Are NHS prescription charges helping or harming the NHS?

June 17, 2014, British Medical Journal

NHS prescription charges have been described as unfair, illogical and inconsistent. In an article published in BMJ today, John Appleby, Chief Economist at the King's Fund assesses whether the policy of charging for prescriptions in England is helping or harming the NHS.

England remains the only UK country still charging patients for their – currently £8.05 (€10; $13.5) per prescribed item.

Although prescription charges have been rising, the latest data show that the number of pharmaceutical items prescribed in England reached its highest level yet - over one billion in 2012 - equivalent to nearly 19 per person in that year and an increase of 62% since 2002, writes Appleby.

Yet only around 10% of prescribed items attract a charge due to a host of exemptions – for children, elderly people, those in receipt of welfare benefits and others.

Appleby also points out that, while prescription charges have held up, the actual cost of drugs has been falling in real terms since 2004 - partly due to greater use of cheaper generic drugs rather than branded drugs.

But as charges for an increasing number of drugs start to exceed their price – and especially for out of patent that can be bought over the counter - "increasingly it looks as though there are limits to future charging increases in charges," he writes.

Although charging does raise money for the NHS – estimated at up to £700m in 2012 – Appleby suggests that abolishing charges may be worth it "if charging dissuades some people from seeking care or cashing in prescriptions, increasing their risk of needing emergency treatment in the future."

Yet a study in Wales found that making prescriptions free for everyone seems to have no effect on access to and take up of care and treatment.

Although these results disprove the contention that dispensing rates would rise steeply if the prescription charge was removed, they also suggest that the charging regime was not a substantial barrier to accessing NHS care, explains Appleby.

However, he says, this is not necessarily an argument for increasing or widening the scope of patient charges and "the standard economists' downward sloping demand curve (where higher prices mean lower demand) could well reappear depending on charging levels, exemption arrangements, and other factors," he concludes.

Explore further: Scrap 'iniquitous' and 'outdated' NHS prescription charges, urges DTB

More information: Paper: www.bmj.com/cgi/doi/10.1136/bmj.g3944

Related Stories

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

May 14, 2014
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.

Wales faces deepest NHS cuts of all UK countries

May 25, 2011
In Wales, the NHS is set for a real budget cut of nearly 11% over four years, while England escapes the deepest cuts across the four nations, according to John Appleby, Chief Economist at the King's Fund in the British Medical ...

Cancer drugs underprescribed in Wales compared to England

March 4, 2014
Patients suffering from cancer in England are up to seven times more likely to be prescribed expensive cancer drugs than fellow sufferers in Wales, a new study assessing the impact of the Cancer Drugs Fund (CDF) has revealed.

Expert questions Lansley's claim that NHS spending will become unaffordable

July 13, 2011
England's health secretary Andrew Lansley has said that if England keeps on spending on health at the current rate, the NHS will be unaffordable in 20 years' time. But in an article published in the British Medical Journal ...

NHS productivity challenge would be 'undoable', says expert

June 19, 2012
Asking the NHS to find nearly £50 billion in efficiency savings would be "frankly undoable" says John Appleby, Chief Economist at the King's Fund, in an article published on BMJ website today.

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.