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Patients in England continue to pay the price of charges

The Prescription Charges Coalition, of which PDA is part, have published a new report on the impact of prescription charges on people living with long term conditions in England.

Wed 22nd March 2023 The PDA

The Prescription Charges Coalition brings together around 50 organisations and professional bodies, including the PDA, to campaign to scrap prescription charges in England for people with long term conditions that are not currently on the exemption list.

Research undertaken by the coalition in 2014 and 2017 found that the charge is having a significant impact on the ability of people with long term conditions in England to stay well. It is also impacting medicine adherence, quality of life, employment opportunities and their health outcomes.

The latest research demonstrates the impact of the charge on people with long term conditions, who have also faced:

  • the NHS England decision to move many over the counter medicines off prescription and make people buy them
  • Coronavirus – due to long waits to see health professionals and also for treatment; and
  • the current cost of living crisis.

It is clear the prescription charge exemption system needs urgent reform, as it is not meeting the needs of people with long term conditions, and is putting their health at risk.

Key Findings

Key finding from the report include:

  • Nearly 1 in 10 people have skipped medication in the past year due to the cost of prescription(s). Of this group:
    • 30% now have other physical health problems in addition to their original health condition.
    • 37% now have other mental health problems in addition to their original health condition.
    • And over half (53%) have had to take time off work as a result of worsening health.
  • Additionally 1 in 10 (9%) report being unable to collect their prescription due to the cost in the last 12 months.
  • 38% of respondents became aware of the Prescription Prepayment Certificate more than a year after their diagnosis with a long term condition.
  • Around a third (35%) have had the duration of their prescription changed, meaning they’re paying more frequently for their medicines.


“The Prescription Charges Coalition recommends the UK Government takes the actions below to enable people with long term health conditions in England to collect the vital medication they need to stay well:

  • Commit to freezing the charge for 2024.
  • Recommend that prescribers stop reducing the duration of prescriptions – as this prices people out of affording their vital medicines*.
  • Conducts an independent review of the prescription charge exemption list urgently. The review should examine the benefits to the health of the citizens in Northern Ireland, Scotland and Wales of scrapping the charge, and also take into account health inequalities.
  • Scrap their plans to align prescription charges with the state pension age.
  • Ensure information about prescription charge entitlements (including the low income scheme and PPCs) are provided to all those with long term conditions when they are diagnosed with their condition. This information should also be given out when medicines are dispensed and reviewed. Materials covering these topics should also be displayed at all GP surgeries and pharmacies.”


*PDA Note:

As health professionals we are aware of the potential for risk of harm and medicine wastage if policies around increasing prescriptions for longer durations were to be unilaterally introduced. The PDA always encourage decisions around medicines supply to be based upon clinical appropriateness, patient care and safety. However, this recommendation from the coalition demonstrates the conflict of such considerations when, many patients who cannot afford prescription charges are making decisions around self-rationing medication which in turn can impact the effectiveness of treatment, and result in more costly interventions.

Read the report in full (14 pages)


thumbnail of Prescription charge report (March 2023) – final version

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