Prescription Charges Coalition
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Illogical and unfair: The National Pharmacy Association’s take on prescription charges

18/3/2022

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The current system of prescription charges in England affects the most vulnerable people in society and makes the health inequality in this country worse.

At the NPA, it’s been our longstanding position that people should not be denied access to prescription medicines on the basis of their ability to pay.  


As pharmacists, we understand the healing power of medicines. We also know from first-hand experience that people on low fixed incomes who do not qualify for exemption suffer greatly from the current system. 


From a pharmacist’s point of view, processing prescription levies is a task which adds workload but has no patient benefit. We are health care professionals and have no interest in being tax collectors! 


We also believe there would be little return on investment to the NHS from proposals to aligning the upper age for NHS prescription charges at 65 years old, due to the various operational costs. It could also lead to indirect cost to the NHS as people’s health suffers from making a reluctant choice not to take their medicines as prescribed. 


All prescriptions should be exempt from charges regardless of age or medical condition, as is the case in Scotland, Wales and Northern Ireland. 

Far more value for money can be achieved in the drugs budget by reducing waste and improving medicines use, for example through the NHS New Medicines Service, which has recently been expanded to include Parkinson’s, heart failure and stroke.


Pharmacists, like other health care professionals, experience great pressures on their time and they want to spend it with patients, not with paperwork associated with prescription charges.


​The National Pharmacy Association is glad to be part of the prescription charges coalition, seeking reform of this outdated, illogical and unfair system. 

Helga Mangion

Helga is Policy Manager at The National Pharmacy Association. 

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HRT prescription charges reduced - our reaction

4/11/2021

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We welcome the government's proposal that people needing HRT prescriptions will only need to pay once a year for their medication, and call on the Government to ensure this change also applies to men affected by Klinefelter syndrome (KS/XXY). This will significantly reduce the cost a person needing the medication will face, by up to £200 per year.
We pay tribute to Carolyn Harris MP for tabling the Menopause, Support and Services Bill as she has shone a spotlight on the unfairness of people getting vital medication for free in all other UK nations. We also thank all MPs who supported the debate and shared their experiences.
But thousands of people with other long term health conditions are still facing rising costs to simply live well and manage their condition. This is unjust and risks burdening our NHS, as medication remains unaffordable. 
Now is the time for the Government to overhaul the outdated prescription charges exemption list.

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Government consultation on prescription charges

19/7/2021

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The UK Government are consulting on aligning the prescription charge with the State Pension Age. This would mean that people in England would need to pay for their prescriptions until they're at least 66 initially and this would rise as the State Pension Age does.
We are opposed to this proposal as we don't believe the impact of it has been properly assessed for:
  • people with long term conditions who are not on the current exemption list
  • women
  • the over 60s
  • diverse communities
  • LGBTQ communities
  • deprived communities
We will be submitting a response to the consultation, which closes on 2 September and encourage all supporters to share their views as well.
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Prescriptions to rise to £9.35 on 1 April

26/2/2021

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Earlier this week the UK government announced they would increase prescription charges in England on 1 April 2021.
  • A single item will rise by 20p to £9.35
  • A 3-month pre-payment certificate will rise to £30.25 and 
  • A 12-month pre-payment certificate will rise to £108.10.
Chair of the Coalition, Laura Cockram issued a comment that has been picked up by several publications Wales Online, Bolton News and The Pharmacist.
We will continue to campaign for the government to review the exemption list and scrap the charge for people with long-term conditions.  
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Coalition activities in 2020

28/10/2020

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Laura, who chairs the Coalition shares what activities we've been doing this year

2020 has been a challenging year for everyone. As a Coalition we've come together several times to discuss and agree activities we could undertake to raise the profile of prescription charges and get the UK Government to commit to reviewing the exemption list.

Here are some of the things we've done this year to keep our campaign in the news:

In February we featured alongside Joanna, who has a liver condition, in a Radio 4 programme. Joanna shared how unfair and confusing the system is and I shared the Coalition's research and our call for the Government to review the exemption list.

In early March we issued a comment on the announcement that prescription charges were due to rise on 1 April. Our comment was picked up in The Metro and The Sun. 

