To think the NHS medical exemption is not very fair?

[user87382294757]

DH has crohns disease. Needs regular prescriptions and bloods, has an IBD nurse etc.

Advised some conditions can exempt you from prescription charges and checked the list. It says-

You can get all your NHS prescriptions free if you have a valid medical exemption certificate because you have:
• a permanent fistula (for example, caecostomy, colostomy, laryngos-tomy or ileostomy) which needs
continuous surgical dressing or an appliance;
• a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is
essential;
• diabetes insipidus and other forms of hypopituitarism;
• diabetes mellitus, except where treatment is by diet alone;
• hypoparathyroidism;
• myasthenia gravis;
• myxoedema (that is, hypothyroidism which needs thyroid hormone replacement);
• epilepsy which needs continuous anticonvulsive therapy;
• a continuing physical disability which means you cannot go out without the help of another person; or
• cancer and are undergoing treatment for:
– cancer;
– the effects of cancer; or,
– the effects of cancer treatment.

Why these conditions and not others? It seems unfair that someone with diabetes type 2 (which is often self induced through diet and lack of exercise) can get these for free and others with other chronic illnesses cannot?

I'm cross that it seems a selective few illness have been given more priority than others for this. AIBU?

you do all know you can buy a medical cert at a far reduced cost available to all and sundry deserving or not

No. This has not been mentioned or discussed on this thread at all. If only we'd known.

@Omzlas

Regardless of how much it might help, that doesn't help if you don't qualify does it?

And it also doesn't really depend on how the illness affects you. It depends on how much it affects you in certain areas. You might be severely affected in a category other than those that PIP considers.

Decisions aren't being made though. They are just keeping the status quo as there would be uproar if they removed stuff. With regard to diabetes the decision not to charge would have been made in the 1950s when the only medication was insulin.

Yes, I think you're probably right, but how can they possibly defend it when new decisions are being made about all other areas all the time - new treatments and prevention plans and conditions that weren't even identified or recognised a few decades ago?

It definitely needs reviewing to make it fairer but the costs involved would be high. I get my prescriptions free because our household income is low but when dh was earning a decent salary I had a prepayment certificate for my asthma and pnd meds.

In addition, I also know that a high percentage of people who are declined at the first stage, are successful in appeal.

Which is great except the average waiting time for a PIP appeal to get to tribunal is currently standing at 27 weeks. Half a year (longer for those whose appeals are above average time, obviously) without money to live on is a lot of undispensed prescriptions that people can't afford to take to the pharmacy. More than 17,000 people have died waiting for their appeal to be heard.

I believe all prescriptions are free in Wales & Scotland

Diabetes is not solely caused by diet
A new study says that there could be 8 different types. There can be complications if not treated correctly like blindness, amputation etc

The system doesn’t seem fit for service.

I have medical exemption. I use it for the single item I need to take daily (and will for the rest of my life).

I pay for other prescriptions because I don’t believe I should get them free when they’re totally unrelated to the condition.

Isn't the point that people with those conditions are likely to need multiple treatments for other conditions exacerbated by the named condition?

I have a condition on the list which requires a daily medication for the rest of my life. I also currently have 3 other medications to treat other problems that are exacerbated by my exempt condition.

Let's suppose there was a political party that disapproved of public services, publuc spending, and taxation.

Let's suppose that the majority of their supporters and voters got free prescriptions due to age, and didn't pay National Insurance.

For the purposes of this question lets assume that these people are not much motivated by altruism and the public good.

Would the leaders of this party gain approval by extending free prescriptions to the rest of the population?

There is a different way to reduce prescription costs, which is further limitations on which medications are suitable for prescriptions. I believe some such as paracetamol and ibuprofen have already been removed, which is fine because they cost pennies and arguably come under self-care.

Yes, this makes a lot more sense when budgets are being squeezed. When you can buy 16 paracetamol for 30p or less, at shops everywhere, the cost of prescribing and dispensing them on the NHS must represent a colossal waste of money.

Also infuriating, though, is the fact that a lot of the medicines that have to be paid for could actually be obtained far more cheaply if you could buy them over the counter. I've heard that the cost of things like asthma inhalers can be 50p or less. Patients have to potentially pay £9 for them on prescription, when they're not even particularly dangerous in the wrong hands. There are plenty of more potentially dangerous products that can be bought off the shelf. They could always make people briefly check with the pharmacist first, although there must be a way of having it on your records that you have a long-term diagnosed need for them. It's not even like the NHS makes the extra £8.50 or whatever as profit, once all of the many internal costs of prescribing it for you have been accounted for.

