Survey reveals patients skipping meds due to cost is leading to secondary health issues and more sick days24 March 2023 As prescription charges are set to rise this April, a bombshell survey of 4,000 patients with long term conditions has revealed that one in ten skip medications due to cost. This has led to almost a THIRD of those developing secondary health issues and over HALF taking sick days, heaping a bigger financial burden on employers and the NHS, which is already at breaking point. The stark findings are from the Prescription Charges Coalition, which brings together around 50 organisations and professional bodies to campaign to scrap prescription charges in England for people with long term conditions. The Coalition say that medication is still unaffordable for many, with a single item currently costing £9.35, a 3 month prepayment certificate costing £30.25 and a 12 month certificate costing £108.10 – but, worryingly, these prices will increase on April 1. It is calling on the UK Government to urgently review the charges as it is leading to people stopping their medication, cutting tablets in half or prioritising picking up certain prescriptions due to the crippling cost of living. The survey reveals how patients are paying the ultimate price for their health conditions as it has led to hospital stays – with some respondents on wards for up to six weeks – increased visits to the GP, trips to A&E plus mental health issues and time off work. Almost a quarter, 23%, have struggled to keep up with bills due to the cost of living crisis. Some serious conditions such as asthma, multiple sclerosis, Crohn’s and Colitis, motor neurone disease, cystic fibrosis, stroke and Parkinson’s are still not included on the exemptions list despite the need for medication to stay well and, in many cases, alive. England is the only UK country where people have to pay for their medicines. The Coalition argues that if patients skip their medication it leads to further health problems which cost the NHS significantly more. It has condemned the decision to raise the cost of prescription charges, sharing that the rise will result in sick people relying more on NHS services that are already at breaking point. The poll reveals that: Nearly 1 in 10 people have skipped medication in the past year due to the cost of prescriptions. Of this group: Almost a third (30%) of those who have missed medication now have other physical health problems in addition to their original health condition. 37% now have other mental health problems in addition to their original health condition. And over half (53%) have had to take time off work as a result of worsening health. 12% of people who pay for their NHS prescription have cut medication in half to make it last longer. Janet [not real name], 48, a key worker, has been off work for four months after she was hospitalised when she couldn’t afford medication for Crohn’s, which doctors have told her has now led to her contracting Colitis. Not being able to work has affected her mental health. The mum-of-two was reluctant to sign up to a prepayment certificate as she said couldn’t afford the upfront cost and was concerned it wouldn’t be cost effective for her. Due to the nature of her conditions, it means she has to “mix and match” her medication, and will sometimes only try a course of tablets for a few days before realising they don’t work and have to pay for another prescription. She said: “My medication was changing so often but, as a key worker, I don’t have a lot of money and it was becoming difficult. I also rent my house so at the end of the month I have no money. It was a case that with the amount of medication I was on, that I physically couldn’t afford to keep buying different medication to trial things as I was trying some that was making me worse. The doctor would then give me something else. “It just got to the point where I physically couldn’t afford it as I’m spending so much money on the medications and the cost of living doesn’t help. I have just signed up for the certificate but you’re still having to find money constantly. Coming out of hospital I had to spend £120 on medication.” Janet said initially she ended up in A&E as she felt very unwell. After an eight-hour wait, they misdiagnosed her with appendicitis. She added: “It was literally a week after that my daughter ended up calling an ambulance as I was so ill, I had never been as ill as I was, and I ended up in hospital for a week. I didn’t take one of the medications and the doctors think it’s part and parcel of me not taking that. I feel angry, it shouldn’t be like this and I feel it could have been avoided. You work out the cost for the hospital stay and what’s come off the back of it, it doesn’t make sense. “It has had a big impact on my mental health. I wouldn’t wish this on anybody. You realise that by being off work sick you are not doing your normal day. It’s so isolating and makes you feel so lonely. You’re not speaking with people and not doing what you would normally do, you don’t realise it until you’re in that position of how much normal life