The Pharmaceutical Journal
Vol 280 No 7487 p118-119
2 February 2008

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Letters to the Editor

Pharmacy practice

Patients should know the cost of their medicines

From Mr M. M. Furnell, MRPharmS

I recently surveyed pharmacy practice in other countries. Patients who are eligible to receive free or discounted medicines or who pay the full cost of their prescriptions are actively given details of the cost of their dispensed medicines in South Australia, in Ontario, Canada, and in some European countries.

In South Australia this system has been in place for approximately three years. My contact suggested that this practice has made some patients more accepting if their pharmacy did not stock a high cost item and they had to give a day’s notice to obtain it for them.

Similarly, in Ontario, all patients are given an official prescription receipt, breaking down exactly what costs the patient or their drug plan are paying, even for patients who receive free treatment. In parts of Europe the drug cost is printed on the manufacturer’s container label.

From recent personal experience, a patient who had brought his specialist injection with him into hospital but later left hospital without taking it home was surprised when I informed him that it costs £1,200 per dose and as it was his own from home we could not use it for anyone else; he soon returned to the hospital to retrieve it from the ward.

The research referred to in the “Prescribing costs in primary care” report from the House of Commons Public Accounts Committee (January 2008) was inconclusive about whether putting the medicine price on the box was helpful to patients. Comment from a senior Department of Health representative stated that they will be undertaking further research on the topic in terms of medicines waste.

In these days of transparency, I believe that patients have the right to know how much their drugs cost, and may even be interested to know this information. With the coming of the electronic prescription service it should be possible to print the cost of a dispensed medicine downloaded direct from the pricing bureau at the same time as the dispensed prescription is sent electronically to the pricing bureau.

Now may be the time to start the process rolling for this to be included in the software. That way the pharmacist can show the NHS price of the drug without having to disclose any confidential local contract prices and without having to take into account any on-cost allowances payable to the contractor.

Further research will show whether making the cost of a dispensed drug available to patients will affect medicines waste or change medication compliance. Is there information from the recent Australian initiative that can be shared? I think that the Royal Pharmaceutical Society should reconsider the report’s proposal and encourage the research.

Malcolm Furnell
Brighton

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