The results of a survey of PDA members reveals widespread occurrences of patients being unable to afford to pay for the medicines they need. The PDA is a member of the Prescription Charges Coalition, a group of organisations calling on the UK Government to scrap prescription charges in England for people with long-term conditions.

Currently in the UK all prescriptions are free of charge for people living in Scotland, Wales and Northern Ireland. However, there is a growing body of evidence which suggests that widening the scope of long-term conditions eligible for free prescriptions in England would bring about long-term cost savings for the NHS.

Paul Day, PDA Director, said “PDA members are naturally concerned when a patient is unable to afford their prescription charges, and tell us they will explain to the patient the consequences and outline available financial support.  However, this is an issue only government can fix.  Patients being unable to receive their medicines is a false economy, as it is likely to cause the NHS more in the longer term.

For example, a 2018 report by the York Health Economics Consortium, on behalf of Parkinson’s UK and Crohn’s and Colitis UK, found that scrapping prescription charges would save the NHS £0.8 million over 12 months for Parkinson’s sufferers and £20 million for sufferers with IBD over the same period1.

The report goes on to predict that waiving prescription charges for Parkinson’s and Crohn’s sufferers would also have a beneficial effect on reducing health complications, with 11.4% fewer hospital admissions, 9% fewer A&E visits and a 20.4% reduction in inpatient bed days. On top of these benefits there is also the immeasurable improvement to patients’ mental wellbeing.

The PDA survey garnered more than 350 responses altogether and the overriding tone was that pharmacists in England believe the system needed an overhaul to become fairer.  There was also support for rolling out prescription charges exemption to cover a wider array of health conditions than currently qualify.

Over 96% of Pharmacists surveyed said they had witnessed, first-hand, patients refusing to take away a part or whole prescription due to the cost involved. In spite of this initial refusal, 90% of Pharmacists still used their professional knowledge and judgement to educate the patient and persuade them of the benefits to be gained by purchasing and taking the medication. However, if the patient does not have the money to pay for the prescription, these discussions can be extremely difficult for all concerned.

These are situations in which Pharmacists do not receive a lot of training in and yet, in light of the current economic climate, is a conversation which could become all too familiar to our members as the general public look to cut back on spending as the economy suffers due to the pandemic.

Almost all Pharmacists that responded to the survey said that they recommended prescription pre-payment certificates to patients that struggled to meet the costs of their prescriptions, demonstrating an active willingness to do what is right by the patient in light of a system which 90% of respondents described as “unfair”.

Most pharmacists supported a widening of the long-term conditions eligible for prescription charges exemption, but there was also significant support for limiting the exemption exclusively to medications relating to the patient’s long-term health. Over 80% of Pharmacists in the survey felt that broadening the range of patients eligible for free prescriptions would lead to a reduction in incidents where patients decline prescriptions due to financial constraints.

Laura Cockram, Head of Policy and Campaigns at Parkinson’s UK who chairs the Prescription Charges Coalition, said: “We are grateful to the PDA for their contribution to the work of the coalition and to pharmacists for the work they do every day supporting people with long term conditions. We believe that together we can convince the government to remove these unfair charges in England for people with long term conditions.

Lynne Regent CEO of the Anaphylaxis Campaign, said: “For the people we represent, being unable to afford the cost of their medicines can mean that their life is at risk if they have a severe allergic reaction and have not been able to afford to pay for the prescription for their Adrenaline Auto Injectors.

Alison Taylor, Chief Executive of the Children’s Liver Disease Foundation: “For most children and young people with a childhood liver disease, daily medication is lifelong and life-saving. Unfortunately, prescription charges are introduced at a time when young people are transferring from paediatric to adult hospital services and also when they are trying to budget to become more financially independent. This additional cost is an added stress and we cannot risk these patients cutting costs by not taking their medication, especially those on immunosuppressants. Prescription charges are viewed as deeply unfair by our community as our young people are forced to pay for essential medication when others with long-term conditions do not have to. Medical exemption certificates are only available for a very limited range of conditions, based on a list that was produced in 1968 and is largely unchanged.

See the survey result analysis here:

thumbnail of PCC survey analysis

References: Prescription Charges Coalition. 2018. The cost to the NHS of prescription charges for people with long-term conditions. [ONLINE] Available at:

http://www.prescriptionchargescoalition.org.uk/ uploads/1/2/7/5/12754304/ a3_poster_of_all.pdf. [Accessed 1 October 2020].

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