Pernicious Anaemia Society
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Prescription exemption certificates

Has the PA society campaigned for prescription exemption certificates to be made available to all patients suffering from B12 deficiency? If not why not?

It is a deficiency disease absolutely analogous to diabetes mellitus or hypothyroidism (myxoedema).

I have no personal concern as I no longer pay for prescriptions because of my age. However, there must be many younger patients who require ongoing treatment for the rest of their lives with B12 supplements as well as prescription of other drugs to control various related symptoms. It is absolutely inequitable that they are obliged to pay for prescriptions for a deficiency disease which is often genetically determined and unrelated to lifestyle factors.

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That's a very good point Dewbuc as it made me realise that I had to pay for my four weekly cyanocobamalin B12 injections for P.A. (as well as any other medications) for thirty years before I attained the age of sixty. :(

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Dewbuc,

As someone who is now multiply entitled to "free" prescriptions, it no longer directly affects me either. But for some years I was entitled for hypothyroidism. Yes, it did make a difference - not vast but appreciated.

It is, as you say, inequitable that PA sufferers are not also entitled.

However, unless or until this changes, I'd like to point out the prepayment certificate available in England. More than 12 prescriptions a year make an annual certificate financially worthwhile.

nhsbsa.nhs.uk/help-nhs-pres...

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I'm hypothyroid and have been for many years before I was diagnosed with PA, so my prescriptions are free already. The one thing that isn't free is the flu jab I think it should be as PA is an autoimmune condition. I agree that the B12 jabs should be free especially as those with PA may have other conditions. On the other hand I buy my own B12 as I can't manage on the 3 monthly jab that I get at the doctors.

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Most don't actually pay for B12 injections administered at surgeries - though there have been some cases where some do - eg because they have been told to collect the phials themselves and bring them in for the injections - and that really is a rip-off.

Getting B12 injections for free (paltry though the offer is) also doesn't mean that you get other medications for free - but until the NHS recognises that people really do need treatment more than once every 3 months and delays in diagnosis and poor treatment are resulting in other complications that require on-going medication (which might well be preventable if diagnosis was prompt and treatment more appropriate) I am not sure that the case for free charges will be seen as being as urgent as it is for thyroid conditions and diabetes were daily medication is required.

I have no doubt that there will be talk going on in the background but suspect that it probably isn't at the top of the agenda, but the only way to know for sure would be to ask the question directly of the PAS - this forum is sponsored by the PAS but it is not run by the PAS.

In addition to prepayment there is also a financial assistance scheme for people who are on low incomes

nhsbsa.nhs.uk/nhs-low-incom...

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It isn't only having B12 injection doses free what we could really do with Gambit62 it is also a certificate enabling us to obtain the drug on demand as and when we need it. There is no way the medical profession is going to give the control of it up easily though, despite having done so as in the case of Ibuprofen and Paracetamol. It may be the way to get it removed from the Prescription Only prohibition is to get the Cosmetics industry to campaign for it prescription free as once it is readily available then the pharmaceutical warehouses would be offering it at similar prices to those in Germany and Spain. Then, just as for Paracetamol and Ibuprofen, the GP's could prescribe it for their patients who could suppliment their supply if they needed. Anyone else could buy it over the counter as it is unlikely to cause any more cases of adverse reaction to it than some Statins which can be bought now over the counter along with extremely powerful Proton Pump Inhibitors like Nexium.

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Kcbrecks,

I'm really not sure what point you are trying to make. I believe that even in the UK it is possible to supply injections of B12 without prescription if it isn't being used for medical purposes - it certainly seems to happen with some 'cosmetic' outfits so I don't think getting the cosmetic industry to lobby is going to work.

My response to the original question is that free prescriptions for people with B12 absorption problems won't address the issues around poor and treatment. These issues should be a much higher priority for the PAS than obtaining free prescriptions for all other medication used by patients with B12 absorption problems, regardless of whether the the medication actually relates directly to B12 absorption problems.

B12 injections provided at a GPs surgery should always be free of charge - as per Laura1961 below.

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A'hh, I wasn't aware of that with the cosmetics industry. As far as I could find injectable B12 is only available here on prescription. My point is there are other drugs which were in this status which are now over the counter medications yet are still prescribed by GP's. My wife has paracetamol for instance as a prescription item as a treatment which is then free of charge as she is of pensionable age.

I agree that B12 injections at the surgery are also free of charge, but not if you are self injecting and have to pay the prescription charge.

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paracetamol and ibuprofen are not over the counter medications - over the counter medications can only be dispensed under the supervision of a pharmacist. It is a very long time since either of these fell into the category of over the counter.

Yes it is possible to get prescriptions to cover other medications - whether over the counter, prescription only or other, and if you are exempt from prescription charges you also won't pay for these.

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I see we are at a misunderstanding here, I should have said perhaps off the shelf as both if them are readily available without prescription, as is injectable B12 in other countries within the EU. This would be a most useful situation.

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The term is, I think, General Sale List (GSL) for medicines that require licensing but can be sold from open shelves (supermarkets and corner shops as well).

OTC is used with different emphasis by different people.

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Thank you for that helvella, it was quite a surprise when I checked into OTC to find it to be an expression with very specific meaning when applied to a pharmacy. You can learn something new every day.

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I have always had my B12 injections free at the doctors surgery. i am 56 and its it the only prescription i get free! Because it is for life I was told everyone does.

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The point I was making is that if B12 deficiency was accepted as valid reason for a medical exemption certificate then all prescriptions would be free, just as for thyroid disease and diabetes. In view of the many related symptoms, this could be of benefit for those on average incomes who currently pay for everything. In the meantime as pointed out already a prepayment scheme can save money if you need more than 12 prescribed items a year.

I am currently in the US where high dose oral B12 is widely available and i was fascinated to see a glitzy B12 shop with a medic who diagnoses and treats B12 deficiency in a shopping mall.

Sadly I think the ready availability and the unjustified claims of weight loss, sleep improvement etc detract from the very real issues of genuine B12 deficiency. I suspect it is this kind of publicity and commercialisation that is contributing to the dismissive attitude of doctors and subsequently the very poor medical diagnosis and management we have all experienced.

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