In March we wrote to the Minister, Lord Bethell to urge him to suspend prescription charges during the pandemic. His response received in September ruled this out. We managed to get some media coverage for our plea. The Royal Pharmaceutical Society also supported our call. Jon Ashworth, the shadow health spokesperson raised our concerns in parliament.

Just as the charge was set to rise in April we issued another media comment, which was picked up in The Sun and coalition members shared our call for an urgent review of the charge on their social media channels. 

In July the story of Caiden was featured on LBC as his mother was worried about how he would pay for prescriptions. We shared our concerns and reiterated our call for the Government to take action to review the list.

We also asked supportive MPs and peers to ask questions in parliament about prescription charges.

Charities have been hit by the pandemic, so are rightly focusing their efforts on supporting their members. We continue to stay in touch and discuss how we can build our evidence and arguments to convince the Government they must take action and scrap the charge.

If you'd like to share your story or experience please email us.

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“Time to make it count”

29/10/2018

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The recent coverage of the NHS clampdown on “prescription fraud” coincided with the anniversary of my daughter’s death.

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​Emma had mitochondrial disease. It’s progressive and currently there is no treatment and no cure. There are only drugs to manage your symptoms and, with hope, prolong your life. Emma became ill at 21, at a time when the world should have been at her feet. She largely got her head around all that and dealt with her illness with tremendous courage, but she could not understand why she was also forced to struggle to pay for the prescriptions that were so essential to her when others were exempt. 

She worked reduced hours due to her illness and lived with her partner, a newly qualified nurse, so was not entitled to any help with charges.  The cost and injustice were too much for her to bear.  For her, the lack of exemption from prescription charges effectively invalidated her illness. It was as if the NHS was saying, ‘Other illnesses count, but yours doesn’t.’

When you support your child of any age through a serious illness, your desire to protect them grows ever stronger, at the same time your ability to do so grows weaker. When you can’t alter the big things – the illness, the prognosis, the pain your child is in – it becomes more important to try and at least change the things you can.  At first, we paid for the prescriptions ourselves, but Emma didn’t want dependence on her parents as an adult, so we decided to take it upon ourselves to collect Emma’s prescriptions and reluctantly, but purposely ticked the box that said she didn’t have to pay, because it seemed the least incorrect thing to do. We wanted to be held to account, to have our day in court, to pay the fine if we had to …  and to raise the profile of this injustice. We didn’t do it lightly, but couldn’t support such a system within the NHS – an NHS which we believed was about the burden of cost not falling on the long-term sick.

It’s astonishing that people with cancer had to pay prescription charges for their drugs until 2009 when cancer was added to the exemptions list ... the only time it’s been adjusted in 50 years. And yet people with illnesses just as devastating still pay for their vital prescriptions drugs every single day.  This is not about ‘my illness is worse than your illness’ in any way. This is about treating people fairly and equitably.
I have to speak for Emma and her feelings on this because she can’t: the illness that the prescription charge exemption didn’t acknowledge killed her last September, aged just 28. Her ‘long-term illness’ has ended all too soon.

The most we can hope for now is that Emma’s death will count. On Emma’s behalf, I ask you to please see how cruel and unjust it is to negate someone’s illness by not including it on the exemptions list.
We need outrage. We need the same outrage for Emma – and others like her with a whole variety of horrendous illnesses – that we’d have for people with cancer in this position. Having an unfair list of conditions which are exempt from prescription charges is simply not okay. 

We need a review. We need change – and we need it now.

Author: Christine Beal 
​
You can find out more about Emma's Mito Mission here 
​https://www.youtube.com/watch?v=KZVu61sFH6g

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The Government's response to our petition

24/8/2018

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Left to right: Jackie Glatter, Crohn's& Colitis UK, Derry Begho Asthma UK, Police Officer, Anushka Anand, NRAS, Emma Lawton Parkinson's UK, Matina Loizou Parkinson's UK, Hannah West MNDa.

The petition hand in

In June campaigners from Asthma UK, Crohn’s and Colitis UK, Motor Neurone Disease Association, National Rheumatoid Arthritis Society and Parkinson’s UK, took our petition to the heart of Government. Signed by almost 23,000 supporters, our petition called on the Government to scrap prescription charges for people with long-term conditions. Back in July we heard back from the Government about the petition we delivered to Downing Street.
The Health Minister, Lord O’Shaughnessy, said in his letter ‘The Government has no plans for a review of the prescription charging system in England. As you know, almost 90 per cent of prescription items are free on the NHS in England, and a broad range of prescription exemptions are in place’.

