The Pharmaceutical Journal
Vol 270 No 7239 p320
8 March 2003

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Another view of prescription charges [more]
At a glance — or at a peer? [more]

Another view of prescription charges

New rates for prescription charges for 2003–04 are likely to be announced imminently and they will come into effect at the beginning of April. The vast majority of people in the United Kingdom are exempt from charges, but there are many millions who are not and some of them find it a struggle to pay. As we have said previously (PJ, 15 June 2002, p826) in England and Scotland there is no political will to try to make the grounds for exemption more rational. The fact that some people with chronic illnesses are exempt from charges while others are not is based on historical precedent rather than clinical need. In Wales, patients up to the age of 25 are exempt, and the charges are currently frozen at least until after the elections to the Welsh Assembly take place in May.

In an "Agenda for 2003" article (PDF 45K) in this week's issue (p336), Dr Ellen Schafheutle examines prescription charges from a different angle: what is known about the impact of prescription charges on compliance. There is evidence from here and abroad that any charge is a deterrent, with people eking out their supplies by not taking the medicines as recommended and sometimes even choosing not to have a prescription item dispensed.

This is an issue that the Government needs to do something about. With so many of its strategies geared towards ensuring patients are given appropriate medication, particularly as recommended by the various national service frameworks, it makes no clinical sense to pursue one agenda while another acts as a disincentive. Dr Schafheutle is undertaking research to identify those patients most at risk of not taking essential drugs on the grounds of cost. Let us hope that this work will provide another piece in the jigsaw that will encourage the Government to overhaul the prescription charges system.

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At a glance — or at a peer?

New guidance for the design of labelling for medicines and their packaging was announced earlier this week (p321). Although it is to be welcomed as a way to help tackle medication errors, does it go far enough? Labelling should be plain, clear and should let patients, carers and health professionals identify at a glance the information to make sure that the medicines can be used safely — so said Lord Hunt when the guidance was launched. What a pity the guidance was not more specific and did not dictate, for example, that the drug name and dosage had to be set larger than the manufacturers' name or logo and in an easy-to-read typeface.

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