To think £290 for my prescription is insane?!

[Justintimeee]

Posting here for traffic

I was diagnosed with ADHD 18 months ago and have been receiving monthly medication since.

I have been having follow up zoom calls with my psychiatrist every 6 weeks at a cost of £170. On top of that, to actually have the prescription written is £25 and the meds themselves are £95 so it is a huge cost for me.

The meds have completely turned my life around so I really do not want to go back to life without them.

The issue is, I can no longer afford to pay for the £170 follow ups so regularly. I have asked for a prescription but it has been refused if I don't book a follow up so I am at a loss... I had no idea they were mandatory for me to get medication when I have been diagnosed.

Do I just find another doctor? Is it the same everywhere? I have been refused shared care due to some NHS rules against accepting patients from private ADHD doctors so I don't know what to do.

I am in Essex if it helps.

@Pinkprescription Your experience isn't the only one though.
Some women who use hrt find their GPs are specialised enough to deal with gynae stuff, they see a private consultant, and then they get their hrt on repeat from the GP.

*are - aren;t

My partner had a private ADHD diagnosis a few years back and the GP took on a shared care agreement and now he has free prescriptions (we live in Wales )

Yeah, except it’s not. Plenty of people happy and willing to use their ‘expertise’ to take advantage of vulnerable people. Snake oil merchants, it’s been happening since humans first set foot on soil!

Talk to your psych.

They are running a business.

Tell them you can't afford the 6 week calls.

See what they say.

I was told with dd that you need an agreement to shared care BEFORE you go private, in other words if your gp advises to go private due to waiting lists they will in advance agree to take you back.

The problem is that there are people (not necessarily drs) in private practice who will diagnose anyone with ADHD and prescribe meds, the meds can also be abused, used illegally eg 25% of high school kids in the USA admitted to taking them to increase grades! It's getting ridiculous now with just how low the bar is to get powerful stimulant drugs and nobody really knows the long term side effects. I'm not commenting on if they are right for any of you, but at a society level something is wrong

Having a history of problems shown on your nhs records is extremely unlikely in adults though who have spent their lives being blamed, inattentive, lacking focus, unable to keep to time problems with relationships. All the symptoms blamed on a failure of that person. The medical profession are unlikely to have been involved at all

Private prescriptions, which is what we're talking about, are definitely not free in Scotland.

Yes ! I went to a private menopause clinic as my surgery was useless and but me on anti depressants. The GP won't accept the diagnosis and I pay private for my medication that friends get for £18 a year for on NHS. I'm 55 of course I'm peri but the GP says I'm depressed

There is no such legislation, don’t make stuff up.

Yes my GP wouldn't do this either. They will not share care with any private consultant in any specialism - HRT, cardiac etc etc. They have now decided they will not share care - for example just prescribe meds and do blood tests with any NHS hospital out of county. So there is no point to right to choose.
This means my meds are posted to me by the NHS hospital I attend which is in the county where I live (but GP is in next county and the only one I can register with.) Bonkers

I am on shared care. I did talk to the GP Dr in advance though, and they had heard of the private clinic and considered it to be reliable.

My main suggestion would be to call around GP practices to find one that would be more willing (or switch to a virtual GP) and also contact private clinics to ask them if they would take you on with fewer appointments. Once the meds are stable, I would have thought that you would have an appointment every six months.

We had the same in 2020– a couple of months of titration and then handed over to the GP.

But remember that there is a shortage of some ADHD medication right now and GPs have been told not to prescribe for new patients.

That's awful for your son, sounds a bit like the difficulty diabetic patients have been having getting their wegovey I think it's due to all the private purchases of it for weight loss?

*Willyoujustbequiet · Today 07:38

It's because many private diagnoses are meaningless and not worth the paper they are written on.

I know someone who was repeatedly refused by the NHS who chose to go private and was diagnosed after a 20 minute phone call.

These are controlled drugs that can have serious side effects. I'm not surprised the NHS questions the validity of some private firms.

ADHD, to my knowledge, must have symptoms present from childhood. They do not happen overnight. I would imagine in most cases this would evidence a medical history at the GP which warrants referral to CAMHS. As happened with my dc. Ours were done on the NHS within 4 months. I realise it's a postcode lottery but there is choose and book. I would seek an NHS diagnosis tbh*

I was diagnosed in the NHS psychiatrist’s waiting room before I had said a word😂

I then had to go through the forms I had filled in and at the end I scored 9/9 in both sections.

