Paying for Treatment

We all know that Asthma can be a critical thing. Depending on how servere it can be, you can end up having to pay for lots of treatment... new inhalers or steriods.

A couple of years ago, I questioned why Asthmatics have to pay for their treatment when it is a form a medication they NEED to survive during an attack. After writing with to my MP and asking people various questions, I accepted that that's how it is. And yes, you can get a pre-paid prescription which can help.

My Asthma is not as bad as it used to be and in this last year it has calmed down dramatically. However, today I have had to use the last two puffs on my inhaler (which I hadn't used in a while) and a couple of hours later, needed to use it again. Living 20miles away from home (where my new one is), I had to visit a surgery where in the town where I worked to get one as soon as possible. They were great and supplied me with two after filling in a form. I paid £7.20 for this.

Now from my point of view, I needed it before it got worse and have need a nebuliser. If I hadn't had any form of payment on me, im not sure if I could have had them.

For something we depend on, do you feel it should be free on the NHS, just like medication for diabetics?

I would love to hear your views, so hopefully we can maybe start a new campaign and push this view in the UK -to make inhalers free on prescription.

18 Replies

  • *takes cover behind the rubbish irish system in anticipation of another scripts debate*

  • Jenna, aside from the issue of whether asthmatics should pay for scripts, I'm a bit concerned about you running out of salbutamol. I know it's easy to forget these things when your asthma hasn't been so problematic recently, but it's important that every asthmatic should carry an up-to-date inhaler with plenty of doses left. You never know when you're going to need it.

    If you ask your GP, they should be prepared to prescribe you two or three inhalers at once as a one off, so that you can always keep a 'spare' around in case you run out. This will avoid you being caught without any and having to pay for inhalers.

    Em H

  • thanks, I completely agree with you. My last symptons were last August, and had 2 puffs left of the one in my bag (full ones being at home) - which wasn't sufficient for today until I got home this eve. But always have one on me.

    Asides that, it still can become expensive for lots of people. Even though those who earn a certain amount have to pay (not taking into consideration their outgoings), if people cant afford it, it may influence how much medication they take -which in turn may make things worse.

    I dont know what the case is for other countries as far has medication for Asthma and Diabities goes, but both should be made free as we depend on them - In the Uk and other countries, and I believe we should fight for it. I know for some this isnt a big deal, but it is for many others, and it should be made aware.

  • Hello Jenna

    You've got my support. The script system is not fair. I know several ladies who are on 'thyroid' tablets and get ALL presciptions free because they need to take thyroid tablets for the rest of their lives. Three of these super sized ladies are relatives and I often wonder if 'thyroid trouble' is not just an excuse for not making the effort to lose weight I've certainly never known any of them to be ill.

    I got rattled when I had cancer treatment - I chose not to have Chemo and opted for a daily pill. I took this for five years and had to pay for my scripts - if I'd had Chemo it would have been free! I've no axe to grind now as being retired I don't pay for prescriptions but I don't consider them to be free as I paid into the health service for 46 years. I really don't mind whether medicine is 'free' or paid for but it should be the same for everyone.

    Best wishes


  • paying

    Hi there

    im new to this site but totally agree with you all I visited my GP last week for new inhalers and upto now my asthma hasnt given me any real problems although my prescription cost me £14 .00 then whilst at work i had a severe attack and had to go A&E a new presciption for antibiotics and steroids cost me another £14.00 these can be life threatening attacks so should be free

  • Hi all,

    This is a topic that has been discussed on AUK many times and there are always a variety of opinions. I just thought I would reiterate the options regarding payment for prescriptions.

    Certain conditions are medically exempt from prescription charges. Asthma is not one of these conditions, but the list does include diabetes (unless diet controlled), hypothyroidism, other hormone deficiencies and epilepsy. You can see a full list at as well as instructions on how to apply for exemption by filling out form FP92A (available from your GP's surgery). The conditions that are exempt are a fairly arbitrary list, which was drawn up some years ago and is a bit of a historical relic now. If you have one of these conditions, you will not have to pay for any of your prescriptions, even for other conditions.

    If you do not have an exempt condition, but are on a low income, you may be entitled to help with NHS costs including prescription charges. More information here - - and from form HC11. You need to fill out form HC1, which is available from some GPs, job centres and hospitals, or you can get a copy by phoning DH Publications Orderline on 0845 610 1112.

    If you do not qualify for help with costs, it may be worth your while to get a pre-payment certificate (PPC). This means that you pay a one-off charge and all your prescriptions are paid for. A 12-month prepayment certificate costs £102.50 and a

    3-month one costs £27.85 - this means that it works out cheaper to get one if you have two or more items a month, or more than 4 items in 3 months, or more than 14 items per 12 months. You can buy them on a 10 month direct debit plan to spread the cost. For more information and to buy one online, see this site -

    I personally don't mind paying a small contribution towards the cost of my prescriptions - after all, it is many times less than the drug is actually worth, usually. A single Seretide Accuhaler is listed in the BNF as costing £40.92. I dread to think how much it would cost me if I lived in a country where I was expected to pay for the bulk of the cost of my medication. I do agree, though, that the exemptions are rather arbitrary and unfair. If anyone has to pay, everyone should have to, perhaps apart from exemptions on the grounds of low income.

