Oxfordshire GPs offered £1.5m prescription savings scheme
NHS managers are offering GP practices half the money saved if they cut the cost of drugs given to patients, including residents in care homes.
Medical journal Pulse revealed the scheme has been offered to all GPs in Oxfordshire.
Oxfordshire Clinical Commissioning Group (OCCG) says it wants to improve quality and cost-effectiveness.
But campaign group Patient Concern has called the plans "appalling".
OCCG aims to initially save £1,454,000, based on £2 per registered patient.
In papers seen by the BBC, practices are asked to review prescribing in areas "where the cost effectiveness of prescribing could potentially be successfully improved, without impacting on the quality of patient care".
It suggests reviewing "medicines and prescribing in care homes and the frail elderly to optimise medication".
Pritt Buttar, chair of Oxfordshire local medical committee, said: "This scheme is slightly different in scale but fundamentally it's no different to other schemes of that sort.
"It's generally an attempt to encourage GPs to prescribe drugs that are equally effective but at a lower price.
"There is a cost in doing that, so the money that is paid to practices is proportionate to the extra work they do in order to save the system some money.
"It's not going directly into doctors' pockets."
But Joyce Robins, from Patient Concern, said: "I think it's quite appalling.
"We've trusted our doctors for generations to give us the medication that we need, not the medication that is cheapest, or if they can cut it out altogether even better.
"My heart sinks at the way we're going. I think it's most distressing.
"It's very, very worrying for elderly people and people are panicking."