I always wonder what my life would have been like if someone had just looked at me for a few seconds and realised that something was seriously not right.

It was my dd who came to me with a list of symptoms she had found when she was googling why she did certain things
which others just didn’t do and asked whether I thought the symptoms applied to her now (young adult) and when she was a child.

I looked and said I had all those symptoms even as a child and I don’t have ADHD.
12 weeks later I came out of the psychiatrists office clutching my first prescription of Elvanse 20mg. I would have been diagnosed 4 weeks earlier if I had got round to filling the forms in.

Did you see the Panorama about private ADHD diagnoses? All about the money they can get from people.

Not saying your diagnosis is incorrect but it's why you can't just move over to NHS as lots of them are wrong!

Lots of trusts are refusing adult referrals due to medication shortages and long waiting lists for children to get diagnosis

how often are the follow-ups? I'd expect every 4-6 weeks when titrating meds, then when stable probably one at 3 months, and then every 6 months long-term.

We saw the GP for DD's ADHD referral - he looked at the history (hers and wider family) and the 2-3 year waiting list and strongly advised us to go private if we could possibly afford it and then pop in the forms for shared care.

Diagnosed 2 months later via a former very senior NHS psychiatrist who now has a private practice - took 6 months to get titration right and prescriptions are now passed over to GP and 6 monthly reviews with the private practice.

It's a complete postcode lottery - and down to the views of the individual GP.

I had another GP in the same practice refuse to prescribe medication that my NHS consultant had asked for (for a completely different physical issue) - because she personally didn't approve... despite saying to me "I'm not an expert in this area so I don't feel comfortable" - well, no dear, that's why the prescription has been issued by someone who is an expert. The arrogance was quite something. Happily one of the partners at the surgery was more than happy and did a lot of eye-rolling over the waste of time and resources caused by his colleague's dislike of a particular group of meds that she admitted she knew nothing about.

So well worth shopping around for a more pragmatic GP or GP surgery.

BTW, Right to Choose also a postcode lottery - some areas are no longer allowing this as so many have used it due to the waiting lists.

It is entirely appropriate for a GP who feels that something is outside of their expertise not to prescribe as the medicolegal liability lies entirely with the person who signs their prescription and patronising comments such as 'well no dea' aren't helpful. Those GPs who will sign anything put in front of them are dangerous.

Disagree - it was extremely dangerous of her not to fill an existing prescription and leave me without medication that would have needed to be titrated down not just stopped abruptly.

I'm the daughter of a GP - he was horrified, as was the senior partner in my practice. If you are not comfortable because you have zero knowledge of that particular area then pass over to one of others in the practice, don't just refuse.

Consultant was also furious - they ended up getting me an emergency supply - so she wasted huge amounts of time and resources.

@bobomomo It's getting ridiculous now with just how low the bar is to get powerful stimulant drugs and nobody really knows the long term side effects

Well, given Ritalin has been taken since the mid 1950’s, I’d say the medical profession has a pretty good grip on this. Nearly 70 years experience with a medicine, which can pretty much also be extended to the class/newcomers of the same class (not all adhd meds belong to the same pharmacologic class though), and you don’t think anyone knows about long term side effects. Really?

Aren’t stimulants controlled medications in the UK? My son doesn’t take them anymore but when he did, his paediatrician had to call a government line and get an authorisation to prescribe for any new medication or dosage change and this authorisation then went on his prescription. So it makes it difficult for an unlicensed and unqualified person to dispense this class of medication. Also, the quantities dispensed were regulated, so you couldn’t get your repeat until the previous bottle was finished, so only every 30 days. I found the process very regulated, compared to other pharmaceuticals. This is in Australia where most ADHD treatment is private. Most specialists who do private also work in the public sector too.

I had my diagnosis on the NHS last year after an 18 month wait.

Where I live, there's an adult ADHD clinic who send out prescriptions to the local pharmacy (or you can collect directly from the clinic) so you just pay the normal prescription charge - or not if you're exempt.

Is there a facility like this where you live that you could switch to?

I'm not sure that discussing personal experiences or the ethics of whether too much prescribing is helpful to the OP.

There is obviously a huge range of personal experiences, across the UK but none of those actually help her because she's already explained what the decision is of her GP.

The only thing she can do is to discuss the financial side and the very frequent reviews with the dr treating her.

If they are aware of her situation they may agree to fewer reviews. They choose how often to do those and they are running a business.

@Justintimeee Contact the dr and tell them you can't afford reviews every 6 weeks, so what can they suggest.