What is the issue?

This year marks the 50th anniversary of the Medical Exemption List which is the list that determines who is eligible for free prescriptions. Except for the welcomed addition of cancer in 2009, it remains unchanged. This means that several conditions are not included either because they had not yet been discovered (such as HIV) or those affected by it were sadly not expected to live into adulthood. It remains grossly out of date.
We know that many people are struggling to keep up with the costs of medicine they need to keep them well. Too many people are forced to make impossible choices between heating their home, buying food, or paying for their prescriptions. We know that this has an impact on medical adherence,33% of survey respondents told us that they have not collected their prescription due to cost.

The economic case

In May 2018, the York Health Economics Consortium published new findings that showed that scrapping prescription charges for just two long-term conditions (IBD and Parkinson’s) would save the NHS over £20 million a year.
Savings came from:
  • 9% fewer A&E visits for people with Parkinson’s
  • 11.4% less hospital admissions for people with Parkinson’s
  • 7,149 less flares for IBD
  • 3,887 fewer GP visits for people with Crohn’s Disease
These findings show us what we already suspected, scrapping prescription charges would in fact save NHS England money. At a time when budgets are tight, the Government should listen to evidence that shows the economic benefits of ending prescription charges for long-term conditions.

What's next?

The Government’s response is disappointing, but we are bolstered both by new evidence and your support- thousands of us will keep pressure on decision makers to revisit prescription charge exemptions.
As a coalition we are working hard to keep prescription charges on the public agenda. Last week, Clinical Lead for Asthma UK, Dr. Andy Whittamore, told BBC Radio 5 live how prescription charges were barriers to people accessing life-saving medication (listen from 0:38)

Support our campaign

Our campaign doesn’t end with the petition hand in. You can help us by meeting with your local MP to discuss how prescription charges affect people with long-term conditions. Download our lobby pack - a complete guide with useful information and tips on meeting with your MP.

You can also keep up to date with all of our latest campaign work by signing up to our mailing list. 
DOWNLOAD THE LOBBY PACK


Author

By Anna Argyrides, Policy and Campaigns Assistant at Parkinson's UK

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One birthday I won’t be celebrating

1/6/2018

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I was born in 1968 and so was the medical exemption list. This list decides who pays prescription charges and who doesn’t, but I didn’t have a say in getting Parkinson’s.

I was diagnosed with Parkinson’s aged 9, though I’ve had the symptoms since I was 7. Fortunately for me I had a working tax credit exemption until recently, which meant I didn’t have to pay for the more than 200,000 tablets I’ve taken in my lifetime.

Since losing that exemption I’ve had to ration my medication to spread the cost, prioritising the most urgent ones and leaving others for later. I now pay monthly through the prepayment scheme. It’s stressful because I can’t live without my drugs. I’ve been on levodopa for so long that my body couldn’t cope without it.

I’ve had to start counting the pennies more and more. I resent paying it as it could still cost me thousands throughout my life and there is nothing I can do about it! I’ve worked for as long as possible and paid my national insurance contributions, so it’s galling to think that I’m being treated differently to other people whose long-term conditions are exempt.

Last summer I shared my story as part of the Prescription Charges Coalition launch of their report Still Paying the Price which found that among those like myself currently paying for prescriptions, a third had not collected medications due to the cost. Others reported skipping or reducing their doses to save money – leading to worsening health, time off work and emergency hospital admissions.

New research published just last week by the York Health Economics Consortium now shows that for people with Parkinson’s (and inflammatory bowel disease), charging for prescriptions is a false economy to the NHS. By removing prescription charges, people like me are better able to stay well and avoid health complications- which would mean fewer GP visits and emergency hospital admissions. For each working age person with Parkinson’s the NHS would save £93 per year by scrapping prescription charges.

Next week the medical exemption list will be 50 years old- but I won’t be celebrating. It is time to change this unfair and outdated system. Add your voice by signing up to the Thunderclap.

​Matt Eagles @MattEagles

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The economic case for scrapping prescription charges for people with long-term conditions is here!