    Hope it helps people to know what the options are regarding prescription charges, anyway.

    Take care

    Em H

  • Hello Liz,

    Unofrtunately Thyroid Dysfunction (especially Hypothyroidism, an underactive thyroid) is a very real problem and can cause sufferers some significant symptoms. Fortunately, when it's diagnosed (and the only way to properly diagnose it is by a blood test, it's not diagnosed just on symptoms and signs) and corrected, most of these disappear. You are right in making the connection between being overweight and Hypothyroidism, as sufferers often notice weight gain or difficulty in losing weight. However, that usually reverses when the thyroid hormone is replaced by tablet treatment ;) You most likely won't notice people being ""ill"", in the classical sense, as it's something that develops very very slowly over months and years with symptoms like tiredness, lethargy, weight gain, constipation. All of which are very common in everyday life anyway, even if your thyroid is normal!

    As I said above, you need a biochemical abnormality on your blood tests before hypothyroidism and hyperthyroidism can be diagnosed. No doctor will commence supplimentation with thyroid hormone without this, as over-dosing a patient with thyroxine (the synthetic version of thyroid hormone used) can be extremely dangerous. Once you've had hypothyroidism confirmed on a blood test, your doctor then has to fill in and sign a medical exemption form for the PPA (Prescription Pricing Authority) in order that the patient can receive free scripts.

    Sorry for the long explanation, or if it appears patronising in any way - it's not meant to be but I'm not sure how much you know about thyroid problems and the way the medical exemption system practically works. Forgive me if I have been over-detailed, but I thought I should correct misconceptions.

    Kind Regards,


  • As some people know, I am blogging for the NHS Choices Asthma blog, which is proving to be really interesting. One of the other bloggers has posted an interesting post about prescription charges recently, which I very much agree with (in fact, I rather wish I had posted it myself!).

    You can see it at

    (cut and paste into your browser, and then delete any spaces that the forum software has put in)

    The link to see all the blogs is

    Em H

  • or just the asthma blogs at:

  • or just the asthma blogs at:

  • Hi Emily and all. Thanks for your posts. My eyes are opening wider :)

    Em, I have just read the post you linked and it makes an interesting read and is very well put.

    My point is, agreeing with Liz and Snowdrop, all who experienced it knows it can be life threatening. We do get it very good in this country, we are lucky compared to most and should be extreemly grateful. However, I am not just aiming this at the UK.

    Its something Asthmatics depend on - like other big illnesses (diabeties, thyroid etc), it should be prescribed as free... also like birth control (even though we dont depend on this!).

    Lt's settle this, It's not about whether we can afford it or not. Although taking into account the various help you can get with pre-paid prescriptions and income -based help, there are still people who have a very tight income who do not qualify and struggle to do their weekly shop becuase of bills and rent - ive been there! and because of this, do struggle to find £7 (and like a previous comment, when it does not work you pay again for steriods and more treatment).

    If i was talking about flu medican or any other short term sickness, I would have stopped talking. But this is a serious illness that can be with people for the rest of their lives. We basically pay to have a deep breath that will keep us living and healthy as we can be (yes a little dramatic, but it is true). Because its long term, because we DEPEND on it just like insulin, it should go in the list of illnesses which are prescribed free medican - crucial to daily life.

    Also note, i dont mean steriods becuase these can be avoided and can be dangerous, just the preventitve and reliever

  • Hello Jenna,

    I agree in principle with what you're saying and agree that it should be ""all or none"" when it comes to ""life-dependent"" treatment. However, it can be difficult to draw the line between what is and isn't ""life-dependent"".

    That aside, I'm a little confused by your last sentence (don't worry, it doesn't take much). I assume you are referring to steroid tablets such as prednisolone? Used in short courses (as a ""rescue"" medication for bad attacks or exacerbations), prednisolone can be vital in reducing inflammation in the lungs and preventing attacks and exacerbations from worsening, and has a very good safety profile. Yes, there are side effects (show me a medication which doesn't have 'em!) but there are far more associated with long-term steroid use, something which isn't taken lightly (see many threads passim).

    Whether steroids can be ""avoided"" is really highly contentious and probably not true, I'm afraid. No matter how well you manage your asthma and how diligent you are with your preventative treatment, there will always be something that can set you off - whether it be the evil cold/flu bug that was circulating in November time last year that hit me, or the inconsiderate smoker who affected another member's friend; no matter how well you manage your asthma, you may need a course of steroids at some point. Then of course there is the group of asthmatics who have more severe disease and depend on daily prednisolone dosing to keep more severe attacks away, whilst living with daily symptoms besides.

    Just another thought to add into the mix ;-)

    Kind Regards,


  • Jenna, I am a little confused about how I am supposed to avoid steriods, I have spent the past 3 years trying to avoid them, I look into the little pot I decant my tablets into each morning and wish there were not a whole bunch of little red pills looking back at me, try as I might I can't avoid them they are sadly a part of my life. Actually if I suddenly stopped taking my steriods I would probably end up very very sick in a very short space of time, someone once said that if you are steriod dependent you can get free scripts but others here say not I am confused.


