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Plan to scrap prescription charges for long-term conditions

By Nigel Praities

Government advisers are considering proposals to make prescriptions free in England for everyone with a condition lasting over six months.

Pulse understands the option is one of a number to have been discussed by a review panel set up by the Department of Health to implement its pledge to abolish prescription charges for long-term conditions.

GPs would judge when a condition had lasted over the time limit under the approach, which has been criticised by the BMA.

An alternative proposal would set a maximum spend limit on prescriptions beyond which everyone became eligible for free prescriptions.

Pulse learned of the proposals as the first research to compare the effect of abolition of prescriptions charges in Wales found the policy did not appear to have fuelled rising dispensing rates.

The Welsh Assembly Government-sponsored study, which has also been submitted to the DH review panel, surprisingly found dispensing rates were rising higher in the North East of England than in Wales.

Professor David Cohen, professor of health economics at the University of Glamorgan and lead investigator on the Wales-PREFERS study, said he had found little evidence that abolition of prescription charges resulted in people taking more medicines than before.

‘An analysis of all drugs in the BNF showed there was an increase in dispensing in both Wales and the North-East, but incredibly the increase in the North-East was actually higher than in Wales,' he said.

The study found a small increase in the dispensing of drugs commonly charged for, but this was a small percentage of the number of overall prescriptions.

Professor Cohen said the study was being considered by the chief medical officer and made English proposals to limit free prescriptions to patients with long-term conditions look foolish.

‘There are always going to be anomalies and any attempt to shift them will result in anomalies somewhere else. The literature says that is tinkering and is a waste of them and that is exactly what England is doing now, in my view,' he said.

The BMA also favours the approach taken in Wales where prescriptions have been free for everyone since 2007.

‘Administering free prescriptions for patients with conditions lasting over six months would still involve unnecessary and costly bureaucracy,' a BMA spokesperson said.

‘The BMA remains firmly of the view that the abolition of all charges is the fairest, simplest, and least bureaucratic option.'

Dr Bill Beeby, chair of the GPC's clinical and prescribing subcommittee, said the proposals would create another layer of expensive bureaucracy.

‘I am not sure how GPs can define a long-term condition in a way that you can fairly say they can be exempt. Under this, there will be all sort of things that can be classed as a long-term condition, such as insomnia. Should sleeping tablets be free?'

Prescription charges in the UK

April 2007 - Prescription charges abolished in Wales

Jun 2007 – Scottish Government announces phase-out of prescription charges, with reductions in cost year on year until they are abolished in 2011

Sept 2008 – Northern Ireland Assembly announce plans to abolish prescription charges by 2010

Sept 2008 – Prime Minster Gordon Brown announces free prescriptions for all cancer patients at Labour Party Conference and sets up review panel to look at abolishing charges for all patients with long-term conditions 'at some point in the future'

Dec 2008 - Prescription charges cut from £6.85 to £3 in Northern Ireland

Mar 2009 – Prescription charges rise in England from £7.10 to £7.20, while Scottish prescription charges fall from £6.85 to £5.00

Summer 2009 - Prescription Charges Review due to report to ministers on their findings

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