Since 1995, free prescription charges have been available for both men and women, relative to the State Pension Age (SPA) of 60 or over. Justified by the fact that after the age of 60, individuals were no longer working and thus the cost of potential prescription would have a greater personal economic impact compared to those who were still working. However, as the SPA increased to 66, the argument posed is that there are a larger proportion of individuals over the age of 60, who are economically active and can thus contribute to prescription charges. But is the reasoning as clear cut as it initially seems?

There are various factors to take into consideration when evaluating the fairness of this change. £600 million of revenue annually are generated for NHS England, an undeniably large fund that covers NHS costs. The significance of such revenue is demonstrated when the price of drugs are also taken into consideration. At the end of the 2020/21 year, the cost of dispersed prescription items was £9.61 billion in England, an increase of 3.49% (£9.28 billion) from 2019/20 according to the Office for Statistics Regulation (OSR). Yet the volume of drugs dispersed reduced between 2019/20 and 2020/21 reduced by 1.9%, suggesting that increased cost had been driven by drug companies. A prominent example would be pharma firms- Accord- UK and Advanz Pharma being fined £260 million by the government in 2021 for increasing the price of hydrocortisone tablets by 10.000%. According to the Competition and Markets Authority, one pack of tablets, originally costing less than £1 for the NHS had increased to £80.

Pre-paid checks (PPCs) are available to those who require frequent prescriptions but do not meet the requirements to exempt themselves from charges. With PPCs, individuals save money if they need 11+ items in 1 year, either via a 3-month certificate (£30.25) or 12-month certificate (£108.10). However, some argue that this is not enough. The Prescription Charges Coalition points out that the cost of prescription charges and the rate at which it increases far outweighs the rate at which wages increase.

Concerns also arise for those with long term health issues that cannot be covered by exemption or PCCs. For example, asthma, where sufferers may be less inclined to use their inhalers at critical times to ration the medicine. Neurodegenerative diseases which progress over long periods of time are also not covered, for example Parkinson’s Disease.

Income gap between men and women may also play a profound impact on whether individuals can afford medicines, where women will be disproportionately affected compared to men. Statistically speaking, women are also more likely to take more sick days, possibly impacting their wages and thus ability to afford prescriptions. Race and age are just as significant. Long-term health conditions are more likely to occur in minority ethnic populations. Such populations are also found to be in lower socio-economic positions, which may possibly further contribute to increased rates of long-term health conditions. In terms of age, the older an individual becomes, the less inclined they are to work an average 9-5 shift, again impacting their income. Studies have shown this is predominant in the age range of 52 to 69 years.

It is understandable that increased NHS costs must be met. However, it is also clear to see that a proposed change in prescription charges can impact a large population of vulnerable individuals with a diverse range of health issues. As life expectancy continues to rise and presumably the SPA in accordance, the question must also be asked, where will the limit be on prescription charges and related health care costs for individuals in the future?

Resources:

Aligning the upper age for NHS prescription charge exemptions with the State Pension age - GOV.UK (www.gov.uk)

State Pension age timetable - GOV.UK (www.gov.uk)

PCA England (nhsbsa-opendata.s3.eu-west-2. amazonaws.com)

CMA finds drug companies overcharged NHS - GOV.UK (www.gov.uk)