When prescription medication is unaffordable

By Bernadette Meaden
July 9, 2017

We know that millions of people on low incomes often go without essentials such as food and heating. However, if they live in in England there may be another essential item which they cannot afford – prescription medication. 

Prescription charges are now £8.60 per item. The average monthly income of a foodbank user in the latest research was found to be £319, with 16 per cent having had no income at all in the previous month. For people in such dire financial circumstances, and for many others struggling to make ends meet, their medication may be just one more thing they cannot afford.

In Scotland, Wales and Northern Ireland, prescriptions are free for everybody. In England around 90 per cent of prescriptions are dispensed without charge – under 16s and over 60s are exempt. But the majority of the remainder are paid for by working-age people with long-term conditions. A small number of medical conditions are exempt from charges, but there is no rational basis to this. For instance, epilepsy qualifies, Parkinson’s disease doesn’t, diabetes qualifies, motor neurone disease doesn’t.

Now, thanks to the Prescription Charges Coalition, (PCC) we can get a sense of the impact of prescription charges on the health of working-age individuals, and the potential knock-on effects for the NHS and the wider economy.

In June 2017, the PCC published Still Paying the Price, based on a survey of over 5,000 people with a long-term health condition. The findings were disturbing. For instance, 33 per cent of respondents said they had sometimes not collected their prescription from the pharmacy because of the cost. “If I’m running low and can’t afford to renew my prescription before pay day I’ll take a lowered dose until I can pick up my prescription.” 

Of those who reported skipping or reducing doses of their medication because of the cost, 59 per cent said their health had deteriorated or they had developed a related condition as a consequence.  Of those, 50 per cent had needed to take time off work as a result, and 34 per cent had needed additional medical treatment, including hospital admissions.

Some consequences can be very serious, and therefore very expensive, in human terms for the patient, and in financial terms for the NHS.  One respondent said, “I was 19 at the time and couldn’t afford my medication for asthma. [I] ended up collapsing at work and [an] ambulance was called and I was in hospital for a week. I stopped breathing and my heart stopped all because I had to pay for my asthmatic medication.”

People on low incomes and/or in receipt of certain benefits can qualify for free prescriptions, but they may need to apply for a certificate. The regulations are not simple and can be baffling. For instance, Employment and Support Allowance recipients have all been found unfit to work, but some are eligible for free prescriptions, and some aren’t.

Despite the extent to which people were struggling to afford their prescribed medication, 79 per cent of respondents to the PCC survey were not aware that they could apply for free prescriptions through the NHS Low Income Scheme.

The Prescription Charges Coalition is calling for exemptions to be extended to all people with a long-term condition in England. This would surely be an excellent investment. People going without medication which could keep them well, keep them in work, and keep them out of hospital, just for the lack of a small amount of money, is very damaging to them and a terrible false economy for the NHS and the country. 

Meanwhile, foodbanks, advice centres, church and community groups can support people to access the help that is currently available under the NHS Low Income Scheme here 

The Prescription Charges Coalition has 40 member organisations, and is co-chaired by Parkinson's UK, Crohn's and Colitis UK and the National Rheumatoid Arthritis Society.

Still Paying the Price can be downloaded here

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