To think the NHS should tell us the cost of medication

[glenthebattleostrich]

Just been talking to / whining at DH about how I need to order a new inhalor before Christmas but my app won't let me before 25 Dec. Then got onto the cost of prescriptions and wasted medication (I know, bet you wish you were here!)

Out of interest I googled the cost of my inhalor and the one my doctor tried to switch me too (can't use dry powder as it makes my asthma worse for some reason).

My symbicort costs about £38 and my salbutamol £12 to buy. Suddenly i feel better about prescription charges (still annoying that some parts of the UK don't pay or certain conditions get all meds free others dont, bit that's a different thread).

Anyways, after all that waffle, AIBU to think we should be told how much it would cost us to buy medication? I'd be more appreciative of the savings / consider how much I need it and would be less likely to waste medication.

But people who order paracetamol, antihistamines, calpol, emollient etc when it's cheap to get from a pharmacy really ps me off to be honest. Why should the NHS pay for a drug that costs 25p in a supermarket?!?!

I think the theory is that someone paying an £8 perscription charge for something that costs 16p goes someway towards contributing towards the cost of someone paying £8 for something that coasts £600

I'm on the fence with this one. I can see the need to make people aware of the costs but at the same time I do think it would have a negative consequence for people who don't want to be a 'drain on the system'.

I think the people who do waste medication are the sort of people who wouldn't care about the costs anyway. The ones who would suffer would be people who worry how much the medication would costs so might avoid going to the dr.

I must admit I'm not a visit the Dr very often type of person and I tend to self medicate for things I see as simple (not that that always works in my favour and I have left things too long that it required more treatment - e.g. Leaving bladder infection too long and treating at home until it became bad kidney infection). I am also the sort of person who will google any medication I am prescribed for costs and reported side effects etc.

I live in Scotland so we all get free prescriptions. I think it is great that everyone can get the medication they need without the worry of cost but obviously you do get people abusing that. I remember when it was gradually rolling out and the cost was reduced to something like £4.50 for a year or so and then became free. As far as I remember too we only paid one charge for the entire prescription rather than each item. I was very happy with this system and if it was reintroduced I wouldn't grumble. In fact I would prefer the charge to be reintroduced and more funds put into NHS dentistry as I know loads of people who simply can not afford to go to the dentist and suffer in pain every day. I also have major teeth problems I can't afford to get treated - think 5 years+ of braces and jaw operation required as my lower jaw sits too far back and causes daily headaches and face pain - but I'm not considered bad enough for NHS funded treatment. I can't afford the operation myself - I could just about manage the braces if I saved up but that wouldn't solve the jaw problem.

I'm not sure free for all is the best way - I wouldn't mind paying a charge for occasional items such as a course of antibiotics as needed but I do think it should be free for any condition that requires long term medication and not just a set of conditions.

The one thing that does annoy me is the minor ailment service. Yes it is great that parents or people who genuinely can't afford OTC medication can get it but it is misused. A couple of months back DD had chicken pox and I popped into boots to buy some camomile lotion. The pharmacist tried to convince me to get it through minor ailments but I declined as it only cost about £1. I have had similar experiences when buying things such as calpol or headlice treatment but each time I declined as I can afford to buy these things.

Interesting thread. On one hand I agree that the price of meds should be on the pack or prescription form, but understand that it might have a negative impact on those (few) who 'don't want to be a burden' etc. Maybe the answer is more regular prescription med reviews for those who have a lot of items - every 6 months or so the doctor or even nurse could review with the patient and ensure each item is still needed/being used. Have read the tales on here of some relatives/carers etc having to dispose of binbags full of unused meds that have built up in someone's house. That's dreadful, and they can't even be reused.

Knowing the cost of a drug is useless information for an individual, unless you also know all the other variable factors such as cost of care without the drug or how many people use etc.

As for free prescriptions in Scotland it works out better value to do this than pay for administration costs. I read an interesting study a couple of years ago that found that it was cheaper to give free prescriptions than treat those who couldn't afford medication and who later ended up in hospital.

As for pharmaceutical companies raking in money from drugs, what is the alternative? The NHS cound not fund mass drug production or invest in new drug development so what's the alternative?

Misskelly, i know too well what the cost of being without the medication would mean, i would be fertiliser for someones daisies.