Also appalling is where the same medicine can cost more depending on required dosage e.g. if you need, say, 200mg of something, you can get a pack of 200mg tablets as one prescription, but if you're prescribed 175mg, you need both a 100mg pack and a 75mg pack, which count as two prescription items.

Nope!

To PigletJohn

Could you ask your GP to potentially prescribe more boxes so you can pick up 2 boxes for each prescription?

Obviously this depends on what the medication is, your GP will assess the risks, but I was able to do this with something basic (iron supplements) after explaining that I was getting through an entire box every 6 weeks when following the GP’s recommended dosage.

ulcerative colitis (can kill (but rarely) if untreated and can require a lot of medication to control it)

The problem with UC and mortality is that after 10 years of disease activity your risk of colorectal cancer starts to steadily increase due to the chronic inflammation. I've had UC for 16 years and get an annual colonoscopy just to manage the cancer risk. It is probably what will kill me eventually. So UC does kill people, just not directly.

My insurance (I'm in the US) has an annual cap on my costs. Once I hit that cap I have 100% coverage for everything, including prescriptions.

@user87382294757 - has your DH talked to his gastroenterologist about one of the biologic drug therapies for Crohns? I'm on one for my UC (Entyvio) and it's the only medication I've ever had that has actually worked. There are quite a few out there for Crohns and I think the NHS provides at least some of them.

Biologics For Crohn's Disease Treatment

Good luck to him. It's an awful disease.

Only type 1 or type 2 diabetics on insulin get it

Most type 2 don't.

Yes, I think you're probably right, but how can they possibly defend it when new decisions are being made about all other areas all the time - new treatments and prevention plans and conditions that weren't even identified or recognised a few decades ago?

They don't defend it though really do they? Everyone knows it is just based on what life threatening diseases had treatments decades ago.

I have 4 children.

Three of them have free prescriptions for life. 1 has Type one Diabetes. 1 has epilepsy & 1 had Underactive Thyroid!

I have no medical conditions at all. Neither do their father.

I would give their free prescription for life back in an instant, for them to be fit & healthy.

Fingers crossed for the youngest!

PolPotNoodle

IBD can kill too...ask my sister...ah no you can’t cause she dead!!

🤷‍♀️

MissConductUS

I’ve seen uc and crohn's kill.

I’ve seen what my own death will be like. It’s not just the ibd it’s the side effects of the treatments and the other issue which come with the diseases

If the list was drawn up many years ago, as suggested above, then perhaps asthma (for example) was less of a thing then.

There has been a massive proliferation of some conditions since I was a child in the 1960s. I only knew one person with asthma back at the time.

It may well be worth campaigning for these other conditions but, in the meantime, if people could stop picking on the Type 2 Diabetics from their lofty position of ignorance, that would be fab.

MissConductUS- has your DH talked to his gastroenterologist about one of the biologic drug therapies for Crohns? I'm on one for my UC (Entyvio) and it's the only medication I've ever had that has actually worked. There are quite a few out there for Crohns and I think the NHS provides at least some of them.

Yes he has just started on Humira and that was funded so guess we should be grateful for that really. His is quite severe- he also has asthma as well.. anyway yes it can be very serious. He nearly had surgery but wanted them to try other things first- he is also on Methotrexate and Folic acid which we get the prescriptions for and needs the regular blood tests.

Humber seems to be helping thankfully, it is given with a pen into the tummy. His IBD nurse and team are helpful. He doesn't get PIP as that is for if they need help to e.g. deal with it and he can manage it himself most of the time, although it is difficult to deal with.

We would get a certificate for low income but income is just too high as he is self employed, to get that. Income under 16K for the family would qualify.

Thanks for asking.

I guess there are lots of things like auto-immune conditions and they can't fund everything,

There has been a massive proliferation of some conditions since I was a child in the 1960s. I only knew one person with asthma back at the time.

I isn't the proliferation in conditions. It is the proliferation in treatments for conditions. I don't think that there was any life saving treatment for asthma in the 50s or most of the 60s.

Methotrexate is a serious drug and used for cancer but even though it is a cancer drug that doesn't qualify either. Kind of wish he could stop that but in the past that resulted in hospital admissions and steroids etc

PS yes I mentioned the risk and he gets the ten yearly colonoscopy but only after I mentioned it! Another thing is get tested for B12 as ileum can be affected and might need injections for that. (Crohns)

User methotrexate used in autoimmune diseases is a tiny fraction of the dose used in chemotherapy for cancer. I know because I'm on it but fortunately had my dose lowered last year so no longer on 25mg. I'm also on biologic drugs and have been for several years.