Do you think this is right for a doctor to say this?

[MrsVeryIrritated]

Was advised by a consultant to have a change of meds for a condition which impacts my daily life. It is a gastro condition. This is a condition that the GP was not aware of as in the ins and outs of it. When I saw her she said to me " oh these meds are very expensive but then I guess that won't bother you?" I was so taken aback but did say to her "well they are the same cost as the ones I'm coming off".

Is it right for a doctor to say something like this? Would she say eg the same to someone who had to have meds for COPD or high blood pressure?

I presume it's something like biologics? I've never had a conversation with a medical professional who doesn't comment on the cost. They're very expensive and I'm just grateful that the NHS pays for them! I

It's a very strange things to say.

Although I'm not sure what difference the type of illness has got to do with it

I suspect it may be because due to not knowing much about it then they feel it's not a "real" illness.

Maybe it wasn't very tactful of her - not sure what you mean by comparing your condition to COPD or blood pressure?

Some medicines are very, very expensive and I don't think it's a bad thing that people are made aware of it. There is so much waste, people are prescribed medicine then don't take it, leave it to fester and be thrown away because it's "free".

I'm not saying that this is how you think or behave, but I do think generally people need to realise the expense and value of their treatment.

The cost of what they are prescribing is a significant part of a GP remit and sometimes they mention it to patients. It isnt unusual ime, but it can sometimes come across clumsily.

What I mean is that I don't think a GP would say to someone with COPD - you do realise these drugs are very expensive but then maybe they would? If a person relies on a drug to stay somewhat healthy then why say it? People with serious health problems will take their meds I hope!

I've never had cost mentioned to me in all of my 60 plus years but maybe that is a sign of the times. I'm wondering what she expected me to say ? Yes I know or Oh well I won't bother or maybe she was just being factual. All answers appreciated.

GPs can be strange about prescriptions. I wonder if they try to get their costs for expensive meds back by issuing prescriptions for things that are much cheaper than the cost of a prescription. A doctor once printed me a prescription for Ibuprofen - I asked if this was the same Ibuprofen I could buy in Tesco (at the time) for 20p and the GP said yes - so why try to get me to pay £9.30 for it (or whatever the exact cost was at the time) on a prescription?

Do you think she meant it won't 'bother' you in that you won't have to pay for it? As now more people are paying for e.g. insurance and / or ops / appts due to long waiting times?

Maybe that was what she meant in a clumsy way perhaps. My DH is on these type of meds, and I think they had to ask for funding for it via the hospital. Really helps him and hope they do too with you. Try not to worry about it.

As an aside, the med Humira which is the one DH has for crohn's has since come off patent apparently and is quite a bit cheaper.

If he hadn't had it he might have had major surgery which also would not have been cheap!

I have heard from several people they have been asked recently 'can you afford to pay for this privately' as some waiting lists are so long. EG for hip surgery.

I was prescribed a particular prescription item about 13 years ago, to replace two previous one, which weren't being effective after a serious medical issue.
The doctor who initially prescribed it said "These cost about £65 each" (a month's supply).
Which threw me a bit, but l assumed at the time that it was the best thing for me. I'm pretty sure that in the meantime if something cheaper, or maybe two cheaper items instead of the one expensive one, would do the job, l'd be given that instead.
It's never happened. I suppose sometimes only that particular thing will do.
It's not like the States, where apparently people expect to go to their doctor and ask for a particular thing. We trust our GPs to give us what we need, not what we expect.

Yep I wouldn’t take it so much to heart.

If it’s really bothering you, write a note to the practice manager explaining that you appreciate they are expensive but they are necessary, so perhaps there’s a better way to phrase whatever the GP was trying to get at. But keep the note light and cheery - they are not having an easy time.

I don’t think GPS being aware of cost is anything new, I can remember it being mentioned to be 30 years ago (admittedly because I was a dopey student who’d lost a packet of contraception pills, but still.)

This isn’t very new though. The waiting lists for hip and knee surgery have been epic for years.

