Prescription Charges - NRAS Policy Work

Good morning,

I joined NRAS earlier this summer as the new Government Affairs Officer. NRAS has a strong reputation as the voice of people with RA in the UK - as such we are pleased to represent people with RA on various coalitions and policy groups with other charities.

This week I met with other members of the Prescription Charges Coalition to discuss plans for the next few years with a new government now in place. The status of prescription charges in Northern Ireland is a hot topic at the moment and so will be one issue to focus on. Putting aside longer term aspirations of either widening charge exemption in England to all long-term conditions or indeed universal abolition of charges as in Scotland, Wales and Northern Ireland, we discussed the intermediary steps we could take to make prescription charges more manageable for people. Ideas included the promotion of Pre-payment Certificates and a move towards prescribing for longer than 28 days.

I'm interested to hear your thoughts, for those of you in England I would be especially interested to hear at what point you were told about pre-payment certificates and by whom.

I'd like to widen participation in our policy and public affairs work and just one way of doing that is to post updates here on health unlocked. You can find out more in the campaigns area of our website:

21 Replies

  • I use the pre-payment system for myself and husband. I pay by direct debit. I found out from looking online at NHS charges. It has been a god send really as I have two items monthly, but also as I had a lot of infections from first going on a biologic I had to have a lot of antibiotics and creams.

  • Hi I think I found out about the pre payment (I have the yearly one) by looking online as well. I have had the pre payment certificate for over 10 years now. My GP also prescribes some of my medication for longer than the 28 days - says as she can see I attend my blood tests etc and I specifically asked if I could have more than one month at a time as it was such a pain to sort out (I have two months or so for some medications).

  • I used the pre-payment as I was on three items each month and on every other month four. I was informed about this by my doctor when had to start taking all the tablets.

  • I live in England & use the Prepayment Prescription, paying annually. The Pharmacy I regularly use told me about it when they were double checking a long prescription for compatability with Methotrexate shortly after I was diagnosed with RA. Most of my prescriptions are for a month / 28 days at a time.

  • I have 16 different types of pills prescribed every 2 months and 1 script for metoject every 4 weeks - the pre-payment certificate pays for itself within about the first 6 weeks! I also have abatacept infusion every 4 weeks, and am so very grateful to the NHS. I love my pre-payment certificate - my pharmacist told me about it. Virge

  • I use prepayment prescription and I get a year one that I pay monthly, but before that I used to get one every 3 months, but this one is better. my doctor only does my tablets every month but the MTX I usually get more than a months supply. I found out about the prepayment a few years ago and it has saved me so much since being on it. I get about 9 or 10 prescriptions every month so its so worth it. I to live in England.

  • I live in England and have a yearly pre-payment certificate which I pay monthly Direct Debit for. My local chemist told me about this when I had several items on a prescription. This has saved me a lot of money and has paid for itself after three months. I now have 7 items every two months.

  • I too live in England and use pre-payment as have 3 lots meds per month, as well as all the incidentals....I was told by the Pharmacy when my RA was diagnosed(2000) but only when I broke down by the overwhelming prospect as a student of the cost of regular prescriptions and at the unfairness of it all as my very healthy sister gets free prescriptions for her thyroid.....It does save me money but frustrates me that some meds are month only and leflunomide is nearly, but not quite, 2 months! Would be a lot easier if could have all meds for longer scripts definitely and for the same amounts of time!

  • We were told by my brother-in-law so checked online before I saw a Rheumy here to have my meds represcribed when we moved back to the UK so we would could arrange for it to be in place when I restarted my meds. As there wasn't any doubt I'd have to continue on my meds we paid for annual just before I had my appointment. It's saved us a fortune as I have 10 meds represcribed each month & 1 every other month but worked out that even though there was a big saving it still cost us more than what we we had to pay in Spain. There we paid a percentage of the cost of the meds, the more commonly prescribed the med the lower the percentage paid, though I believe the percentage has changed since & is a single percentage across the board. My h had to pay a percentage too even though he's diabetic yet here all his meds not just his diabetes meds are free of charge, which we both think is crazy particularly given the incidence of so many diabetics who shall we say have brought their diabetes on themselves through complications caused by bad diet, contentious I know but it's as it is.

