Free Prescriptions for Asthmatics?

[servewithmintsauce]

Am I the only one who is uncertain as to why asthma isn't an exclusion criterion for prescription charge payment? I guess I shouldn't be complaining just yet as I still fit neatly in the middle of the bracket that says, '16, 17 or 18 and in full-time education', so I don't pay anyway. But when I get there, and for all the people with asthma who currently don't fit any of the exclusion criteria, it's going to be expensive.

I'm going to make this about me, but seriously I'd love people to weigh in with their own calculations, prices and thoughts. I am genuinely intrigued to know what other people think about this and what other people are going through.

My AAP Green Zone has Seretide 50/25 written in it. My Yellow Zone has Seretide 125/25, and my Red Zone has Salamol 100. In 12 months, if we base it one the past 9 months, on my current AAP I will go through 12 Seretide 50/25s, probably 3 Seretide 125/25s, 3 Salamols, at least 4 rounds of Pred., and we'll say about the same for antibiotics. Just for these, at the current recently revised rate of £8.20 per item (that in itself is kinda depressing because my Salamol is much cheaper than that) I would have to pay over £200 just for my asthma medications. I have a Mometasone nasal spray for hayfever which I would need for at least 7 of those 12 months so that's nearly £60. I have Dermol for atopic eczema, which I would probably need 3 bottles of in a year, so thats £24.60. I rely on Pizotifen for cluster migraine prohylaxis, and I need 15 of those a year so thats another £123. Then I have Vitamin D3 which is just that bit cheaper on prescription, rolling in at £41 for the year, and an Otomize or two for ear infections which I am prone to. That's another £16.40. So for everything each year at the lowest numbers possible (in other words, I probably would need more Prednisolone and I might lose a couple of inhalers, I might need a new spacer or peak flow meter, and I have spare inhalers for my ice hockey kit) I would be paying nearly £500. My conditions are currently not fully controlled as it is so while there is hope in other medications in addition to my current ones, that would carry expense. For instance there may be benefits to trialling Montelukast for my hayfever (which affects my asthma) and for the exercise-induced component of my asthma, so if that were to continue, I would need 15 boxes a year, so another £123. There is hope in Imigran injections for cluster attacks, so that is probably at least one a month, which comes to £98.40. And like I say, I could need more of something or spares of something or a new whatever. If I were to have had to pay prescription charges for the past 6 months alone, that's 3 Ventolins (back win I was going through two canisters a month), 3 spacers, 1 peak flow meter, 2 Clenils, 4 Salamols (spares for ice hockey), another Ventolin because the canister from my other one got stolen, 4 rounds of Pred., 4 rounds of antibiotics, 1 Otomize, 1 Mometasone spray, 3 Seretide 50/25, 2 Seretide 125/25, 1 Bricanyl turbuhaler, 1 box of Vitamin D3, 4 boxes of Pizotifen, 1 box of Imigran tablets, 1 box of co-codamol, 10 boxes of Benadryl Plus, and 1 bottle of Dermol; this amounts to a sum of £386.40 (at the rate of £8.05 as I have not filled a prescription since April 1st). That is for half a year. I didn't use half of that second Clenil. I used two tablets from the Co-codamol because they set off my asthma, put me into respiratory depression and made me very sick. The Bricanyl was short-lived because I can't use DPIs.

My point is, if I had typical epilepsy requiring typical continuous anti-convulsive therapy with, for example, carbamazepine, it would only cost me ~£98.40 per yer. But if I were that person, I would not even have to pay that. But because I am asthmatic, I will soon have to pay £150 per year just for my maintenance and reliever meds, not counting Prednisolone and antibiotics for asthma-related infections or flare-ups.

Just to clarify, I know that there are many people with epilepsy on more than one medication, and the other criteria for medical exemption, such as myasthenia gravis and diabetes which isn't diet-controlled, I understand. But asthma and epilepsy..well, they work on a similar scale, price-wise. Someone with severe asthma will be paying A LOT of money in the same way that someone with severe epilepsy would if they weren't exempt. But that's just the thing, isn't it? And exemption makes you exempt from ALL prescription charges. A friend of mine has Type 1 Diabetes and mild asthma. Sure, she doesn't have to pay for her insulin and testing strips and new glucose meters and needles and all the * that comes with diabetes. But she also doesn't - and never will have to - pay for her asthma medications. She is on Clenil 100, 2 puffs once a day, and a Salbutamol reliever which she rarely uses. I have known her for 6 years and not once has she needed Prednisolone. Asthma-wise, she has 4 prescriptions for Clenil and 1 reliever to fill each year. That's only £41 per year, covered by exemption for a condition which is unrelated to her asthma.

I don't know..maybe I'm being silly. But I honestly feel that persistent asthma should be an exemption criterion. Don't you?

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This is a question which I've heard many times over the years. The problem is that given the number of asthmatics in the country, allowing free prescriptions for them all would put an enormous strain on the finances of an NHS which is already struggling to cope financially. And how do you define 'persistent' asthma? It's well understood that the status of an asthmatic can change. My younger son is an asthmatic, and when he was younger we had quite a few scares with him - he had persistent asthma then. Now, at the age of twenty two, he has inhalers but he hardly ever needs to use them. But that may change again in a few years' time.

