Why are some prescriptions free and others aren’t?

[Soubriquet]

Before I start, I just wanted to say I do not hate those who get free prescriptions but I do wonder how the nhs can charge between them

Diabetic medicine is covered. Yet inhalers for asthmatics aren’t?

Both are life saving medication but the nhs only covers one

So how do they decide that?

And for those who have to pay, please don’t forget you can get a pre pay certificate which helps pay for your prescriptions every month instead of having to pay for each one

The thyroid thing is bonkers. The day I was prescribed Levothyroxine, every prescription became free for me, for everything.

I already had a pre-payment certificate because I get over a dozen other meds a month, for all sorts of other autoimmune diseases, but I never needed another one again.

So one element of my long-term, incurable autoimmune disorder attracts state funding, and the other elements don't.

(England.)

@MilkTwoSugarsThanks agreed for England.

It's interesting how people in England think it's 'unfair' when Scotland and other nations/devolved adminstrations have free prescriptions. They don't say it's unfair that, for example,e NI had a seven year waiting list for an urology appointment because, amongst other things, NI deploys some money to free prescriptions for some people who could afford it. The last time I looked there were relative issues across all the UK nations' adminstrations' NHS performance about which someone else could say it's unfair. I don't want to defend the English government's decisions about the NHS though.

@MilkTwoSugarsThanks

I think the problem with campaigning for more meds to be added to the list is that the powers that be will just do away with it so no-one gets anything. And that will probably cause more problems than it will fix.

I think that’s the problem. We don’t want to rock the boat and ruin it for those who are eligible for free medication.

What always puzzled me (and I worked for the NHS) was that if you had a condition which was exempt, you didn't pay for any medication. eg; a diabetic doesn't pay for antibiotics, painkiller or any unrelated treatments either. I always thought it would be fairer if you only got medication for the exempt condition free, and paid for anything else like most people.

I certainly don't want to rock the boat for the 60-67 year olds who may be soon put back into the paying category.

(Again, in England.)

Sometimes an imperfect system is better than none.

If I understand it correctly, only around 10% of people (in England only) actually have to pay for prescriptions. It must cost so much in administration to process those payments, the pre-payment certificate scheme, all the checks that nobody is claiming when not entitled etc., you end up wondering whether it would cost that much more to just make it free across the board - especially as that 10% is likely to contain many of the people who need the fewest prescriptions in the first place.

It is patently unfair that somebody requiring Levothyroxine and with very mild asthma also gets their inhalers free, whereas those with the most serious frequently-end-up-in-hospital kind of asthma are still forced to pay.

a diabetic doesn't pay for antibiotics, painkiller or any unrelated treatments either. I always thought it would be fairer if you only got medication for the exempt condition free, and paid for anything else like most people.

I agree - but the problem with diabetes is that it is (or potentially could be) linked to any number of other problems affecting almost any part of the body. That's why life/critical illness/travel insurance is such a minefield for T1Ds.

The cynic in me does wonder if the decision has anything to do with the fact that, if not well controlled, diabetes can end up costing the NHS a fortune for many years; whereas somebody with severe-enough asthma who can't get the inhaler they need will often, tragically, suffer from an attack and die quickly.

What surprised me is that all my meds are free now not just the one I take daily.
My thyroxine -ok that’s ‘on the list’ but if I need antibiotics I should ( could and wouldn’t mind) paying for those
But apparently the system is all or nothing

It’s an interesting point.

I’ve just looked it up and my Tamoxifen costs the NHS £12.48/month. I would happily pay that myself, and certainly don’t need any other prescriptions for free. Yet there’s no option to do that.

@Kite22

I've wondered this. When I had cancer, I was given an exemption certificate, and it made no sense to me, as I had a few years of prescription, not a lifetime like so many folk have.

They're issued for five years, because (to be blunt) for most patients you're either dead or better by then.

If however you are still on treatment, you can renew the exemption certificate

I paid for years on a pre payment certificate but now have hashimotos so mine are all free
Thank god for the NHS though as some of mine are £300 per injection

Asthma inhalers aren’t on the list as they didn’t exist as a day-to-day regular treatment when the list was created.

Cancer is the only change to the list since it’s creation.

So all the conditions covered were classed as serious conditions that had a known, regular treatment at the time.

The reason people who get one thing free get all medications free is because of the risk of co-morbidites. There’s no point spending thousands over the years on treatment for someone and then they die because they can’t afford to buy antibiotics for an infection. Also people with serious health conditions historically were far more likely to have less employment opportunities.

A friend and I had this conversation very recently.

I also said I felt epilepsy tablets should be free along with asthma meds as diabetics gets theirs for free.

But I guess you could say the same for many long term conditions.

But I do think there's a difference between drugs needed to stay alive and medications to help improve conditions and reduce pain.

For example my ds has a genetic neuro condition. He takes a drug called baclofen. This helps his condition but he could survive without it iyswim?

That’s despicable about cancer.