I don’t see an issue with making patients aware of the cost of their medications.

ds is on one which is over £100 a bottle and has to be specially ordered. He needs it to stay alive so not having it isn’t an option but I don’t see the issue with being aware of the cost.

No I don’t.

Recently a GP mentioned needing to get things on a ‘special’ prescription as it’s not normally prescribed. It was medication for a young child which is normally only prescribed for adults but she mentioned it in the context of she needed to discuss with the pharmacist which medication would be the most suitable and available. I suspect it maybe more expensive but that wasn’t mentioned.

Oh I have had this before and in fact have done so - paid to see a consultant privately and then referred back into the NHS.

Thank you everyone for your comments. I won't be complaining about it as I am very grateful to the NHS especially being a pensioner.

They probably weren't thinking - you'd be gobsmacked how many people get prescriptions for such meds because they get free prescriptions and aren't willing to spend the 20p! GP's don't pay for meds, and the £9.30 (or whatever) doesn't cover the costs of issuing a prescription - there is the time of the doctor, the pharmacist, logistics, admin etc. So even if the drug is 20p, the prescription cost wouldn't cover the total cost. I suspect that the GP was so used to people on free prescriptions expecting every drug to be on prescription that they were simply of autopilot.

But GP's are also restricted both by NICE and Integrated Care Boards in what they are allowed to prescribe and cost is definitely a factor - they are pushed towards using cheaper alternatives, which is all very well if the drugs are exactly the same, but they are often either discouraged or prohibited from prescribing the drugs that people need in favour of cheaper ones that may be less effective.

For example, I suffer from a condition called Meibomian Gland Dysfunction. I have had it for many years but it has got significantly worse over the last 18 months or so following cataract surgery. The treatments that I have used and paid for meyself over the years no longer worked. And they weren't particularly cheap either - some £10 - 15 per item, which I could afford but which somebody not earning as much or out of work would struggle to pay. In days gone past, although I never did, you used to be able to get them on prescription, but doctors are actively encouraged not to prescribe them any longer. You must but them over the counter, which means many people having to choose to go without treatment. Once my eyes got to the stage were over the counter treatments didn't work, the doctor gave me a prescription for stronger treatment - which also didn't work. At that stage I was informed that there was nothing else that she could prescribe, because the health board would not allow her to prescribe better treatments because of the cost. In order to prescribe that she needed an instruction from a consultant. So the NHS spent a whole load more money, first sending me to a consultant who didn't have the correct expertise to deal with this, then to a second one who sent an instruction to the GP to prescribe what everyone knew needed to be prescribed! A whole load of money and time wasted to do what was known to be needed. Not because of the doctors but because of managers who aren't on the coal-face putting cost over necessity, thereby spending more in the long run.

Yes, I've probably over-thought it! I once had a trainee cashier trying to insist that I signed the back of my prescription, leading me to think that more people (within the demographic who need prescriptions) must get them free than pay for them.

Conversely, DH had a lovely surprise picking up a prescription a few weeks after his 60th birthday and finding he didn't have to pay for it (we are on a careful budget so a spare tenner or so is worth having to us!). I had assumed the age was 65.

Tell him not to celebrate yet. The Tories keep threatening to change the free prescriptions charge to the statutory retirement age.

@PlaitBilledDuckyPuss NHS prescription costs don't work like that. The GP doesn't get money back for a prescription for a cheap medicine. They get charged what it costs the NHS to dispense. Do in your case the best value is for GP to advise you to buy it.

Agree they had probably had a long day of people expecting prescriptions for cheap ibuprofen and Calpol.

After a Consultant prescribed expensive meds for me around 20 years ago, the GP said 'we'll just issue one box first to see how you get on with it as it's expensive'. The cost comes out of the GP's budget so I can see why they might be concerned when a Consultant prescribes the expensive ones.

I'd say they were being pass remarkable. And it's either you won't care- because you're not paying, or you won't care because you need them one way or another.