To the OP i think the chemist should be allowed to print the costs out on a sheet and let gp tick a box if the recipient is able to handle the information for example that they may not stop vital meds because of what they cost

Hello! A cheery wave from me, commercial manager in a Big Pharma. Its my job to sell our drugs to the NHS and manage the prives we charge.

It's more complicated than thinking that the list price is what the NHS is charged. The NHS has its own pyrcgasing and supply chain and often big drugs are negotiated region by region or trust by trust, all with differing discounts. The price on the box is meaningless.

Then as an aside, the retail pharmacist is able to soyrce drugs from wherever they like, within legeslative limits, and so may well get a cracking deal on some drugs and pay top whack for others. Again, what they charge the NHS for reimbursement is different.
There's very little room for sentiment, its just a business.

If you want to find out you can.

I don't think we should be told because that incurs a cost, and the NHS doesn't need any more costs.

I think there's a time and a place to tell some patients what their medication is costing. Not in an attempt to make people feel guilty, but in an attempt to instill some sort of awareness.

I have had countless consultations with patients who are requesting another inhaler, or more tablets because they've lost them, or left it on the bus, or gave it to a mate, or dropped it down the loo.

Yes, accidents happen and we've all made mistakes but IME there are a fair number of patients who, largely because they don't pay anything for their prescriptions, have absolutely no concept of responsibility when it comes to their medication.

Of course I would always reissue inhalers etc, you're not going to leave them without essential medication. But for the repeat offenders I do make a point of telling them that this is the fourth time in 3 months they've lost their inhaler, and at 35 quid a pop they need to be more careful with them. The prescribing costs come out of the GPs prescribing budget, it's not some faceless/nameless NHS pot of money.

My colleagues and I also make a point of asking my patients if they pay for their scripts and if I'm prescribing something cheaper than the prescription charge I'll tell them so they can buy it over the counter.

What annoys me on these threads is the assumption that everyone who has free prescriptions takes the piss. While I do get all my prescription only meds for free (not just the one for the condition that causes me to be exempt) as they're on one script so it would be impossible to only get one for free, I would never dream of taking up aGP appointment to get a prescription for gaviscon during pregnancy, as many pregnant women do. The same for lactulose. I wanted to buy my aspirin over the counter but my consultant prefers it to be prescribed.

It's so much better being able to buy basic stuff over the counter in other countries. I often just can't be bothered to go to the doctor so just buy my stuff from the pharmacy. So I end up saving my insurance money and don't have to feel.guilty about being ill. Everyone wins. If I couldn't afford it I would go to the doctor. The UK has a peculiar attitude to drugs. If you want to pick up some fairly innocuous stuff you have to wait 4 years to see a GP but if you.lie and say you slept with a stranger the pharmacist gives you anti biotics. If you want to buy some.more pills you have to go to the surgery but if you say you had unprotected sex you can just pop in and get the morning after pill. It's so fucked up.

I would never dream of taking up aGP appointment to get a prescription for gaviscon during pregnancy, as many pregnant women do. The same for lactulose. I wanted to buy my aspirin over the counter but my consultant prefers it to be prescribed.

Quite.

I have a prescription pre-payment cert which gives me unlimited prescriptions for £10.40 a month.

Even so I dont abuse it.

I needes a thrush treatment and I went in and bought one and another. It took 2 doses to clear it. But i paid for them rather than waste a GP appointment and getting a prescription which I could get as part of the certificate i already pay for.

I have cost the NHS thousands so far in my lifetime.

Brain tumour and complicated twin birth plus lots of kid stuff like appendix, corrected squint and now ongoing physio for pregnancy relaated back problems.

I am on roughly £100 worth of drugs per month I think. I would like to know the cost but more than that I think it should be published that how many prescriptions were wasted each month in local areas.

When my dad died we returned loads of stuff - nutrition drinks (which they don't prescribe anymore) and pain killers - which must've been incinerated. And he didn't incur the 'cost' of a doctor's appointment as they were all on repeat.

The chemist keeps nagging me to collect the latest batch of mine but there is no rush so it can wait.

I don't think it would help in any way - the people that waste resources wouldn't change their habits as its not 'their' money (I know it's all our money

Not true. As I said in my post, I changed some of my habits/medicines based on cost. It's had little or no effect on me but saved the NHS thousands, and I would have done it sooner if I'd known the relative costs.

I have to get thrush medication from the GP as the over the counter ones don't work for me, it only works if I have a 5-7 day course. I'd be happy to buy it over the counter but, as you can only buy the single doses, I'm not going to waste money.

