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Prominent GP calls for end to prescribing charges

The NHS’s prescription charging system should be ditched in England because it is unfair and out of date, an editorial appearing in the BMJ has argued.

Dr James Cave, the GP who edits the Drug and Therapeutics Bulletin (DTB) journal, which is part of the BMJ group, said that exemptions linked to features such as age and pregnancy seem arbitrary, and some qualifying patients are allowed free prescriptions for illnesses that are unrelated to their main condition.

In his editorial, Dr Cave said: ‘Many such exemptions appear illogical and unfair, adding to our belief that the prescription charge is a poorly conceived, manifestly unfair tax.’

According to the editorial, NHS figures show that 90% of all medicines dispensed outside hospital in 2012 had no fee attached, and most were for patients aged 60 and above. About 80% of people aged 18-59 had to pay for their medicines, however.

Another discrepancy is that trusts have to pay the full 20% VAT levy on medicines dispensed from a hospital pharmacy, although VAT is not paid on prescriptions dispensed in the community, Dr Cave argues.

‘As a cost-saving measure, many hospitals discourage doctors in outpatient departments from prescribing medicines to patients sitting in front of them in their clinic. Instead, they are asked to write to the patient’s GP recommending the prescription.’

Dr Cave said that the £8.05 charge per is far higher than costs for off-patent drugs. A pack of 28 aspirin is 74p and the same sized pack of atorvastatin is £1.26.

The follows a Pulse investigation this week that showed CCGs are struggling with prescribing budgets.


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