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Prescription charges are making people sicker, research shows

Nearly a third of people who skipped medication because of NHS costs over the past year now have additional health problems.

By Sarah Dawood

Despite NHS care being free, most people still pay for their prescriptions. Some people receive no charge, if they have certain medical conditions or if they are on income-assessed benefits such as Income Support or Universal Credit. However, a report out this month from the Prescription Charges Coalition – a campaign group of 50 organisations chaired by the charity Parkinson’s UK – has found that people with long-term health conditions are being negatively impacted by prescription charges, with nearly one in ten skipping medication in the past year due to costs. The group wants the government to scrap the charges for anyone with long-term illness.

How much do prescriptions cost?

Currently, a single NHS prescription item is £9.35 and this is set to rise to £9.65 on 1 April 2023. Charges were frozen in 2022 because of the rising cost of living but the government has since decided to increase them. Many people buy a prescription prepayment certification (PPC) instead, which is better value for money if you receive more than one prescription item per month. From 1 April, this will cost £31.25 for three months and £111.60 for 12 months, and patients can spread the cost in instalments if they prefer. Prescription charges were introduced in 1952, abolished in 1965, then reintroduced in 1968 with a list of medical exemptions. In the UK, only England still has a charge, as it has been abolished in Wales, Northern Ireland and Scotland.

[See also: Focus on prevention to keep the NHS true to its soul]

Which long-term health conditions are exempt?

Some people get free prescriptions because of a specific medical condition, such as cancer, diabetes, epilepsy, a rare adrenal gland disorder called Addison’s disease, or having a permanent physical disability. The full exemption list is here. According to the Prescription Charges Coalition, the list of exempt conditions has barely changed since 1968 despite significant medical advances, such as the discovery of diseases such as HIV and increased life expectancy for people with cystic fibrosis.

What does the research show?

The Prescription Charges Coalition surveyed 4,014 people with a range of long-term health conditions in January to February 2023. Nearly three quarters were female, and 44 per cent were aged 45 to 59. It found that 9 per cent of respondents had not been able to collect a prescription in the past year due to cost, and 12 per cent of those who do pay for prescriptions had cut medication in half to make it last longer.

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More than a third (38 per cent) of respondents said that they had only become aware of the ability to buy a prepayment certificate a year or more after their diagnosis, and 35 per cent have had their prescription length changed, meaning they now pay for their medicine more frequently. Another recent survey conducted by the Royal Pharmaceutical Society of 269 community pharmacists in England found that half (52 per cent) had seen a rise in patients asking them which of their prescription items they could “do without”, and half (51 per cent) had seen a rise in people not collecting prescriptions.

[See also: Reforming medical training could solve our NHS workforce crisis]

What is the impact on individuals and society?

The Prescription Charges Coalition research shows that inability to pay for prescriptions has led to people getting sicker. Of those who skipped medication, 30 per cent now have additional physical health problems, and 37 per cent have additional mental health issues. More than half (53 per cent) have taken time off work due to worsening health, while a third had to visit their GP, and a quarter had to seek treatment at A&E or hospital. This resulting medical intervention is costly and adds to the NHS’s existing burden. A GP appointment costs the NHS an average of £30, while a hospital outpatient appointment roughly £120, and a complex A&E visit can be at least £359. One week’s excess use of a hospital bed costs up to £2,532.

If people develop additional health conditions this increases the complexity and cost of their treatment and care. According to the York Health Economic Consortium, ending prescription charges for people with Parkinson’s and inflammatory bowel disease alone could save more than £20m a year.

What is the Prescriptions Charges Coalition recommending?

The group wants the government to freeze the prescription charge for 2024 and to recommend to prescribers – such as GPs – that they stop reducing prescription lengths, which results in more frequent charges. It is also calling for an urgent independent review of the medical exemption list, and for the government to scrap its plan to align prescription charges with the state pension age. Currently, anyone aged 60 and over gets free prescriptions. Finally, it is calling for better communication around entitlements such as prepayment certificates, by informing patients about these at the point of diagnosis and when medicines are dispensed and reviewed. Posters and other materials should also be displayed at GP surgeries and pharmacies.

Where can I read more?

Find out more about prescription charges here, and free prescriptions here.

Read the Prescription Charges Coalition’s report in full here.

[See also: Wes Streeting interview: “NHS privatisation could not be further from my politics, values or aims”]

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