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.

@ForeverDelayedEpiphany *
I disagree. I think they do know what the drugs do, but don't like to admit thd harm they cause when they go wrong. My neurologist said I needed to actually avoid any medication like ADHD or epilepsy meds as they will make my movement disorder symptoms worse (and these medications are potentially a cause of my movement disorder too, as an adverse effect)*

All medicines are used on a benefit/risk basis. All medicines have the potential to cause side effects to varying degrees that differ across individuals. These medicines are no different and should be scaremongered no more than any other medicine. You know that if paracetamol was developed today, there is absolutely no way it would pass the benefit/risk assessment by any regulator, and this is widely recognised. So, you could argue one is safer/better than the other if you want on that basis but of course it’s more nuanced. Ritalin is long off patent. There is no real advantage for anyone, drug companies, regulators, the medical community to partake in such a ‘cover up’ for such an old medicine, that’s now cheap as chips. That philosophy extends to others in the same class (so not all adhd meds). It’s all about anticipated benefit versus anticipated risk. No one is saying it, or any medicine, is risk free. But it’s a case of weighing up the risk without a medicine.

The private doctor who diagnosed my some with adhd and autism recently told someone I had referred to them that their child did not have adhd and gave them parenting leaflets! It’s not a certain thing to get a diagnosis if you go private.

Actually NHS isn’t best, it’s a shit show at best!

it’s no longer fit for purpose, it’s not making adult diagnoses because most people give up waiting (not just with adhd). It’s full of idiots with no understanding about mental health.

the NHS has failed, it’s dead but we are refusing to let it go!

Theres a few posts on here already and I can't see that this has been suggested yet BUT have you looked at Presription Prepayment Certificate that the nhs offers? Its a monthly payment of about £11 per month, it wont sort out the problem with getting repeat prescriptions but it will cut the cost of the actual meds....

You can sign up online or at some pharmacies

The problem is you needed to be diagnosed by a psychiatrist who also works in the NHS and will do shared care

Ridiculous that some of them don't do this - they're either clinically able to diagnose you or they're not

Mine was too. My GP still won't accept shared care and waiting time for ADHD assessment on NHS is literally years. It is an absolute joke.

There’s a lack of knowledge about shared care here.

All GPs will do shared care. They just might not do it with a private psychiatrist.

Hi my Gson is waiting for Dr's refferal, he is 14, possible Autism, ADHD, been waiting 10 months - anyone know what going Private involves? Other services also involved, daft system as nothing links up and you have to keep repeating everything as nobody seems to read up on case before appointments.
Any help would be great ir ideas for help.
Thankyou

This is the reason. If an NHS GP writes a prescription they are legally responsible for the decision to give you medication. So if they do not trust who has diagnosed the condition, it is too big a risk to give a prescription.

Or, as has been suggested, these private providers set their bar far too low.

@WriterOfWrongs I was told as long as you found one that observed NICE guidelines the NhS would take it over .. that worked for us but I understand adhd meds are different

My adult child was told by the GP to fill in the Psyche UK questionnaire, results were then sent to the GP. They were then referred to Psyche UK to be put on the waiting list for assessment.
Does this mean they will initially paying private until the meds are stabilised then the GP will take over with shared care or does it mean it is all through the NHS? I’m finding the right to choose conditions a bit confusing.

This is possibly wasting time as I can be of no help whatsoever. I just wanted to express my horror and sympathy which are in equal measure. Would this sort of treatment be available through BUPA or some such private medical cover? I am not sure about the rules if it's a pre established condition however if it were viable I would think it still cheaper than the exorbitant fee at the moment.

Was that specifically shared care?

Regardless, as you say, ADHD meds are different. 3 big factors why:

• they’re controlled drugs. Unlike SSRIs, you can’t take them into every country. They’re regulated worldwide to varying degrees.

• they are much more expensive than SSRIs.

*the demand on the NHS for shared care with a private psych for ADHD meds is much, much greater then the demand on the NHS for shared care with a private psych for SSRIs.

NHSE rules on shared care very clearly state that it only starts when consent has been given by the GP and it is up to the consultant to give enough meds until then. So the consultant should have been aware of that and made sure that they had enough - very cheeky to be 'furious' when it was in fact them who failed the patient.

Private health insurance rarely covers mental health, if so often very restricted cover, and I don't know any that cover neurodiversity.

They need to ask their GP if they will share care with Psychiatry UK - it's a practice by practice decision.

https://www.adhd-360.com/cqc-reports/

• not getting the necessary physical measurements
• poor governance
• poor documentation of reasons for prescribing decisions
• poor compliance with mandatory training
• poor complaints managing and emergency planning
• no audits
• manager didn't understand their role and legal responsibilities regarding data protection
• patient concerns not listened to

It is companies like this which give private ADHD assessments a bad name

Except that these were meds I'd been on for over 14 years and the GP had been happily doing all the repeats. Right up until I went to pick them up and chemist said it had been refused.

Couldn't get an appointment for over a week so had to get Rx from the consultant. Turned out a new GP had arrived in the practice and while admitting she knew very little about the condition or the medication she just abruptly stopped the prescription - not even a call or a text to say she was doing it.

Fair enough - wasn't clear that this was long-standing meds, that's not good.

I completely disagree and would argue that this is a very simplistic viewpoint that fails to recognise that mental health can impact the public purse in far more varied ways than just the NHS.

Currently, the NHS can only manage extreme cases. This is not just a question of capacity of psychiatrists it’s also a matter of funding. Many people who struggle to get help on the NHS and go private would not be able to work if they did not do so. I’m not wealthy by any means I just don’t have a choice. It’s much cheaper for the state to provide medication than it would be to provide housing and benefits.

Then I want to address this fallacy that private psychiatrist are solely motivated by money and NHS psychiatrist are inherently better. Only a truly unwise person is going to pay money to see someone inexperienced. My psychiatrist has 30 years of NHS experience, why should his diagnosis be questioned by someone who is likely to be less senior. That would be a complete waste of funds.

I agree that an NHS trained Doctor should put a certain amount of years into the NHS. However, psychiatry on the NHS is a very hard profession. I don’t think it’s inherently wrong for doctors to decide after a certain period of time that they would rather work with easier clients.

Luckily there are other non classified POM medications and stimulants that work well with ADHD and much easier to obtain, but you have to do a lot of research which admittedly might be tricky with ADHD.

The bar is set so high to save the nhs money. The panorama documentary was poorly run as the man who was tested told the adhd companies different things to what he told the nhs. No consistency. My son’s nhs exam (which I witnessed some of) was run like a police interview, very strict, very dismissive. The private company was relaxed and got to know my son first before any questions. Why would we pay over £2000 so far if we didn’t think it was working? Within 1 hr of taking meds my son was able to sit and concentrate on college work- I’d never seen anything like it.

The bar is set high because these are potentially dangerous drugs that should be carefully prescribed.

ADHD does not always show in childhood- if a child’s needs are all met and they are bright then it doesn’t always show ie emotional needs, dietary, enough sleep and lots of exercise. Take 1 away or add something into the mix and then it can become exacerbated. My sons didn’t show til he was 15- when he was diagnosed with Crohn’s.