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Case study:
Cutting drugs costs for NHS patients

Prescription pills

University researchers have helped cut the cost of prescription drugs for thousands of NHS patients. Work by community pharmacy researchers at the Faculty of Biology, Medicine and Health has led to a key policy change on how people pay for medicines.

In the past they could only cap their annual charges by buying a pre-payment certificate, currently £104, with one lump sum. Under the new rules they can take advantage of the scheme in a more affordable way, by paying in monthly instalments.

Dr Ellen Schafheutle
Dr Ellen Schafheutle

"It means people can budget for their year's prescriptions without having to find all the money up front," says Senior Lecturer Dr Ellen Schafheutle.

"It puts a protective mechanism in place for those who are struggling financially."

Dr Schafheutle and colleagues, Professors Peter Noyce and Karen Hassell, have been at the forefront of UK research into access to medicines and the impact of prescription charges. Together they have spent over ten years exploring how charging can influence patients' behaviour and affect health service resources. They also led a Europe-wide study into how other countries tackle the problem.

In the intervening years she has published a number of papers on prescription costs and has been invited to talk to the Royal College of Physicians on the issue.

In 2006, and again in 2009, they submitted written and oral evidence to parliament, making recommendations backed up by a decade of quantitative and qualitative research.

"While prescriptions are now free in Scotland and Wales, around half the population of England still has to pay £7.85 for every item," said Dr Schafheutle.

"It's a complex issue but charging can be a false economy if it deters the essential use of drugs. Patients who end up in hospital can cost the NHS much more.

"It was a key policy change that made pre-payment certificates accessible to many more people."

Dr Ellen Schafheutle / Senior Lecturer

"Pre-payment certificates cover the cost of all medicines for up to a year. But until recently the £104 fee had to be paid in a lump sum, and for many of the most vulnerable it was simply unaffordable so it didn't work.

"If they couldn't find £10 to fund one prescription, how were they going to find £100?

"We said pre-payment certificates should provide a true cap on the cost of drug therapy. An immediate way of addressing that was by devising a method of paying by instalments."

Following the researchers' evidence the government introduced a new monthly direct-debit scheme and also launched a three-month certificate, replacing the existing four-month one, to deal with shorter-term problems.

"It was a key policy change that made pre-payment certificates accessible to many more people," said Dr Schafheutle.

"It was our research that helped inform that policy."

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