to think we shouldn't have to pay for Asthma Inhaler Prescriptions?

[MaddyHatter]

Just that really.

If people with Epilepsy and Diabetes and even people with Thyroid issues and those taking the Pill don't have to pay, why do Asthma sufferers have to fork out £16 or more every couple of months for medication that can and does save our lives?

I think it contributes to the rather lackadaisical attitude towards Asthma, and just how serious a condition it is.

toomuchtooold my mum is on Symbicort as well and brought her from having barely 50% lung capacity to normal in weeks. I really worry when she moves over here with us .

I haven't read the whole thread but I've often thought this.

I have asthma and have been admitted before. I have three different inhalers plus Montelukasts. The asthma nurse recently told me that I am too blasé about my condition and that people like me die of asthma! Charming I know!

Anyway, I have just bought a pre payment certificate on a monthly plan and it's a revelation! If asthma drugs can't be free on the massively stretched NHS, I'm happy that this option exists.

No I didn't appeal the PIP decision as I don't think it would have been successful. I think I would have got lower level DLA, but that has been abolished. PIP is about being able to do basic life things, but having to work part time does not figure. And having incontinence and having to eat ready made meals, gets you hardly any points.

I agree with the comment about means testing. I am above means testing, just. But if I had to pay even £10 to visit a GP and my medications, I would be really affected. All these type of proposals are promoted by those who probably go to the GP once a year and have antibiotics for an infection every few years.

It's more not right that people who are on thyroid etc not only get this free (which I agree with btw) but they also get every other prescription free that isnt thyroid related? It should be disease specific

But what is disease specific? That takes a Drs judgement. I have a friend with bipolar who has thyroid problems from taking lithium. So now he gets free prescriptions. Should he only get it for thyroxine and not lithium as they are taken for separate diseases? Or should he get it for lithium as well as the thyroid problems are a side effect of the lithium?
Sometimes these are difficult questions. So it is probably easier and cheaper to give it for everything.

For those annoyed by the blanket aspect of those covered by free prescriptions, it is because having one of these chronic illnesses makes you predisposed to other things. Therefore the other prescriptions are usually a direct result of the original condition.

As time goes on I am almost definitely going to suffer from other auto-immune diseases. I have been fortunate so far. In 8 years of free prescriptions, I have had one free prescription on top of the ones for my tablets. So stopping the free additional prescriptions would have saved the NHS less than a tenner in my case.

I am fed up of armchair doctors / economists talking out of their backsides.

I cant believe the anger over this. I also cant believe people done know about PPC's which I am sure have been mentioned on here.

Rather than complaining about £8.40 per item, and moaning about the unfairness of not getting it free like Diabetics, get a PPC.

I have a permanent endocrine condition which is not one of the disorders that entitles me to free prescriptions.

I need 2 items per month. Instead of moaning about unfairness, i bought a prepayment certificate.

it cost £104 for the year, £8.67 per month or 28p per day.

For 28p a day I get unlimited prescriptions.

I had a UTI and it needed 2 different antibiotics to get rid of it, I didnt pay any extra for the ABs as I had the PPC. It covers everything.

not good enough to get an unlimited amount of medication for 28p per day, you want it free.

No wonder the NHS is in debt. You couldnt get much better value than 28p per day for an unlimited number of prescriptions.

*don't know not done know

Queen i agree 28p a day is a bloody bargain.

But thats not the way its paid...........its what it works out at.

There are a lot of people who wont be able to afford to pay £104 all in one hit.

Brasty - I have spent weeks of my life in hospital with brittle asthma and have been dependent on many medications on the past so I am not someone unacquainted with ill health or needing long term medications. I am well currently and very grateful for that and very sorry you are not well.

However, I maintain that I would prefer less people to get completely free prescriptions and more people to make contributions towards the cost of healthcare. Be that through higher tax, prescription sibs riot ions, prepayment or a sliding scale according to means testing of done offer way. Those who can't afford it should not suffer any hardship to procure medication or healthcare, absolutely, but I do think increasing entitlement to free prescriptions as per the op is not the way to go.

There are a lot of people who wont be able to afford to pay £104 all in one hit.

Yes, I am one of those people. The NHS has that covered too.

I pay it by Direct Debit over 10 months at £10.40 a month. So you break down the cost if you cant pay in one hit.

