Removing prescription charges for patients with mental health disorders: Would it improve patient outcomes in the UK?

The cost of copayments can deter patients from complying with essential medication. This can have a detrimental effect on health outcome and consequently healthcare costs. People with mental illness are commonly treated with regular and effective medication and are one group that is potentially vulnerable to these negative effects of copayments on compliance. Despite the existence of prescription charge exemptions in the UK, mental health disorders do not qualify for free prescriptions under the current list of chronic medical conditions. It has therefore been advocated by some that people with long-term mental health problems should receive exemption from prescription charges. Indeed, the existing evidence suggests that free medication would improve access, compliance and, consequently, health outcomes, which is also likely to result in savings of healthcare expenditure. However, simply adding mental health disorders to the list of chronic conditions qualifying for prescription charge exemption may not be the most appropriate way of achieving this. Despite alleviating the economic burden of people with mental health problems, such a move would leave other, equally deserving, chronic conditions excluded and would perpetuate the inequity of the current prescription charge exemptions. This article therefore suggests the need for a much more in-depth review of UK prescription charges and exemptions. It discusses possible ways of protecting vulnerable population groups against problems of medication cost and affordability, whilst taking the issue of limited National Health Service resources into account. © 2006 Adis Data Information BV. All rights reserved.