NHS England is to launch a consultation next month which could see GPs stop prescribing medicines which are available over the counter for a fraction of the cost.
Gluten-free foods, prescriptions for hayfever tablets, indigestion remedies and omega 3 supplements as well as travel vaccinations are among the items which may no longer be available on the NHS if major cost-cutting plans go ahead.
NHS England hopes to save up to £400m a year under new national guidelines.
A consultation will be launched next month after local health posses identified “significant areas” where savings could be made.
The review, which will take into account the views of patient groups, clinicians and providers, could extend to over-the-counter medicines which can often be bought at a much lower cost without prescription.
This could include items such as paracetamol, sun cream, cough and cold treatments, and heartburn and indigestion tablets, which are thought to cost the service £128 million per year.
Travel vaccines protecting against typhoid, hepatitis A and cholera, and a triple jab for diptheria, polio and tetanus, will be subject to review.
Lidocaine plasters and fentanyl, a painkiller for cancer patients, are also among the 10 items under the focus of the initial consultation.