  • I have a yearly pre-payment certificate and pay monthly by direct debit. I found out about it from a poster in my pharmacy and then looked online. However, my rheumatology nurse did ask if I was aware of it so that was good.

  • It was only 2 years ago my local chemist told me about a pre payment certificate!! I buy a yearly one as otherwise my drugs would cost me 800 pounds a year!!! Which is a lot of money I don't have. RA is a long term condition, so why can't we get free prescriptions ??? My GP will only give you one month of drugs but if we could get two months supply that would be better. Thank you for bringing up this issue as a lot off us don't manage to work anymore. Therefore we have lost our income. Our voices need to be heard.

  • I am a nurse so knew about it, but since getting I'll I have already spent 40 quid - I wasn't to know I was developing a ltc at first, and needed to change then add analgesics had a reaction to naproxen, and then pay for MTX.

    At the hospital pharmacy the wee girl pharmacist gave me a lecture because I refused the folic acid... I said I wasn't paying 8.20 for it when I could get 270 400mcg tabs for £2.10 in tesco....she was outraged and got her calculator out to see how many tablets I would need to take!! She was so annoyed at my attempts to save some money, she didn't bother to go through MTX with me! I should have told her I eat plenty of broccoli ;)

    I'm going to buy a prepayment now though, my Gp only gives me one box meloxicam and cocodamol at a time, i will need more mtx soon, I was given six weeks worth, and then il take the prescribed folic acid I suppose!

  • My sister who is a pharmacist technician told me. I can't work due to how RA and my other diseases effects me and if I had to pay for each item I would have to not have the medications.I have 10 items a month

  • I was told by my pharmacy when I first went there after my first private consultation with my consultant. I then asked for advice on here, where the resounding opinion was YES and I am very relived it did! I was forced to go private to see my Rheumy due to my GP. My Pharmacy is very good and I have 3 DMARDS, inc MTX injection, steroids, anti-inflamm, folic acid, plus all my pain relief. My GP is very good as she has added 500mg/8mg co-codamol onto my 2 pages of repeats just from a hand written note I stapled to my repeat. But I was aware of it because of my Mum who also had RA and my Aunt who also has RA. Without it, I'd be totally stuffed...especially after paying £1000 towards my private consultations! I am now on the fabulous NHS 😀

  • I did have a prepayment card when I was working which I found out about online when first diagnosed but since it ran out I cannot afford to pay for another and also sometimes cannot afford meds since I am unable to work now due to health. vicious circle. It is embarrassing to tell drs that you havent the money to get better.

  • I was informed by my IBD Specialist Nurse when I was first diagnosed in hospital with Crohns disease. I have six + prescriptions per month so my pre paid yearly card has saved me a fortune over the years. I have recently been ill health retired from work so it is imperative for me now.

  • Nobody ever told me about prepayment certificates but as I get a lot of infections as well as RA and should be taking my meds for it but am not it would have been helpful to know. I actually came across it online when I was looking for help with my prescription charges. However because I'm on a low income I have just applied for an HC2 certificate which would entitle me to get all my prescriptions, eye tests and denta treatment for free if I qualify. If not, I will be getting a PPC

  • Hi, i found out about the prepayment system whilst in the queue in the hospital pharmacy, there was a poster on the wall, for the last 2 years i have the yearly prepayment and pay £10.40 monthly, im on 6 different meds and its a godsend, definately would recommend and frequently do.

  • I have never paid for prescriptions as from the age of 15 I had to take thyroxine. I am now well beyond the age where I would have to pay. My point is that all through those years when thyroxine was the only drug I needed on a regular basis I couldn't understand why all other medications were free also, eg antibiotics, etc. Probably not a very popular view but how much revenue was the Govt. missing out on from people like me. I do think this is something that should be addressed. Hope I haven't upset too many people!!

  • Like Thelmar I take thyroxine so am exempt (crazy system) but now all my family are in Scotland none of us pays anything. I do realise that this is open to abuse, and I resist putting things like Dermol on the prescription, but it is an amazing system. I think there should be pressure for it to be adopted everywhere. I'm sure the admin of a payment system is expensive. And the idea that people are going without the prescribed drugs is outrageous.

  • Thank you for all your responses, they are very helpful. Some of you have mentioned the rather bizarre situation of medication for treating thyroid conditions (and just a handful of other LTCs) being exempt but not many other LTCs including RA.

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