The Pharmaceutical Journal
Vol 270 No 7241 p401
22 March 2003

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Letters to the Editor

Prescription charges

A £1 levy for all would be better than a charge

From Mr A. R. Korsner, MRPharmS

Your recent "Agenda for 2003" article, "Do high prescription charges undermine compliance?", prefaced by "Prescription charges are likely to rise as usual this April ...", reinforces my view that "charges" are pointless and ineffective for the purpose they are intended.

No one can be unaware of the problems posed to low wage earners when faced with a payment of £18.60 for a three-item prescription. Many times every day, in the hospital outpatient pharmacy where I am currently working, I find myself needing to counsel patients on what they might not need, alternative preparations, or what is cheaper to buy in a pharmacy (while others wait and get frustrated). Many patients are earning the minimum wage and three or four items represent almost a day's net take home pay. One feels desperately sad to take the money from them. On the other hand a vast majority of our patients are unwaged and pay nothing at all.

I would prefer to see a prescription levy. Few would, reasonably, not be able to afford a levy of £1 an item yet most would not think it worth paying if it were for something they did not really need.

A levy is the ideal way to discourage the far higher cost of medicines waste. I shudder when I see the quantity of returned drugs and appliances and work out the costs of their destruction. I get even more upset and frustrated when I think that that money could be more usefully allocated.

With no exemptions and everyone paying a nominal fee, administration would be simplified (community pharmacists lose so much money here). I think more money would be collected overall and the savings, as a result of less waste through over-prescribing and admission to hospital, would be significant.

Patient outcomes and benefits would also improve.

Am I the only person who can see this?

Adrian Korsner
London N20

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