Question about NHS and medication coverage

[steve2470]

I'm sure some of you have been reading the heated discussion in GD about medication coverage in the US. How is the NHS for covering medications ? Simply curious, as always. Thank you kindly.

Steve

[muriel_volestrangler]

1. For most medications, there's a standard per prescription charge of £7.85

Various groups get free prescriptions, such as children, over 60s, pregnant women, and people on benefits. If you're getting a lot of prescriptions, you can pay for a period for all of them.

http://www.nhs.uk/nhsengland/Healthcosts/pages/Prescriptioncosts.aspx

The controversy comes in because some medications are not covered by the NHS. NICE,the National Institute for Health and Clinical Excellence, evaluates treatments such as drugs, and decides if they are effective enough for a type of treatment - an evaluation which considers the price to the NHS as well as the clinical effectiveness (and can also mean a drug is approved for some circumstances, but not others - it might be accepted as effective for one type of cancer, but still thought unproven for another, and so restricted to the first).

http://www.nice.org.uk/page.aspx?o=AboutGuidance

[steve2470]

2. ok thanks for that thorough explanation nt

[Denzil_DC]

3. Related to NICE's role that m_v's mentioned, there's also the pop phrase "postcode lottery."

See Google for its prevalence.

Basically, even if NICE approves a drug or treatment, if it's new and/or expensive, there's no guarantee a patient in a particular administrative area will be able to receive it, depending on the policies and priorities of their regional health authority.

You'll maybe notice if you visit that link that the term's especially popular with the UK's RW press as a means to pick away at the foundations of the NHS, but it's a real phenomenon, and here's a brief explanation from The Guardian (over ten years old, but not too inaccurate in principle):

What is the postcode lottery?
The postcode lottery is shorthand for seemingly random countrywide variations in the provision and quality of public services - the huge gap between the best and the rest. Where you live defines the standard of services you can expect. So if you live in the "wrong" area, and, in extreme cases, on the "wrong" side of a road, you may get a poorer service than your neighbour or you may not get the service at all and have to pay for it privately. The postcode lottery is a big issue in the NHS, where the gap between the rhetoric of a comprehensive and universal "national" service and the reality is increasingly stretched.

Some problems are universal, even with single payer healthcare systems (especially when they're subject to creeping and not so subtle privatization).

[steve2470]

4. thanks for that, very useful ! nt

[Denzil_DC]

6. I should also add - no doubt confusingly for non-British people -

that only England levies prescription charges nowadays. In the rest of the UK, there are no such charges (this is from 2011):

Scotland has joined Northern Ireland and Wales in abolishing prescription fees - leaving England as the only part of the UK to charge for them.

No one in Scotland will have to pay for prescribed medicines following the move brought in by the SNP government.

It comes on the same day charges per item rise in England by 20p to £7.40.

But despite the charge, 90% of items dispensed are given out free as children, those on low incomes and cancer patients are exempt.

Prescription charges have been falling in Scotland for the last three years and stood at £3 before the 1 April change, which will mean the Scottish government losing out on £57m a year.

Under devolution, Wales was the first part of the UK to make prescriptions free - four years ago - and Northern Ireland followed in 2010.

[dipsydoodle]

7. You can also get prepayment certificates

A three month PPC costs £29.10 and will save you money if you need four or more items in the three months
A 12 month PPC costs £104.00 and will save you money if you need more than 14 items in a year


http://www.nhs.uk/NHSEngland/Healthcosts/Pages/PPC.aspx

and those over 60 years old are exempt from any prescription charges.

[LeftishBrit]

5. 'creeping privatization' -sadly too true