Imagine being told by your GP that after months of ill-health all the tests confirm that you have a life-long condition.
You may have to change your life to cope with your symptoms and have regular medical appointments. And what about work – how will they take it if you need to drop a shift at short notice because you’re unwell? Medication will help but as you are in work, not on benefits and live in England, you’ll need to pay £8.80 for every item on your prescription. How’s that going to affect the family finances?
As a community pharmacist I often hear exactly these kinds of concerns from people who come in clutching a prescription and needing advice. They’re not alone – around 15 million people in England have a long-term condition.
Some long-term conditions attract the prescription charge, but others don’t, which is deeply unfair. This situation has arisen because the list of those exempt from prescription charges was set up 50 years ago and hasn’t changed since. It was established at a time when people with certain illnesses weren’t expected to live that long and other conditions hadn’t even been discovered yet, for example genetic disorders, some autoimmune diseases and HIV.
Large scale surveys of patients http://www.prescriptionchargescoalition.org.uk/evidence.html consistently show that 1 in 3 people who work and have a long-term condition struggle to afford their medicines. Some have to ration the medicines they take. People frequently say to me about their prescription “I can’t afford all of these – which one can I do without?” Others have to choose between paying for their medicines or household bills. They face medicines poverty because they have an illness they don’t want.
The same surveys show that around 1 in 5 people with a long-term condition don’t buy a pre-payment certificate, https://www.nhs.uk/NHSEngland/Healthcosts/Pages/PPC.aspx a kind of season ticket for people needing regular medication, because they feel they don’t get enough prescriptions to benefit from one. This is particularly true if your condition fluctuates and some months you need a lot of medicines and then others you don’t. Buying a pre-payment certificate is also beyond the means of many at £104 per year. If you are on a zero hours contract with a variable monthly income, paying regular instalments for medicines you may or may not need that month becomes a luxury you can’t afford.
It’s true that the NHS needs more money. Often people think the prescription charge goes directly to the pharmacist, or goes to help the NHS. It does neither. It goes into the Government’s tax pot to use as it likes.
Prescription charges act as a tax on the sick that impacts on people’s health. If you can’t afford to take the medicines you need regularly and you become really unwell, the Government ends up paying for the knock-on expense of hospital admissions and at around £400 a day for a hospital bed that’s a significant cost. This isn’t a party political issue. The problem has existed for decades.
The Prescription Charges Coalition is an organisation made up of 40 charities campaigning to abolish unfair prescription charges for people with long term conditions. It is calling on all political parties to abolish the unfair list of selective medical exemptions drawn up in 1968 and ease the financial burden on those least able to pay, improving health and reducing costs in the long-term too. Join the campaign today by signing the e-petition https://e-activist.com/page/19623/petition/1?ea.tracking.id=PCC today and help end medicines poverty for those with life-long conditions who can’t afford to pay for their medicines.
The reason for Poppy’s morning struggle? Ankylosing spondylitis (AS), a form of inflammatory arthritis which most commonly affects the spine. It can also affect other joints, eyes, bowels, skin, lungs and heart. At best, AS can be managed with anti-inflammatory drugs and exercise, but at its worst, a combination of strong medications is necessary.
Poppy was diagnosed with the condition three years ago, after showing symptoms from the age of 13.
Poppy gets on with life as best she can, studying at Manchester Metropolitan University and working part-time to support herself through uni. She is supported by her partner Ben, who Poppy describes as “amazing”. Her university is understanding, but teachers and peers will never know just how painful life can be with AS – even something as simple as sitting in the wrong type of chair can cause incredible pain and discomfort. Despite this, Poppy maintains a positive, proactive attitude.
She has, however, seen some dark times due to AS. Over the years she has been prescribed a huge number of different drugs to help her with her daily pain and fatigue. Poppy also is also hypermobile, meaning her joints painfully move beyond the normal range, and lives with fibromyalgia, a long-term condition that causes pain all over her body. As such, it took a long time for her consultant to be able to find the right combination of drugs. At one point, Poppy was on seven different drugs to combat her condition.
The monthly cost of these prescriptions was £61.60 – an unaffordable sum for a student working part time. This meant that she often skipped her medication for two to three weeks at a time, forcing her to miss lectures due to pain and her inability to move.
Without medication, so many people with ankylosing spondylitis like Poppy don’t have the quality of life that people who don’t live with a long-term condition do. Please support those who need it by signing the petition, which calls for the medical exemption list to be revised and include free prescriptions for all those living with a long-term condition.
