Paying for prescriptions


I wondered if anyone else is having the same problem - my GP will only prescribe one of each type of inhaler (I'm on becotide and ventolin) on each prescription. So before I was getting two for nearly 7 quid and now I'm getting one for the same price, doubling the cost. My GP says it's because some people are using too many inhalers - I asked about if I was and it appears I'm not, so to me it seems like a money making scheme.

I checked on the BNF and the inhalers seem to cost from between £1.50 and £3ish, so even on two per prescription they're making some profit out of me. I've spoken to other people in Oxford who say they've had similar happen to them recently and wondered if anyone knew why. And if there are any ways around it?



25 Replies

  • correct me if i'm wrong but don't you pay per item on your prescription therefore if 2 ventolin are prescribed you pay for 2 inhalers ? if you are having quite a lot of prescriptions it may be worth considfering a pre payment certificate. a 12 month one is just over £90 and is worth it if you have 14 or more items in a year.

  • Hi,

    Thanks for the reply, but no, if you order two of the same thing (or three, etc..) on the same prescription then you pay the same price as for one.

    Part of my problem with this is also that people with other chronic illnesses like diabetes don't pay for their prescriptions anyway so I kind of resent it in the first place, and even more when the cost is doubled.



  • i agree have you signed the petition against paying for meds if you asthmatic on the home office web site? in the meantime tho it might be worth looking at prepayment cert mine easy pays for itself.

  • yep, the price for inhalers is just too much, I have to wait till there's a bit of cash around to pick them up, at least my GP gives me 2 at a time, but shocked to realise their's such a mark up! this country's attitude to asthma sucks

  • The price quoted in the BNF cannot be taken as the true ""cost"" of the medication in question, and should only be used as a rough guide. For example, the pharmacist has to be paid a dispensing cost in addition to the actual cost of the drug.

    Bear in mind that, no matter what you have on prescription or what it costs, your GPs will not make any profit, so they're not running any kind of profiteering scam! Salbutamol is probably the cheapest of the asthma medications in real terms, but also remember that medications like seretide can cost around £50-60 baseline for one inhaler.

    If you're struggling to pay for prescriptions, then get leaftlet HC1 (I think) from your pharmacist which tells you about free prescriptions. If you're not entitled under this scheme, then, as has been suggested, look into a prepayment certificate which works like a season ticket.

    The list of people who get free prescriptions is actually very limited, so it's not just asthmatics who have to pay for their prescriptions. There are many chronic illnesses that are just as ""deserving"", if you like, for example heart disease. The government are due to be reviewing the exemption list but, if their track record with the rest of the health service is anything to go by, then I won't hold my breath. (Sorry, terrible pun not intended.)

    For what it's worth, I prescribe two inhalers at a time for my patients.

  • if (like us students) you are on a low income, and find paying for your medications too pricey, maybe you can qualify for a HC2 certificate, not sure what the brackets are tho

    and i agree with zebra, this country (with the exception to some of the doctors and nurses who are very understanding of asthma) has a terrible attitude towards an illness which over 5 million of its residents suffer, a good percentage even have it severely. It makes no sense, but when you meet a doctor who will help its good.

  • I use seretide which I believe costs £64 which lasts about a month plus uniphyllin and also get ventolin inhalers, and pred when bad so in my case I am really getting the benefit. I buy the pre-payment certificate. Thank God for the NHS.

    I do think that people with illnesses that are deemed fit for free prescriptions should have to pay for prescriptions that are not related to that illness. Correct me if I'm wrong but people with thyroid problems need the one drug which is free therefore working out a lot cheaper for them as us asthmatics often need multiple drugs?

  • Carla has a very good point here.

    But asthma is a life threatening condition TBH cost should not be a factor, its peoples health, and its a sorry state of affairs

  • A little information is a dangerous thing. If you read the BNF without full knowledge of what the information in it means it is often easy to draw the wrong conclusion.

    For example, the BNF quotes the net price for Ventolin at £1.50. But this doesn't include the dispensing charges or VAT.

    A quick Internet search finds a number of stores that will let you purchase prescription-only-meds without a prescription. For obvious reasons I'm not going to post a link to any of them here, but the cheapest I could get Ventolin for is £8.23 - so even for a drug as cheap as this, you still save over £1 for each single inhaler you get prescribed. And the saving is over £9 if you get two inhalers as a single prescription item.