If people say they can't afford £10.40 a month for 10 months a year, they are currently managing to pay £8.40 x 2 for two inhalers a month.......which is more than the £10.40.

There is really no excuse to want it free just because. There are affordable way to pay.

I have to pay for my warfarin, without taking it daily I would get a blood clot, either a DVT (have had two prior to being put on anti coagulation medication for the rest of my life) stroke or a PE any of which could kill me.

I do think it is unfair that the birth control pill (which I can't take due to my condition) is free, but the drug that I have to take isn't.

I would hate to be the person who picks the drugs which are exempt the charges and the ones you have to pay for, but if it was up to me all drugs taken daily to keep someone alive should be free.

I am lucky in that my GP lets me get 90 day worth at a time so 4 charges a year which could be a lot worse.

Sadly, they are probably not buying the inhalers, but instead hoping if they have a serious attack someone will call an ambulance for them in time.

I take this direct from the NHS Business Service Authority website:

Direct Debit - the most convenient way to pay. The most convenient way to pay for a 12-month PPC is by Direct Debit, which allows you to spread the cost by paying for it in 10 monthly instalments. By using this option we can also normally automatically renew your PPC. You would not have to worry about forgetting to renew your PPC.

I do think it is unfair that the birth control pill (which I can't take due to my condition) is free, but the drug that I have to take isn't.

The pill free of charge is cheaper to the NHS than an abortion if an unwanted pregnancy occurs because someone didnt want to or couldnt pay for the pill. I guess that is the reasoning they employ.

I'm surprised by the lack of understanding on this thread of how the NHS, and basic health economics works. Mind, it's a very emotive topic and I do completely understand people feelin like they are being treated unfairly when they have to pay and someone else doesn't. Also I work in the area of drug pricing so I have more of an understanding of this than most.

Birth control is free because the cost of the increased population were it not would far, far outweigh the cost of administering free BC, making it cost effective.

No one person "picks the drugs" which are exempt, it is largely down to old clauses out in place before other chronic diseases became so expensive to manage, and in pet also due to complex health economic calculations based on huge amounts of data submitted by the pharmaceutical companies.

Drugs are cheaper in countries like Cyprus because they are priced differently by the pharma companies based on government willingness to pay, which in turn is based on a number of things such as GDP, how they make their reimbursement decisions (cost effectiveness vs budget impact vs straight affordability) and price caps. They charge more in countries such as the UK and less in countries such as Greece, because if they tried to charge more in Greece, the drug wouldn't be made available at all.

The thing is, the prescription charge is often astonishingly low compared to the cost of the drug. Not in all cases but in many. MS drugs, for example, are very expensive. And the fact is, in cases such as these the prescription charge is considered when the decision is being made whether to fund the drug at all or not. So it's often a case of "make it available but charge a co-pay" or "don't make it available at all/make it available on private prescription only".

It's complex, far from ideal, and a great shame for those who suffer chronic illnesses. But the NHS is under funded and diseases like asthma would, frankly, cripple it if prescriptions were free. For diabetes, the HUGE cost of potential complications, and the low compliance rate of medication users are enough to justify free prescriptions. Unfair, probably. But economically sound.

Wrt overdiagnosis of asthma:

www.nhs.uk/news/2015/02February/Pages/Is-asthma-being-over-diagnosed.aspx

So, where did the figure of 1 million come from? All the UK press rallied round a statement in the draft guideline that said: “studies of adults diagnosed with asthma suggest that up to 30% do not have clear evidence of asthma”. What followed was clearly a “back of the envelope” calculation extrapolating this to the number of people receiving treatment for asthma in the UK, which is around 4.1 million. This gave the magic figure of 1.23 million potentially misdiagnosed people.

Unfortunately, the 30% figure in the draft guideline is not referenced, so we can’t find out how accurate it is. We also don’t know whether it applies to specific asthma subgroups, such as those of a specific age, or the severity of a person's symptoms. This makes it difficult to assess whether this calculation is accurate, or even reasonable.

So basically someone pulled a number out of their arse and then multiplied it by 17...

