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The PCC is an alliance of over 40 organisations concerned with the detrimental impact of prescription charges on people of working age with long-term conditions. Following a survey, to which over 2400 people in England responded, the Paying the Price report was published in March 2013. It was followed, in March 2014, by a survey exploring the impact of prescription charges on the working lives of people with long-term conditions. Over 5,000 emails have been sent to MPs and more than 20,000 people have signed an e-petition on the issue, which is consistently listed as one of the most significant burdens for people living with one or more long-term conditions.
Zoe Oakley is 35, has two children and works part-time.
I have high blood pressure due to an inherited kidney disease. The consequences of this is that my kidneys don't control my blood pressure so it often gets too high resulting in nausea, heart palpitations, and headaches; it's like I can feel heartbeat in my head.
I've been on a concoction of tablets since I was 17 years old. My medication won't cure me, but it does help prevent strokes, and prolongs my kidney function for longer. If I don't take my medication, I start reacting negatively within a few hours.
I've had trouble affording my prescriptions - if I was running low I have had to wait until I got paid before getting my new batch of medicine. Sometimes this meant I had to skip certain pills to make them last longer. This has resulted in me being hospitalised twice, with brain scans and other tests to check there was no long term damage.
I really believe the life-saving drugs I rely on should be free, as they are for people with some other long term conditions.
1. Prescription charges are a barrier to accessing medicines for many people of working age who have long-term conditions in England.
The PCC research found that costs were by far the biggest factor that prevented people from taking their medication as it had been prescribed. Pharmacists also report people asking them which of their prescriptions they can do without. Research from the PCC shows that one third of those with long-term conditions, who are paying for each prescription item, are rationing their medication due to the cost. Many respondents reported missing doses, cutting tablets in half and substituting cheaper but less effective over-the-counter alternatives to “eke" medicine out until pay day. Of the 36% who reported not taking their medicine as prescribed due to the cost, three quarters felt their health had got worse as a result and 10% said they had ended up in hospital. Not being able to afford prescriptions can lead to emergency hospitalisation, which may result in a cost that is greater than the revenue raised.
2. There has been no assessment of the consequences of prescription charges for people with long-term conditions.
People with long-term conditions, of working age, are disproportionately affected by prescription charges as they need regular and on-going medication, often over their lifetime. Many fall just above the threshold for low income exemptions, as they try to work in spite of their condition. The prescription prepayment certificate is felt to be unaffordable by a significant proportion, and is not effective for those with fluctuating conditions. As highlighted in the Health Select Committee Report into NHS Charges in July 2006, and in response to parliamentary questions and debates since, “There is a woeful absence of evidence about the effects of charges in this country. It is known that harmful effects occur but they are largely unquantified." Where people take their medicine correctly, they often report having to cut back on essential household costs, such as food, rent, utility bills or petrol to get to work. The stress of making these choices is likely to impact on an individual's condition and health outcomes, and their ability to stay in work.
3. Medical exemption criteria, set in 1968 and largely unchanged since, are outdated and illogical.
Many conditions that people now live with for years either didn't exist when the exemption criteria was created, or had such a short life expectancy it was not thought necessary to add them. On top of this, there are many elements that just don't make sense. For example people with cystic fibrosis are not exempt, unless they develop cystic fibrosis-related diabetes. There is a clear and pressing need for a review of the criteria and for this to be extended to all those living with long- term conditions in England. Many people suffer with more than one long-term condition. It is currently possible to have all of the conditions represented by the PCC and still have to pay prescription charges.
We are currently running a survey to find out about the impact of prescription charges in 2017. The survey has been completed by just over 2300 people so far. Early results show the following:
For further information, contact co-chairs of the coalition.