Posted by: Nicholas Swetenham | March 16, 2009

The prescription charges maze – 2

I wrote about the confusion and complexity of prescription charges across the UK last month. Since then, the BMA has issued a press release stating its position that it would be much simpler to scrap them entirely in England like everywhere else. Hamish Meldrum:

“Making the list of exemptions longer will not make it fairer. Ultimately, we could end up with a situation where only a tiny proportion of prescriptions attract a charge, which would be nonsensical.

Abolishing prescription charges altogether is the fairest and the simplest option.”

See it in the Telegraph, Mirror, Guardian & BBC.

Note also that the charges are set to increase by 10p to £7.20 in April: Mail, Telegraph, Mirror, BBC.

Now here is where it gets really interesting: although I agree that scrapping the charges entirely would make the system more consistent and fair, take a look at this article from GP Magazine Pulse. It suggests that prescription rates in Wales have significantly increased since the scrapping of prescription charges, particularly for NSAIDs. Now this is the crux of the matter: resource allocation. Prescription charges are among the NHS only co-payments, along with dentistry charges. Do we really want to be paying for people’s aspirin when they have a hangover, or making it even easier for people to have amoxicillin dished out to them in flu season? Or do co-payments, on the contrary, discourage people from taking drugs they need?

The wikipedia article linked references a meta-analysis that show co-payments may also discourage necessary use of medication, by the same token as they discourage unnecessary use. So perhaps scrapping is the most ethical solution. Let us hope the government are wise enough to increase NHS funding appropriately if that is their intention.
P.S. Co-payments should not be confused with top-up payments.

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