25/5/2018

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Everyone involved with this campaign has known for a long time that the additional costs to the NHS, resulting from people with long term conditions not taking their medication due to its cost, were likely to outweigh the money raised by charging them for the prescription they need. 
Thousands of people effectively told us so in our first Paying the Price survey back in 2013 and then again last year in the follow up report Still Paying The Price. 

Nevertheless, it was still amazing to see the scale of that potential saving to the NHS when the York Health Economics Consortium first shared the findings of their economic modelling with us.  Over £20 million per year in NHS savings for just two conditions of the 46 now covered by the Prescription Charges Coalition.  This gives us for the first time, a robust economic case for scrapping prescription charges for all long-term conditions.
​

It was fantastic to be able to share this with MPs in Parliament this week (Weds 23rd May).  Thanks to the invaluable support from the many people who wrote to their MPs to attend this briefing session, 41 MPs and 3 researchers attended, many of whom were very interested and willing to give their support to the campaign to end unfair prescription charges for people with long-term conditions.  Other MPs wrote to express their support and willingness to write to the Minister to call for reform.

We now need to build on this. 
On 5th June, we are handing the petition into Downing Street – please help make this the strongest it can be by signing if you have not already done so and forwarding on to family, friends, work colleagues and anyone you think might be interested. 
​
Thank you for all your support and please continue to help us to make prescription charges an issue that can no longer be swept under the carpet.
​
Jackie Glatter, Health Service Development Manager, Crohn's& Colitis UK

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The Injustice of prescription charges for kidney patients

11/5/2018

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Right now, in the UK, there are about 60,000 people with kidney failure, with just over half alive due a kidney transplant and the remainder on dialysis.

Transplant is the gold standard treatment for kidney failure, but not everyone is able to have one and sadly there are more people needing a kidney transplant than there are kidneys available via the organ donor register. Every single day, one person will die while waiting for that precious call.
 For those 29,000 people on dialysis, they need either to go to hospital three times a week for 3-4 hours at a time for their life-sustaining treatment or they can do this at home. Either way, dialysis is a very challenging treatment. People on dialysis often have other conditions to manage, such as diabetes, and many people will feel unwell during and just after dialysis itself, as blood pressure can be too high or too low, and nausea, fainting and confusion are common.

Currently, some dialysis patients will qualify for free prescriptions, but this – rather complicated – exemption is based on the fact that any dialysis patient who has a permanent fistula (which is access for dialysis needles) that ‘requires an appliance or surgical dressing’ is entitled to medical exemption. They also need a doctor to confirm this and the NHS guidance on this even states that ‘whether or not you have a permanent fistula that requires an appliance or surgical dressing is a matter for your doctor's clinical judgement’. This means that in some cases a doctor will approve patients for exemption, but in some cases, they may not – based on their own interpretation of the rules. We have heard from a number of dialysis patients who were able to get exemptions and others who were not, so we know that there is a postcode lottery out there with some patients slipping through the net.
 
If that isn’t bad enough, the injustice really kicks in for those people who do receive that life-transforming transplant. To ensure that your body doesn’t reject your new kidney or kidneys, transplant recipients have to take immunosuppressant medication for the rest of their lives. They also need to take many other medicines to manage blood pressure, diabetes and the other conditions a person with kidney failure will have. Despite this, because they are now no longer on dialysis, they no longer qualify for free prescriptions. At the time when a person possibly needs it the most, this support is taken away.

Many patients go on to purchase a Pre-Payment Certificate, but they tell us how unfair it is and how they feel discriminated against, or that they were not aware their exemption was removed and have had to pay a fine. This group are also affected by the recent reports that the NHS will no longer provide sunscreen on prescription, as their immunosuppressants give a risk of skin cancer which is six times higher than the rest of the population.

It is not fair that anyone with a long term health condition should have to pay for their prescriptions and we think the current system is particularly unfair for kidney patients, who need to take medication for the rest of their lives, just to stay alive. We’re calling on the Government to review and reform this unjust and outdated system to make prescriptions free for everyone living with a long-term condition in England, as they are in other parts of the United Kingdom.
here to edit.
​
Fiona Loud, Policy Director at Kidney Care UK

SIGN THE PETITION NOW
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The Prescription Charges Coalition is chaired by  Cystic Fibrosis Trust and the National Rheumatoid Arthritis Society.
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