Scrapping prescription charges could drive up drugs bills

11 Mar 09

Prescribing rates in Wales have increased substantially more quickly than in England since the Principality abolished charges in 2007.

Figures obtained by Pulse for six common drug classes show that in five of them, prescribing rates increased faster in Wales than in England, while in the other the rates of increase were the same.

Last week the BMA demanded England follow the example of the other three home nations and move towards abolishing all prescription charges, labelling the current system as ‘outdated, iniquitous and detrimental to the health of many patients’.

But the new figures, provided by Cegedim Strategic Data, indicate removing charges could raise drug bills as well as trimming £500million from NHS revenues – perhaps by encouraging patients to get medicines on prescription rather than over the counter.

The biggest difference was in prescriptions for NSAIDs, which in England saw a 3% decrease between 2007 and early 2009, compared with a 13% increase in Wales.

Elsewhere, prescribing rates for all antibiotics rose by 7% in Wales in the same period, compared with just 1% in England.

Wales also had steeper increases in prescribing for PPIs, SSRIs and statins, while prescribing of inhaled steroids went up by the same proportion.

Dr Peter Fellows, a GP near the Welsh border in Lydney, Gloucestershire and member of the GPC prescribing sub-committee, said it was time to put an end to ‘the whole concept of postcode prescribing’.

‘It’s even worse now because there are differences between the four countries of the UK. It’s a question of levelling the playing field,’ he said.

In its submission to the Department of Health’s review of the long-term conditions exempt from prescription charges, the BMA called for an overhaul of the whole system to avoid creating ‘a new set of arbitrary winners and losers’.

The submission warned prescription charges could act as a disincentive to taking medication and that patients on low incomes but just above the exemption threshold were unfairly penalised.

It highlighted asthma and heart disease as often requiring medication over a prolonged period but not being exempt from prescription charges.

BMA chair Dr Hamish Meldrum said: ‘The system isn’t working and is unfair on many patients. Making the list of exemptions longer will not make it fairer. Abolishing charges altogether is the fairest and the simplest option.