For more information on ankylosing spondylitis (axial spondyloarthritis) visit www.nass.co.uk.
The world has changed remarkably in the last 50 years, especially in terms of medical and technological advances. In many ways, this is extremely positive for people with Crohn’s Disease, Ulcerative Colitis and other long-term conditions. Greater understanding, more drugs and new surgical techniques have transformed the options and outcomes for people who are living with Crohn’s and Colitis compared to 1968, when the prescription charge exemption criteria were created.
However, there is still no cure available and, in fact, the more we find out, the more complex these conditions turn out to be. What is particularly difficult is that people with similar symptoms often respond differently to the same treatment, which means it can take months or years of pain and frustration to arrive at a treatment that works and, even then, this may fail over time.
We have been told by the Government that the records no longer exist which would explain why certain conditions were included or excluded from the prescription charge exemption list. What we do know is that, because the list hasn’t been comprehensively updated for 50 years, it is completely out of step with changes in the management of Crohn’s and Colitis and many other conditions besides.
In one of the peculiar quirks of the system, those who have a permanent stoma (an opening on the wall of the abdomen that diverts the contents of the bowel out of the body) are eligible for free prescriptions, while those with Crohn’s or Colitis who require continuous medication to manage their condition are not. All clearly face a significant additional cost burden throughout their lives and it is crucial that this is recognised.
This arbitrary distinction makes no sense today and is leading people to self-ration medication they need to keep them well. As a result, flare-ups can occur and can result in people needing stronger and more expensive treatment, potentially leading to surgery and an increased risk of colorectal cancer. This affects their ability to work and can have a devastating impact on family, social life and an individual’s self-esteem.
The current language of the NHS is focused on ‘value’, ‘medicine optimisation’ and ‘self-management’, yet this archaic and inequitable system of charges and exemptions is entirely counterproductive to these aims and it is high time that it was overhauled by the Government.
It’s time for change. It’s time to end prescription charges for people with long-term conditions.
A Freedom of Information Request by Moneysavingexpert.com found around 800,000 people are overpaying by an average of £50 a year because they do not have a prescription prepayment certificate.
Matina Loizou, Co-Chair of the Prescription Charges Coalition, has been quoted in the Telegraph: “It is unacceptable for the NHS to say they are helping by offering a discount they fail to promote.
“While prepayment certificates offer some relief to those who can afford the upfront cost, they are not widely publicized. We speak to people who are forced to choose between purchasing medicine and heating their homes: something has to change.”
Commenting on NHS England’s consultation, launched today, which proposes to rein in prescriptions for many over-the-counter products, Matina Loizou, Senior Policy and Campaigns Adviser at Parkinson’s UK and Co-Chair of the Prescription Charges Coalition, said:
“NHS England has decided to play the role of Ebenezer Scrooge this Christmas by launching this cruel consultation.
“If seen through, these proposals would be a catastrophic blow to some of the country’s most vulnerable and unwell people who rely on a variety of medication and treatments to live, work and be well.
“We’ve heard distressing and alarming experiences from people who are facing impossible choices over whether they should eat, heat their home or pay for essential medications. Expanding the list of products unavailable via prescription will increase the financial burden on people throughout the UK who have already suffered enough.”
To read more about the consultation, please follow this link.
Commenting on proposals to reinstate prescription charges in Northern Ireland, Matina Loizou, Senior Policy and Campaigns Adviser at Parkinson’s UK and Co-Chair of the Prescription Charges Coalition, said:
“The reintroduction of prescription charges in Northern Ireland would be a blow to some of the country’s most vulnerable and unwell people who rely on medication to live, work and be well.
“In England, where prescription charges are still in place, we’ve heard distressing and alarming experiences from people who are facing impossible choices over whether they should eat, heat their home or pay for essential medications to treat life-threatening conditions.
“It’s a travesty that prescription charges in England are preventing people from getting the treatment they need, and alarming that Northern Ireland would consider reinstating prescription charges even in a budgetary outlook.”
For further information on the proposal, please follow this link.
How to make a ‘blistering reality’ Christmas card:
On 20th October, the BBC's Rip Off Britain investigated why England is the only home nation to pay for prescription charges. The programme looked at case studies from people with long-term conditions in England and Scotland. It featured the Prescription Charges Coalition Co-Chair, Matina Loizou from Parkinson's UK, discussing the negative effects of prescription charges on people with long-term conditions in England.
