Scrap 'iniquitous' and 'outdated' NHS prescription charges, urges DTB

The NHS prescription charge is 'iniquitous' and 'outdated' and should be scrapped, urges the Drug and Therapeutics Bulletin (DTB) in an editorial published in this month's issue.

England remains the only UK country still stumping up for this additional 'tax' on medicines, it says.

There are a host of exemptions to of the charge, including age, pregnancy, and some , such as and , but these exemptions also extend to unrelated conditions for qualifying groups.

"Many such exemptions appear illogical and unfair, adding to our belief that the prescription charge is a poorly conceived, manifestly unfair tax," says DTB.

The latest figures for 2012 show that 90% of all medicines dispensed outside hospital attracted no fee, with most of them going to patients aged 60 and older, yet 80% of those aged 18 to 59 had to pay for their drugs.

The £8.05 charge per item also compares starkly with the cost of many of the commonly prescribed drugs that are now off patent, declares DTB. For example, a pack of 28 aspirin (75 mg) costs just £0.74 while a similar number of the statin atorvastatin (20 mg) cost just £1.26. And 28 omeprazole (20 mg) capsules for indigestion cost £1.15.

Quite apart from this disparity, there's the cost of all the red tape required to underpin the collection and checking of exemptions and the management of pre-payment certification.

The prescription charge has long been a contentious issue, says DTB, and even contributed to the resignation of Aneurin Bevan, the architect of the NHS, in 1951.

Since then, various calls have been made for a fundamental review of the charge, including from patient organisations, the Royal Pharmaceutical Society, and the BMA.

Several alternative arrangements have been suggested, including getting the patient to pay for drugs at cost plus a reasonable dispensing fee to the pharmacist, which, incidentally is how private prescriptions can be dispensed, says DTB.

Although fees for private prescriptions vary widely, they can actually end up being cheaper than an NHS prescription.

Another anomaly is that while value added tax (VAT) is not paid on prescriptions dispensed in the community, NHS trusts have to pay the full 20% levy on medicines dispensed from a hospital pharmacy. This may contribute to "perverse prescribing decisions" which don't serve the patient well, says DTB.

"As a cost saving measure, many hospitals discourage doctors in outpatient departments from prescribing medicines to patients sitting in front of them in their clinic. Instead they are asked to write to the patient's GP recommending the prescription," it points out.

This means the patient has to contact their surgery/GP to get the drugs they need before taking the prescription to a local pharmacy, which DTB describes as "clearly very inefficient and hardly patient-centred."

It concludes: "[Prescription] charges are clearly outdated and iniquitous, and we believe it is time that politicians showed their commitment to a patient-centred NHS and abolish prescription charges in England."

More information: Taxing medicines: editorial, Online First, DOI: 10.1136/dtb.2014.5.0250

add to favorites email to friend print save as pdf

Related Stories

Half of at-risk flu patients are still not vaccinated

Feb 03, 2014

(Medical Xpress)—A new study by The University of Nottingham and Boots UK reveals community pharmacy can play an important role in getting more at-risk patients vaccinated against flu, including those with ...

Recommended for you

Determine patient preferences by means of conjoint analysis

Jul 29, 2014

The Conjoint Analysis (CA) method is in principle suitable to find out which preferences patients have regarding treatment goals. However, to widely use it in health economic evaluations, some (primarily methodological) issues ...

FDA approves hard-to-abuse narcotic painkiller

Jul 25, 2014

(HealthDay)—A new formulation of a powerful narcotic painkiller that discourages potential abusers from snorting or injecting the drug has been approved by the U.S. Food and Drug Administration.

Race affects opioid selection for cancer pain

Jul 25, 2014

(HealthDay)—Racial disparities exist in the type of opioid prescribed for cancer pain, according to a study published online July 21 in the Journal of Clinical Oncology.

FDA approves tough-to-abuse formulation of oxycodone

Jul 25, 2014

(HealthDay)—Targiniq ER (oxycodone hydrochloride and naloxone hydrochloride extended release) has been approved by the U.S. Food and Drug Administration as a long-term, around-the-clock treatment for severe ...

User comments