The argument concerning free prescriptions for the primary condition but not for anything unrelated to it is another complex one. I seem to recall a reading a paper which discussed the option of restricting the number of medications available free of charge for a given condition eg. diabetes 1. Can't remember where I saw it now - Google the subject and I'm sure you'll find it. The problem you have with it in general is where do you draw the line as to what can be described as a complication of the primary condition which therefore might justify a 'free prescription' status.

Out of interest, where did you get the figure £150 from. The annual prescription pre-payment certificate costs me £104.

[servewithmintsauce]

Thank you for providing me with an adult perspective on this issue, that's very much appreciated.

Sorry, I should have made it clear that I was calculating all my figures in the basis of not paying for a pre-payment certificate: in other words, if I were to pay the prescription charge for each item with no discount or anything like that, then that is how much j would be paying.

As far as I am aware, persistent asthma is in the simplest of terms asthma requiring daily controller medication. Asthma severity is a different thing altogether and independent of persistent status to an extent. My point was that people with asthma require daily controller medications and potentially life-saving reliever medications and it surprises me that, although our controller medications in most cases are not as immediately necessary as insulin for someone with diabetes, they are - especially for those of us with moderate to severe asthma - every bit as necessary as anti-epileptics are to someone with epilepsy. A person's asthmatic status changes but then so would their prescription status in the same way that as soon as my mum could no longer control her diabetes on diet alone, her prescription status changed.

Yes, it's very difficult to determine where you draw the line. Asthma and diabetes have no currently proven link but that's not to say there isn't one. There are many possible complications of all types of diabetes and it is almost impossible to know what is and isn't related to someone's diabetes.

Thank you again for giving me a more mature perspective. As a teenager it can be easy to jump on something and say ""this is unfair!"" without quite considering all the angles. By my understanding, the PPC covers ALL prescriptions, even those that aren't for asthma. Again that's another thing with asthma; how would you define whose allergies and eczema are atopic, and whose are not? Whose glaucoma is related to steroids and whose is just age? Either way, I could save a significant amount with a PPC.

Also, do you know anything about an 'HS2' for uni students with asthma? It's apparently something to do with extending that 'free prescription' period through your time at university..but I'm not entirely sure.

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I don't recall that prescriptions were free at university level (by that I mean aged 18 years plus) whe my son was there. There is a form called HC11 online that will give you more information. Your GP practice should certainly be able to give you more advice on this. Even though his asthma was much improved by that time he did still qualify for free flu jabs, and I recommended to him that he got the free pneumonia jab before he went up as well.

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Hi, I too have seen many arguements regarding free prescriptions for asthmatics but agree with Maggie that there are so many people with this condition that it cannot be financially viable given the current state of the NHS to do this. Unfortunately there is not an endless pot of money and every decision to give some funding to one cause would take it from another and I do not envy the people who have to make these decisions. Another slightly off topic issue which highlights this is the fact essential items are supposed to be free of tax - but yet women's sanitary items are taxed! But if they weren't where would the extra tax come from - what would be taxed more? If there was less tax collected what spending would have to be cut back? This is not aimed at any particular political party policy past or present - just an observation

I've only just been diagnosed myself with adult onset asthma and have had 4 prescriptions last month but my asthma is far from controlled so I am going to wait until it is then see if a PPC will be worthwhile for me in the long term. As well as free prescriptions for certain illnesses there are free prescriptions for other groups which includes those claiming some benefits which are aiming to assist those who really cannot afford their medications. In addition if you are on a low income, and this includes the student question you were asking, there is a form to fill out to request a certificate which gives you a discount. I think there may be a couple of different versions so make sure you get the right one. When you get to uni there will be a place where you can get advice on these kind of things so they will help you out. When I was at Uni 10 or so years ago it was a 25% discount on prescriptions. To claim this there was a fairly comprehensive booklet to fill in which also asked about the financial status of those living with you (which I understood to be those in your student digs), your family, etc. Personally I gave up after a couple of pages and just paid the full charge and avoided going to the doctors or getting prescriptions when my funds had run low. This may however have been a contributing factor in getting plueracy and cracking a rib through excessive coughing following 2 bouts of bronchitis back to back which I never actually went to the doctors about - if I'd have gone the doc may also have seen the signs of an asthma flare up back then, but hey, ho, we live and learn....

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I'm adrenal insufficient (and steroid dependant) so I am eligable for free prescriptions. I am also a student and have a HC2 form which entitles me to free prescriptions, refund on travel for hospital treatment, free dentists, and something about free wigs/prosthetics etc which i'm not sure about as I dont need them. You can get a form from the pharmacy - its a 'snapshot' of where you are at atm and lasts a year - if you fill it in before you go to uni then you will be entitled as you have no income (i assume) and are living off your parents. I rang to ask how to fill it in (when I didnt know all the details of uni accomodation and my course) and was told that as I have not started the course I shouldn't fill it out like i'm already at uni.

A prescription pre-payment cert is completely worth it. All your medications would be covered and so assuming you need at least 2 prescriptions a month it is cheaper that way. Once you're at uni you'll usually find doctors 'get' that we dont have much spare ££ and so they're usually good about prescribing as much as possible if you have huge outgoing expenses for your health.

ANd yeah - sadly the variable nature of asthma and it being diagnosed in most people who have any infection-related episodes of wheezing mean that its unlikely ever to get on the list! Sad but true! Remember conditions like CF which is more consistently severe, degenerative and debilitating arenot yet on the list for medical excemption (although diabetes and things are common so many will be excempt) so asthma isnt alone. Its a very old list!