However, in my mind, I feel it is unfair that, because Cancer charities have a big profile, then anyone diagnosed with cancer, can then automatically get medication for free.
I had hormone treatment for 5 years, that was almost like a "belt and braces" thing for me, not in any way as important - or indeed as costly - as for so many with other illnesses. Just using the examples above, folk with diabetes and folk with asthma, who obviously have the condition for life. Obviously Cancer covers so many different conditions and so many different levels of illness / wellness - I am not minimising others who have had different outcomes from me, but it is the "blanket" decision that seems wrong.

I hope you’re in remission now though Yes, thank you @Soubriquet

Again though, the identified issues are those that are complex. So you could say a diabetic should only get diabetes meds free… if they get an infection in their toe they should pay for antibiotics. But the toe infection could become very serious or even life threatening in a diabetic which is why all prescriptions are free.

Don’t get me wrong, I am asthmatic. I had loads of meds last year when my asthma was poorly controlled (inhalers, medications, steroids), thank goodness I had a pre-payment monthly card. I think the modern day thinking is yes there are many conditions which meet the criteria of one thing impacting on their health due to other conditions but the budget simply isn’t there. They can’t/won’t take it off people who already meet criteria but they won’t add any other conditions in due to cost.

@Soubriquet

No. It’s a very strange set up

I can see why some medications are free. Birth control is and always should be free but why are some life saving medication not? It’s random

Yes birth control is. However the degesterol and mirena failed for me and so I have to take northisterone which isn't free! Luckily my GP gives me 3 months worth on a prescription.

Yep it’s completely unfair and needs changing. I have asthma and also ulcerative colitis. Both require lifelong medication otherwise I won’t survive. However with the colitis medication is free if you’ve had your bowel removed. The system is a joke and needs changing. Either it’s free for all conditions or for none. It’s not fair.

@sueelleker

What always puzzled me (and I worked for the NHS) was that if you had a condition which was exempt, you didn't pay for any medication. eg; a diabetic doesn't pay for antibiotics, painkiller or any unrelated treatments either. I always thought it would be fairer if you only got medication for the exempt condition free, and paid for anything else like most people.

This would make sense.

Free prescriptions for life saving meds for your condition and charges for everything else.

My mum has cancer and gets huge boxes of paracetamol as takes it every 4 hours.

I had a headache round hers once and asked for 2 paracetamol. She gave me a whole blister pack in case I needed more and to save me buying it.

I did point out a box of paracetamol is about 16p 🤣

The complexities of conditions are why no government has touched the list in decades, other than Gordon Brown adding cancer.

None of them want to be the ones to remove the free prescriptions from people, but they know if it’s reviewed then a lot more conditions would have to be added.

It’s a daft system anyway. Prescriptions should be free for all to prevent people ending up costing the NhS ££££ in treatment when their minor infection becomes something they are hospitalised for.
Equally though there should be the option to pay for drugs if you choose - which I know a lot of people would.

That would also help with things like paracetamol - when my friend was terminal she had to get paracetamol on prescriptions because none of the local pharmacists would, understandably, sell her the number she needed. It should have been easy enough for her to take her prescription for 100/200 and fo to a chemist and buy that amount with the pharmacist able to use the prescription as a way of showing that it was not irresponsible to sell her that amount.

@JustLyra my prescriptions are free but I actually buy antihistamines online as I can't cope with the questioning every time and the delays it causes! Pharmacy refuses to prescribe, then they ring the GP, GP rings the consultant, consultant confirms I've been taking 4 antihistamines a day for 25 years and am not yet dead, please prescribe them...
I just buy hundreds at a time online

[quote NotMyCat]@JustLyra my prescriptions are free but I actually buy antihistamines online as I can't cope with the questioning every time and the delays it causes! Pharmacy refuses to prescribe, then they ring the GP, GP rings the consultant, consultant confirms I've been taking 4 antihistamines a day for 25 years and am not yet dead, please prescribe them...
I just buy hundreds at a time online [/quote]
That’s one of the stupid situations that shouldn’t happen. People shouldn’t have to buy stuff online

Yet you can understand the pharmacist being wary of handing over lots of a specific drug because they’d get the blame if something went wrong, but there should be a simpler solution.

It’s one of the downsides to people moving around more as in years gone by the Pharmacist would know both the Dr and the patient so would be much easier to sort.

Eh? Doesn't the pharmacy just dispense whatever the GP has prescribed? Are they trying to overrule the GP?

I was surprised when I needed a prescription just after my 60th birthday. I had assumed the age for free prescriptions had gone up with the retirement age.
I tried to pay but was told there was no way to do that.

@WeBuiltThisBuffetOnSausageRoll

Eh? Doesn't the pharmacy just dispense whatever the GP has prescribed? Are they trying to overrule the GP?

They can if they think there has been an error. I take lots of pain meds and have done for years but my pharmacist queries it with the GP every time. I think it can be because some medications require regular tests or check ups to make sure they're doing the job and doing no harm. But often they just think it must be a mistake.

No I agree actually. I find it hard to reason why I as a diabetic get all my prescriptions free (even if it isn't diabetes specific medication) yet my DM who has severe asthma and has much much lower income than me has to pay for hers??

I don't understand how they make these decisions!