  • My opinions on this topic are well known and can be summed up thusly:

    Either ALL prescriptions should be free, or NONE of them should be.

    Therefore, I'm afraid I can't possibly agree with you solely wanting free *inhalers*. You rightly say you can't live without them - there are many people who can't live without steroids, or leukotrine inhibitors, or sub-cut infusions, etc. Why shouldn't these be free too? They certainly can't be avoided, as Bex and Cathy have pointed out below.

  • Bex, you can get free prescriptions due to medical exemption if you are dependent on steroids due to primary adrenal insufficiency (Addison's disease), ie if there is a primary failure of your adrenal gland to produce its own steroid. In the same way, you are exempt if you have hypothyroidism, hypoparathyroidism or hypopituitarism. I *think* the 'logic' (I use the word loosely, and I don't agree with it) is that it is not 'fair' for people to have to pay for medications like hydrocortisone or thyroxine when other people's bodies make a version of it all by themselves. The same argument could be applied to Type I diabetes mellitus and some Type II diabetes.

    If you are dependent on steroids to keep your lungs healthy, as many of us are, you are not medically exempt from paying for prescriptions. I am not sure what happens if you develop secondary adrenal insufficiency as a result of being on long term steroids ie your adrenal gland fails to start producing its own steroid when your steroid dose is reduced. The information I have is not sufficiently clear on what the ruling is regarding that case.

    As for steroids being dangerous and avoidable, well, yes, long term steroids are dangerous (short term courses are very safe, as CathBear has explained). I know the dangers only too well, having been more on oral prednisolone than off it for the last 12 years, and on it continuously since September 2005. I have now developed myopathy (muscle wasting and weakness) and steroid induced diabetes (which ironically makes me medically exempt from prescription charges, as I take metformin tablets). Steroids are a lot less dangerous than the alternative, though - like Bex, if I didn't take them I would become very unwell very rapidly, not just from an asthma point of view but also from the point of view of my body failing to produce its own steroids quickly enough (even in people who don't have any form of lasting adrenal insufficiency, it takes a while for the adrenals to wake up and 'kick in' when you have been on steroids for a while). To put it bluntly, I would not be alive today if I did not take oral steroids. So, avoidable? - not so much. As Cathy points out, even moderate asthmatics will often not be able to avoid the occasional course of prednisolone, however good their management and however quick they are to step up other treatment. The decision to prescribe steroids - even a short course, and especially long term steroids - is always made weighing up the benefits and risks, as with all medications. No-one should ever stop their long term steroids without discussing it with their doctor first - it is not possible to just stop these drugs, they need to be gradually reduced, and this may not be possible or safe in some people.

    I have been told I am likely never to come off oral steroids, so I have to accept the diabetes, myopathy, weight gain and other potential future side effects like eye problems and osteoporosis. It's a small price to pay for being alive and being able to breathe.

    On that somber note, I'll take us back to the original topic by saying that I agree with PeakSteve - either all prescriptions should be free, or none of them should. The current system of exemptions is ludicrously arbitrary. I do think that the scheme to help with health costs for those on a low income should stand, and perhaps be reviewed, as ancedotally it appears that some people who are on a low income but don't qualify are going without medication as they can't afford it. For the rest of us, just over £100 a year for a PPC is not a huge sum to pay (and I say that as someone on a fairly low income, being dependent on benefits and with debts still from medical school). If all prescriptions were free, tax payers would end up paying for it anyway in the form of income tax or National Insurance. As has already been noted, compared to a lot of countries we do have it rather easy.

    Just some late night/early morning ramblings!

    Em H

  • Have recently had discussion with my GP and endocrinologist about as I have secondary adrenal insufficiency and he has said no to the medical exemption for free precriptions. If i get down to 7.5mg AND endocrinology convert me to hydrocortisone then it will be deemed as same as addisons and will get medical exemption. The way it was explained to me is that technically at minute my adrenals are asleep not destroyed and so could recover in theory so don't get the free scripts.

    If anyone has had different advice to this please post as would love to go back and argue my case!

  • I am very sorry guys, in regards to my last comment, I meant; being that inhalers are the basis in which are meant to help prevent Asthma getting worse and therefore requiring further treatment like steroids or antibiotics (and yes, also meant dangerous long term-depending on dosage etc). I feel the basics should become free just like insulin as it’s a nessessity.

    I also partially agree with Steve in that it should be all or nothing. Im sure I wouldn’t have thought like this if it wasn’t for other illnesses with free prescriptions! 

    Bex, I know what you mean; again I meant the preventatives are meant to help us avoid it. I know this isnt possible after being on courses of steriods every two or three weeks and finally getting admited to hospital when they were not working. Im sorry to hear your on them practically permantely. This is another thing where we question ‘should it be free’ –something that we require long term.

  • Jenna, thats Ok I am sure you did not mean to offend. Some of us like me are not on steriods practically all the time we are on them all the time. I get excited about getting the pred down to 20, it never lasts but there is something very satisfying about seeing only 4 little red blighters in the pot!

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