Coping with prescription charges in the UK

Objective: To explore cost-related behaviour in patients subject to prescription charges. Method: A questionnaire was designed and employed to survey 244 patients with either dyspepsia or hypertension who paid for their medication, either through prescription charges or over-the-counter medication. Respondents were identified through 21 community pharmacies in the North of England. Analysis was descriptive. Key findings: The NHS prescription charge caused over two-thirds of respondents to have to make key decisions about whether and how they could afford to have their prescriptions dispensed. The strategies used by the respondents to cope with this cost, such as (i) ones initiated by patients, (ii) those involving self-medication and (iii) ones involving the general practitioner (GP), are presented. Respondents' views about medication cost issues and the GP's involvement are also discussed. Conclusions: This study provides further evidence that prescription charges may act as a barrier to the use of prescribed medicines, and that patients who have problems affording their medication use a number of strategies to reduce cost. These strategies suggest that such patients do not take their medication as intended, or even have them dispensed, with potentially negative impacts on health outcome. However, patients do not generally raise the challenge that prescription charges present to them, or strategies they use to cope with cost, with their GPs. This has implications for improving concordance through the Medicines Partnership programme. Awareness about patients' affordability problems needs to be raised and incorporated into concordant consultations.