    Remember, in the US and Canada you have to pay full price for every prescription item; some of these costs you can claim back against your health insurance (which of course you also have to pay for), but some you can't. We have no such issues here in the UK.

    It's not a money-making scheme; it's a cost offsetting scheme. For every prescription item that costs less than the prescription charge (and there can't be very many that do) there's an item that has a retail value of the better part of £100 which costs the patient less than 7 quid.

    So before you all rant about GP profiteering and the way the NHS treats asthmatics, perhaps it's wise to do a little research?

  • I am in the enviable position of getting free prescriptions because of my diabetes this means I get everything free including all heart and asthma stuff. Now I am not complaining but it does seem unfair that all is free why not just the diabetes bit cause them there could be more money to fund other chronic illnesses.


  • Den, you make an excellent point.

    I feel like I'm banging my usual drum here, but the list of conditions that qualify for free prescriptions is outdated and patently unfair.

    Either all prescriptions should be free (and that's never going to happen), or none of them should be - and if the current government has its way and privatises healthcare (which is what it plans to do) then the latter could soon be the case. And at least that would be fair.

  • Just to add, the most anyone would have to pay for prescriptions at the moment is £95 a year, using the prepayment certificate, which i think is excellent value for my health. i appreciate this every time I go and pick up symbicort x2 which would be well over that if I had to pay what it costs. and there are the various exemptions for those whose circumstances mean they can't afford £95 so they dont have to pay for scripts.

    The NHS is heading towards privatisation already, and what i dont like is the way it is being done surreptitiously and inequitably.

    Oh, but to go back to the original point, the prescribing only one of an item rather than two is a time factor as much as a cost one - it seems silly to give someone only enough meds to last two weeks or a month or whatever when it is aon ongoing condition, it just means more faffing about and more work for everyone and more chance of scripts being messed up. although aren't there changes in the pipeline that mean pharmacists can prescribe repeat medication?

  • Not sure about the pharmacists actually prescribing, but there was a lot touted about electronic prescriptions a few months back which would mean that the repeats would be sent directly - and electronically - to the chemist. Bit like the current chemist-pick-up scheme but without the paper.

  • Ok im confused...this message will prbs be a bit confusing too but here goes anyway

    If u have a prescription that looks like this

    Bricanyl Turbohaler 500mg PRN then under quantity it says 1 (u pay £6.65)

    But if it looks like this

    Bricanyl Turbohaler 500mg PRN then under quantity it says 2 (do u pay once or twice) so would it be £6.65 or would it be £13.30?

    Thanx Emma x

  • Hi me,

    It would be one prescription charge. It's not charged per physical item, but rather per entity. This is to get around problems of quantity - say if I wanted to give someone a month's (28 days) prescription for some tablets, and they needed to take 2 tablets a day, then I would prescribe 2x28 tablets as they come in boxes of 28. So it would look like this:

    Happy Sugar Medicine 25mg tablets

    Take one tablet twice a day

    2*28 tablets

    The patient would only pay one prescription charge, even though they've got two boxes of tablets.

    If, however, I issued two separate prescriptions for the same medication, i.e. for 28 tablets, like this:

    Happy Sugar Medicine 25mg tablets

    Take one tablet twice a day

    28 tablets

    Happy Sugar Medicine 25mg tablets

    Take one tablet twice a day

    28 tablets

    ....then that would be two prescription charges, even though the total quantity is the same.

    So with your inhalers, you might get

    Salbutamol Sulphate metered-dose inhaler 100mcg/actuation

    Take two puffs when required

    2*1 inhaler

    ...for that, you'd get two inhalers for one prescription charge, i.e. £6.whatever!

    Hope that makes sense!


  • wow thats silly

    last time i had 11 seperate prescriptions because the doctor couldnt work out how to put them on if i payed charges (which i dont because im under 16) i would have had to pay £73.15 but that couldhave been 1/2ed if hed put it under 1 inhaler X 2

    *makes note to self to go to the gp that can put more than 1 quantity on a perscription* or to get a prepay cert!