you’re missing and how it affects you.” The Coalition says the average cost to an NHS surgery for a 9 minute GP appointment is £42. While an outpatient appointment costs the NHS around £235. The average cost to the NHS of a person attending A&E in 2021/22 can range from £77 to £359. Data from Age UK shows the average excess bed day in the NHS costs between £2,089 and £2,532 a week for non-elective and elective inpatients. While these costs may not all be current, they clearly outweigh the burden of prescription charges. For instance, taking the example of an individual who had to stay in hospital for five weeks – this admission would have cost the NHS over £10,000 in bed costs alone, without even adding any further costs for investigations or tests. In contrast, the cost of prescriptions is tiny and could keep more people well and out of hospital. Laura Cockram, Chair of the Prescription Charges Coalition and Head of Policy and Campaigns for Parkinson’s UK, said: “We are deeply concerned about these findings which is a clear message that the prescription charge exemption system needs urgent reform. It is not meeting the needs of people with long term conditions, and is putting their health at risk which we fear will intensify as the charges increase on April 1. “The charges for people with long term health conditions fail those who are being forced to make tough choices every day about whether they feed their families, pay their bills or take their medication, which as we have seen from our survey could keep them out of hospital. “We know the price rise will result in sick people relying more on NHS services that are already at breaking point. “Far from this government’s aim of improving life expectancy for people with stroke, dementia, asthma and mental ill health, this increase in the prescription charge will create a health emergency for people with these conditions and other long term conditions in England. The UK Government must urgently commit to reviewing the prescription charges exemption list, or it will fail in its bid to create a healthier nation.“ The Coalition is asking the UK Government to commit to freezing the charge for 2024 and scrap their plans to align the prescriptions charges with the state pension age. It is also calling for an independent review of the prescription charge exemption list urgently. It also wants information about prescription charge entitlements, including the low income scheme and prepayment certificates, given to all those with long term conditions when they are diagnosed with their condition. The survey revealed that almost 2 in 5 (38%) people with long term health conditions only learned about the prepayment certificate more than a year after their diagnosis. This information should also be handed out when medicines are dispensed and reviewed. Materials covering these topics should also be displayed at all GP surgeries and pharmacies. It is also recommending that prescribers stop reducing the duration of prescriptions – as this prices people out of affording their vital medicines. Around a third (35%) of survey respondents reported they had the duration of their prescription changed, meaning they’re paying more frequently for their medicines. Board Chair for England at the Royal Pharmaceutical Society, Thorrun Govind, added: “Ongoing prescription charges in England prioritise revenue generation over the prevention of ill-health and undermine the principle of an NHS free at the point of use. “This unfair tax on the sick means pharmacy teams often see people struggle to afford all the medicines they need, which can lead to further health problems and extra costs to the NHS. We need urgent reform of the whole system.” Prescription charges were introduced in 1952, abolished in 1965 and reintroduced in 1968 with a system of exemptions that continues today. The charge itself has risen almost every year since 1979, although the charges were frozen last year by the Health Secretary, to recognise the impact of the cost of living. The UK Government states that 89% of prescriptions in England are currently dispensed without charge, but most of the income to the NHS from prescription charges comes from working-age people with long term conditions. While certain health conditions entitle people to a medical exemption certificate and therefore free prescriptions, only a handful of conditions qualify. Aside from the addition of cancer in 2009 the list of exempt conditions has not changed since 1968, even though there have been significant medical advances. For instance people with childhood conditions like cystic fibrosis who were not expected to survive, or conditions that didn’t even exist at the time like HIV. The Coalition of 50 charities also includes the Royal Pharmaceutical Society, Royal College of GPs, Disability Rights UK, Kidney Care UK and Asthma and Lung UK. For more information and to sign up, visit the Prescription Charges Coalition website. For more information or media enquiries, please contact Victoria Birch, Senior Media and PR Officer at Parkinson’s UK, 0207 9639311 or vbirch@parkinsons.org.uk.