What we pay to take our medicine

Always laugh when you can.  It is cheap medicine.

When Lord Byron first offered this advice he could not have imagined the scale and cost of medicines prescribed in England 200 years later (which are certainly no laughing matter).

According to government figures, published by the Health and Social Care Information Centre there were just over 1 billion items prescribed in 2012 by community pharmacists, appliance contractors and dispensing doctors. The Net Ingredient Cost of these items, which excludes the cost of dispensing and fees was approximately £8.5 billion. This equates to almost £160 per head of the population.

Prescription charges paid by patients amounted to about £480 million and although this seems a lot it is only 5.7% of the total Net Ingredient Cost.

What accounts for the remainder?

In England, prescriptions are free of charge to :

  • people on Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Partners and children of recipients of these benefits will also be entitled to free prescriptions if they are included in the benefit award. People getting Universal Credit as part of the pathfinder scheme are also entitled to free prescriptions. Recipients of Working Tax Credit and/or Child Tax Credit, may be entitled to free prescriptions, depending on income
  • over 60s
  • people with a listed medical condition and have a valid medical exemption certificate issued by their GP.
  • those having treatment for cancer, the effects of cancer or the effects of cancer treatment and how a valid medical exemption certificate. This applies to prescriptions for all NHS medication, not just the cancer medication
  • people on prescribed medication to prevent a pandemic disease, for example, pandemic influenza
  • those who have a continuing physical disability which means being unable go out without help from another person and have a valid medical exemption certificate
  • under 16s.
  • students in full-time education.
  • recipients of a war or service disablement pension, need prescriptions for the disability and hold an exemption certificate
  • prison inmates
  • women who are pregnant, or have had a baby in the last twelve months and have a valid exemption certificate. This includes miscarriages after the 24th week of pregnancy, or stillborn babies
  • those under a community care order who are expected to take medication to treat a mental disorder.

Department of Health leaflet HC11 and www.nhsba.nhs.uk provides more information regarding eligibility for help with prescription charges and health costs (including NHS dental charges, sight tests, vouchers towards the cost of glasses and contact lenses, travel costs to and from hospital for NHS treatment or travelling abroad for treatment and wigs and fabric supports).

Prepayment certificates for a cost-effective option for people who require regularly prescribed medication and to have to pay prescription charges. Prepayment certificates can be obtained for 3 months for 12 months (which can be paid for in 10 equal monthly direct debit instalments). They can be obtained over the phone or online from the NHS Business Services Authority, 0845 850 0030 or, www.nhsba.nhs.uk, or from a pharmacist or from the local Clinical Commissioning Group (CCG).

Prescription charges have long since been abolished in Scotland and Wales.  Given the scale of the contribution they make to the cost of prescribed items overall in England it would appear to be more cost effective to look at ways of reducing the £8.5bn+ bill (remember this excludes fees and dispensing costs) than to persist with the charges and the complex series of exemptions

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