    Emma x

  • Cathbear - now I'm confused. I was told the charge was per drug. I for example am on HRT, it showed as one item on the prescription but because the box contained oestrogen tablets and progesterone tablets I was being charged twice.

    My GP is pretty good in that I get prescriptions for inhalers*2, 6 months of HRT but for some reason (expense he says) he will only prescribe my blood pressure tablets one month at a time (well actually he has given me 6 scripts with one month on each)

    As it happens its not a problem to me now as I do prepayments certificates but it would be nice to know what the rules really are.

  • I wonder if it varies between regions? where i am one medication counts as one item, no matter what amount you have. but then, ok, with inhalers the amount I get is ""two"" but for pred it is ""200"" (tablets). Imagine if each tablet was a separate item on the prescription! you'd definitely want a pre-pay cert for that!!!!!!!!

  • Sorry, it probably wasn't the best method to use the same drug to illustrate the principle!

    I'm a little baffled by the hormone tablet situation though - will have to look into that.

  • Im pretty sure its per item not amount so like u said re pred tabs. Maybe worth speaking to your gp and explaining and say if you find i am one of those who uses too much you can go back to 1 inhaler? worth a try?

  • OK, courtesy of the PPA I found the official line:



    Unless the patient claims exemption a single prescription charge is payable where:

    11.1.1 The same drug or preparation is supplied in more than one container.

    11.1.2 Different strengths of the same drug are ordered as separate prescriptions on the same prescription form (see also paragraph 12.4.2).

    11.1.3 More than one appliance of the same type (other than hosiery*) is supplied.

    11.1.4 A set of parts making up a complete appliance is supplied.

    11.1.5 Drugs are supplied in powder form with the solvent separate for subsequent admixing.

    11.1.6 A drug is supplied with a dropper, throat brush, or vaginal applicator.

    11.1.7 Several flavours of the same preparation are supplied.

    More than one prescription charge is payable where:


    11.2.1 Different drugs, types of dressing or appliances are supplied.

    11.2.2 Different formulations or presentations of the same drug or preparation are prescribed (but see 12.4.2) and supplied.

    11.2.3 Additional parts are supplied together with a complete set of apparatus or additional dressing(s) together with a dressing pack.

    11.2.4 More than one piece of elastic hosiery* is supplied.

    * (Anklet, legging, knee-cap, below-knee, above knee or thigh stocking).

    Cathy, do you mind me asking what is the type of HRT that you take? Usually I would have thought HRT would be counted as a ""preparation"" rather than two different drugs together. I prepare to stand to be corrected, but I've never had anyone say anything to me about having to pay a double prescription charge for their HRT.

  • I asked some esteemed colleagues the question re: HRT and script costs.

    The reason why you will be charged a double script cost is because the box of tablets will contain more than one type of medication.

    The tablets will likely be all combined progesterone and oestrogen, but in different strengths for different times of the month; for example, 14 tablets of oestrogen 625mcg, and 14 tablets oestrogen 625mcg + progesterone 10mg.

    Some cyclical hormone packets may contain 3 different types of tablet, and so attract 3 prescription charges.

    The things they don't tell you at med school (to be fair, it's a pharmacy issue though!)

    Well worth the PPC though.

  • Thats pants!!!! were already paying waymore than are foriegn partners!!!! come on pharmacies!!!!

  • Wheezyab - an urban legend, I'm afraid.

    If you're an intensive prescription-drug-user, you're better off in the UK than pretty much any other country.

    The next cheapest is Denmark, where their equivalent of a Prescription Prepayment Certificate costs just shy of £130. In France it's possible for your PPC to cost anything up to £500 depending on how expensive the drugs you take are, and how many scripts you need per year.

    (Caveat: In France, prescription charges are based on your paying a percentage of the retail price of the drug, and that percentage varies from 35% to 100% depending on how serious the illness that the drug treats is, based on a government-held list of conditions. Therefore it is possible for a single prescription item to cost as little as 35p, but the AVERAGE price per item is £6, and you could end up paying the full retail price for some drugs.)

  • Cathbear

    I'm not sure if I was on Prempak C at the time or Trisequens (which is what I am on now). Looking at your post though it probably was the Prempak C as I think it had 2 types of pills - Trisequens has 3. Was changed to Trisequens because pharmacist could not get Prempak C

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