Somebody mentioned nutrition drinks not being prescribed. I presume different areas have different criteria as MIL has them prescribed.

caroldecker Well lets hope someone funds antibiotic treatment they'll come a day when the bacteria will win;!

We use quite a bot of Ibuprofen taken with a proton pump inhibitor to stop your gut being damaged and our chemist will let us have more than the normal amount as he knows we are aware of what it can do, same with paracetamol which can be very nasty in overdose.

Interesting re Original -v- generics been having some fun with Viagra substitutes and the ones Asda knock out are just as good and much cheaper in case anyone's DH or DP needs a chemical assist to get lift off;-)

I've been thinking about this thread - and something struck me. About the NHS and 'our' attitude to it. How we take it for granted really. It is an expectation.

'We' are worried about telling patients how much their medication costs in case it makes them feel guilty/not be treated.

In lots of countries they know exactly what it costs - because if they can't afford it they don't get it - don't get treated. If that means they suffer - even die --tough.
We really are incredibly lucky to have free health care. It is a privileged not a right - maybe the people who do waste the resources need reminding of that.

Just realised that could be misinterpreted - I don't mean the people who have health conditions and really need the medication - I mean people who get eg free paracetamol and don't care cos it isn't their money and after all they pay tax ...

I was thinking about this earlier today because a while ago I ended up going privately for ongoing issues. I don't see the medication as necessarily the big thing, particularly as people need it sometimes. It is the cost of investigation that is just as big - full blood tests costs a good £300 (sometimes more depending on what is being tested), MRI and CT scan looking at another few hundred. The antibiopics are really not that much. It has made me mindful when I go to GP nowm

I'd prefer not to know. A few months ago I needed a cream that the GP said is used reluctantly as it's so expensive (£70). I have the same painful issue again now but am dreading going to the doctor and keep putting off making an appointment. I feel guilty and worried about having to ask for the treatment, knowing how expensive it is. Knowing the cost has stopped me getting help, I'm sure other people would feel the same too.

I've just looked up the cost of my meds. It's £1.87 per month. I'm being ripped off!

My injections are £62 each, I use one a week and am on them for life. I know a woman in the US and she has to pay I think it's $5000 before she can even start on them
But without them I'm even more immunosuppressed and very high risk of neutropenic sepsis so I suppose cost/benefit pay off...

Oh and I could get my antihistamines on prescription but it's cheaper to buy them, I'm on 4 a day and it also saves the questioning every time which is a long winded ringing consultant/GP etc

I'm in the US and am on several medications for a chronic condition that I'll be on for the rest of my life (if I want to have a rest of my life, anyhow ). We have a bizarre system here with insurance - some plans, like mine, have copays which means we pay $10, $18, or $36 for a prescription depending on which price list the insurance company has it on, while the insurance picks up the rest. In one case, gabapentin, my cost was $10 while the full retail cost would have been $151.79. Another med, levothyroxine, is so inexpensive at $4 and change that we don't even submit it to insurance, we just pay cash price. Yet another one, for which I pay $36, is a whopping $1480 per month!!

If that's not strange enough, the US has our own version of a postcode lottery. Consumer Reports is one of the better consumer advocacy/information publications we have over here and they did a story on how to get the best prescription prices if your insurance plan doesn't cover them or if you have no insurance and have to pay full whack. They found that in some cases a prescription price could vary more than ten times as much between two stores that were only 15-30 minutes' drive away - in Denver, CO a pharmacy chain charged $330 for the generic formulation of Actos, a Type 2 diabetes drug, while an independent pharmacy nearby sold the same prescription for $15!

All that to say, the price of my prescriptions sometimes does make me feel terrible - my insurance company is paying a LOT to keep me this side of the grass! But it's also helpful in that I can see the prices and sometimes am able to talk to my doctor about whether there's a less expensive equivalent, something I've done for almost half my prescriptions. Unfortunately, even though my DH has a good job - a professor with tenure - I won't let myself 100% assume it will last, same with his insurance, and if the worst should happen I want to make it as easy as possible for us to afford medications.

Oh--and w/r/t paracetamol/ibuprofen/aspirin - over here's it's nearly unheard of for insurance to cover any med available over the counter, prescription or no. The only exception I'm aware of is if the patient is a child covered by the state's medical assistance plan.