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Practice nurses back overhaul of English script charging system

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Two thirds of primary care clinicians think the current exemption criteria for prescription charges in England should be widened to include anyone with a long-term condition, suggests a survey.

A similar proportion want the charges lowered or abolished altogether, according to results from the survey commissioned by the Drug & Therapeutics Bulletin.

England is the only one of the four UK countries to charge patients for prescription drugs.

There are, however, exemptions. For example, while some people with conditions such as diabetes and cancer do not have to pay, others with asthma and multiple sclerosis do.

The DTB survey, carried out by Think Media Consultancy in December, polled 1,800 GPs, practice nurses and community pharmacists.

“The criteria for medical exemption, set as long ago as 1968, are now strikingly outdated and highly inequitable”

Jackie Glatter

Almost two thirds, 61%, of the 416 respondents felt the current medical exemption criteria for prescription charges in England were inappropriate. A similar proportion, 66%, felt exemptions should be extended to cover all long term conditions.

Nearly 90% said the charges deterred some patients from requesting or cashing their scripts, and 74% said charges made prescribers more likely to extend the prescribing period for drugs for patients who have to pay.

Although more than 80% of respondents said they thought paying for medicines made the patient less likely to waste them than if they were free, 65% said the charges should either be lowered or abolished completely.

Overall, 70% were not happy with the current charging system.

One nurse commented: “People often don’t get all their inhalers as they cannot always afford them, hence they often have poor control of their asthma/COPD.”

“Any barrier to life saving medication has the potential to put the lives of people with asthma at risk”

Kay Boycott

Around 40 medical organisations and charities have formed the Prescription Charges Coalition, which is calling for all long-term conditions to be exempted from charges and is running a public petition.

Coalition spokesperson Jackie Glatter, from the charity Crohn’s and Colitis UK, said: “These findings add further weight to a very strong case for reform of the criteria for medical exemption from the charges.

“Our research shows that the cost of prescriptions is significantly affecting people’s ability to manage their long term condition effectively and to work,” she said.  

“The criteria for medical exemption, set as long ago as 1968, are now strikingly outdated and highly inequitable. Reform, to include all long term conditions, is well overdue,” she added.

Kay Boycott, chief executive of Asthma UK, which is also part of the coalition, said: “We support healthcare professionals calling for changes to prescription charges in the UK.

“People with asthma tell us they’ve had to choose between paying for their prescriptions and paying for food, fuel and household bills,” she said. 

“With three people dying of an asthma attack every day, any barrier to life saving medication has the potential to put the lives of people with asthma at risk,” she added.

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