You can watch the episode here.
Do you live in England and have to pay for prescriptions for your long-term condition? We'd love to hear from you. Email us your case study at email@example.com.
Last month we launched our new report Still Paying the Price, showing that people with long-term conditions in England are still struggling to afford the cost of their prescriptions. Many are sacrificing their health or other essentials just to get by.
We found that among those currently paying for prescriptions, a third had not collected medications due to the cost. Others reported skipping or reducing their doses to save money – leading to worsening health, time off work and emergency hospital admissions.
By lobbying your MP you can join the fight to get everyone with a long-term condition exempted from prescription charges. It would make a huge difference to people like Matt, who spoke to us about his experience:
“I’ve had Parkinson’s symptoms since age 7 and started receiving treatment aged 9. Luckily for me I had a working tax credit exemption until recently, which meant I didn’t have to pay for the more than 200,000 tablets I’ve taken in my lifetime – the cost would have been enormous.
Since losing that exemption I have to order my medications piecemeal to spread the cost, prioritising the most urgent ones and leaving others for later at the pharmacy. It’s stressful because I can’t do without them – I’ve been on Levodopa for so long that I’m told my body wouldn’t cope without it. As a result I’ve had to start counting the pennies more in other areas of my life – not going out as much, not buying as much food and worrying about the cost of my son’s school trips.
I’ve worked for as long as possible and paid my national insurance contributions, so it’s galling to think that I’m being treated differently to people whose conditions are exempt. Parkinson’s is a chronic condition that will never get better, and the medication costs can quickly add up. I have to take extra medicines just to control the side effects (like dyskinesia) of my Parkinson’s drugs. I don’t understand how the people responsible for dispensing medications can’t see that it should be exempt.”
Matt was born in 1968, the same year that the medical exemption criteria for prescription charges were created. The fact that they have been amended only once since then (to include cancer) means that almost 50 years’ worth of advances in medical technology and treatments have been ignored in deciding whether Matt should have to pay for his prescriptions.
You can support people like Matt by talking to your MP about these issues. Download our comprehensive lobbying guide to find out everything you need to know.
With your help we can win the fight to end prescription charges for people with long-term conditions.
"Next year will mark the 50th anniversary of the creation of the medical exemption list, and we’ll be campaigning harder than ever to secure an end to prescription charges for everyone with a long-term condition.
To make that campaigning effective, we need up-to-date information on how prescription charges affect the lives of people with long-term conditions.
By taking our new survey you’ll be contributing valuable evidence and bringing us one step closer to securing free prescriptions for everyone with a long-term condition. People like Heidi, who shared her experience with us.
“I’m forty and have Parkinson’s I take 36 tablets a day, as well as wearing a medicated patch. I also take a lot of pain medication for dystonia. I have a total of 19 prescriptions which is £160 per month or £1915 per year. I currently pay over £100 a year for the pre-payment certificate, which is cheaper than buying the medicine individually. However I think what isn't taken into account is the hidden cost of living with a long term condition like Parkinson's. I catheterise 3 times a day. To do this I need disposable gloves, and antibacterial wipes. I need to use alcoholic gel when washing my hands, which I do about fifteen times a day. I also had to pay for an attachable light due to poorly lit disabled toilets. The NHS only supply the catheter."
"Parkinson's has caused me to lose a lot of weight very quickly. As a result, I'm under a dietician and am advised to have a protein shakes and supplement drinks daily. Protein powder costs around £50 per pot. I have difficulty swallowing which means I need to drink thickened drinks, so when I'm out and about, I’ve had to buy a protein shaker style drink bottle to be able to thicken up the liquids I’m drinking. I want to stay healthy, and my GP and neurologist said vitamins would be a good idea, these cost me about £97 per year. To help my mobility there are numerous aids I have been advised to buy, for example a foam roller £40, walking poles £70, yoga equipment £100, gadgets to help undo jars etc. All these things mount up, and with the added cost of individual prescriptions or the pre-payment certificate it’s really expensive to keep my condition under control.”
Please support people like Heidi. If you have a long term condition and currently pay, or have paid in the past, for your medication (or you pay for the pre-payment certificate) spare 10 to 15 minutes and fill in our survey.
You can also share the survey with your friends and family, and on social media. The more people we hear from, the stronger our case for change will be.
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