The BBC article quotes two specialists.
The problem is not overdiagnosis anyway, according to the article. It is rushed diagnosis or disgnosis based on incomplete testing. More testing would cost more money of course. The two specialists complain about trivialisation of asthma, and that people forget it is a potentially fatal disease. This is not actually caused by overdiagnosis but by failure to communicate to patients how important it is to monitor asthma and to return for frequent checkups. Frequent checkups and more monitoring means more cost of course. It is cheaper for doctors to prescribe the medications and instruct patients and parents on how to take them.

A doctor from NICE, Mark Baker, points out that "Accurate diagnosis of asthma has been a significant problem which means that people may be wrongly diagnosed or cases might be missed in others." It swings both ways.

Again quoting from the BBC article linked, Asthma UK's Dr Samantha Walker says: "It is astonishing in the 21st century that there isn't a test your child can take to tell if they definitely have asthma.

"Asthma isn't one condition but many, with different causes and triggered by different things at different ages. Asthma symptoms also change throughout someone's life or even week-by-week and day-by-day.

"This complexity means that it is both over and under-diagnosed, in children and in adults, so people don't get the care they need to manage their asthma effectively.

"As a result, a child is admitted to hospital every 20 minutes because of an asthma attack and asthma attacks still kill the equivalent of a classroom of children every year in the UK."

......So I think we may console ourselves that the entire business of diagnosis is screwed up thanks to successive governments financial starvation of the NHS, and that for every person wrongly told they have asthma there is probably someone else wrongly told they don't have it.

I'm shocked at the assumption that people who have one qualifying dx for medical exemption shouldn't use it for other things.

My earning potential was devastated in perpetuity, including ability to build a pension, by the condition that led to me getting a MedEx card. Prior to that I'd had a yearly pass for years. I struggle to understand how people can manage to be informed enough to post on a website but can't google how to buy a yearly or three monthly card. I'd had one for twenty years before I was so ill I qualified for free for all.

I get everything free because my health is so compromised.

I do work. But I earn about a tenth of what I could expect had I not been ill.

You really, really do not want to be me health wise.

I do agree with the early posters who pointed out the exemptions were done a long time ago. You can't add more now as it would bankrupt NHS, which is why prepayment cards are pushed, especially for people with conditions such as asthma.

The existing flat fee is not related to cost but the initial aim of this was to make sure people weren't deterred from taking more expensive drugs.

Oh, and one of my long term conditions is asthma.

Prepayment Cards arent pushed enough.

the existence of this thread is proof of that. Large swathes of people don't seem to know about the prepayment cards.

My DH has Multiple Sclerosis... Life long chronic debilitating disorder. He is not entitled to free prescriptions.

My friend had type 2 diabetes and is massively overweight and doesn't watch what she eats. Gets free prescription !!!

Go figure! Maybe if type 2's were made to pay they might consider control by diet better!!!

I take Quite a lot of different medications just to be able to get out of bed in the morning. And I'm happy to pay my prescription charges. The fact I'm not exempt due to not being on the relevant benefits, means I have enough money to pay for them. As an ex nurse, I know how expensive those medications are, and thank my lucky stars I pay a token sum on a prepayment card. To get them free would IMHO take the piss. Just because my condition is chronic, does not mean that the NHS suddenly has more money. Some people need to pay. Or we could move to Wales where the prescriptions are free but other elements of healthcare are falling apart due to the redirection of funds. I know which one I'd pick.

Thinking of this thread as I was at the pharmacy this evening. My son needs eye drops for five days and the medication the Dr prescribed cost $400.

re. PPC cards. There is a notice in every pharmacy. There is information on the NHS website. Doctors and pharmacies often mention them to patients and people can't be bothered to fill in a simple form that will save them money.

It's like gas and electric. Many people moan about the cost but about 70% of people remain on the standard tariff, which is the most expensive.

It's not difficult or time consuming but it would appear that most people would rather pay over the odds and then moan about it. .

I don't know. In an ideal world I think everyone with chronic conditions should have free prescriptions but it isn't an ideal world.

I have chronic lung disease and my prescriptions each month would come to over £100. I'm more than grateful for the prescription pre payment card. If we start playing top trumps with illness things would quickly degenerate - it doesn't seem fair as it is, but I wonder what the solution is.

I think the idea a pp posted of a very low charge for all isn't the worst idea, but there will always be those who would struggle to pay, and I hope we are always a society which care for our most vulnerable (I wish) - so I guess the present system is about the best we can get right now.