes that Britain’s higher prescription volumes are not purely clinical but reflect the social structure. Denmark’s lower reliance on medicines for chronic pain and distress is a result of deliberate investments in equality, housing and social protection, creating an environment that reduces hardship and the conditions that drive people to need medication. In the UK, austerity, widening inequality and weakened public health infrastructure contribute to a system where medical interventions are frequently used to manage structural problems.

Implications for health policy

Ultimately the piece argues that Denmark’s lower medication use is not simply a lifestyle choice but a product of social foundations. Where social safety nets weaken, prescribing rises to fill the gap. The comparison serves as a reminder that health policy cannot be divorced from housing, income, and social protection when addressing population health and pharmaceutical dependence.

Conclusion

The Health Gap series aims to explore health and wellbeing beyond hospitals and treatment, examining how culture, politics and society shape people’s lives and their health. The article invites readers to consider not only the medicines people take but the social conditions that make those medicines necessary.