by Jacqui Sneddon, Programmes and Accreditation Manager at British Society for Antimicrobial Chemotherapy and Member of RPS Scottish Pharmacy Board
Different policies on prescription charges across the UK
Within the UK, health is a devolved matter and therefore each nation can develop its own legislation in some areas of practice. This means that prescription charges vary across the UK. Wales was the first nation to provide free prescriptions for all in 2007, followed by Northern Ireland in 2010 and Scotland in 2011. Currently in England, patients who are not exempt from prescription charges are required to pay £9.65 per item dispensed. The abolition of prescription charges in England has been debated several times and was a Labour manifesto pledge at the last general election.
Challenges to equal access to medications in the UK
Prior to prescriptions becoming free in some nations there were exemption criteria to ensure specific patient groups could access medication e.g. elderly, children, those on low income and those with certain medical conditions. These groups make up a significant proportion of patients receiving prescriptions; therefore, one might ask why providing free prescriptions is necessary since most patients don’t pay anyway?
For those requiring regular and/or multiple medications and hence potentially paying a high cost for prescription, there was the option to purchase a ‘pre-payment certificate’ covering 3 months or 12 months of charges regardless of how many items they required, which could significantly cut costs.
Despite these exemptions and pre-payment schemes, many patients in England, where prescription charges still apply, suffer inequality in access to medication; for example, students and working-age adults within low-income families. For these populations, while they may consult their GP and be issued a prescription, they may choose not to have it dispensed or may submit it to their local pharmacy but then not collect it once they know what the prescription charge will be. If more than one item is prescribed, they may ask which one will give the most benefit as they can only afford to pay for one of the medicines.
Cost-Benefit analysis of implementing free prescription scheme across the UK
Is national investment in a free prescription scheme worth it? Many patients already receive free prescriptions or use pre-payment options so the introduction of free prescriptions for all may be less expensive than anticipated.
The benefits in terms of addressing inequity are clear and the public health gains are also significant. Do we really want conditions such as STIs, hypertension and menopause symptoms to go untreated due to the patient’s inability to pay? In the current economic climate with soaring energy and living costs, the availability of free prescriptions is even more important to ensure everyone receives the care they need.
Read more about how we’re campaigning for free prescriptions in England and the results from our prescription charge survey which show the cost of living is having an impact on patients’ ability to afford their medicines.
Read more RPS blogs.