Charged double prescription because of my Levothyroxine dose

[Sick-and-Tired]

Hi everyone!

I do know that if you are diagnosed as hypothyroid you are exempt from paying the prescription charges, but I haven't actually been officially diagnosed (I have high thyroid antibodies which I find out by getting a test through Blue Horizon and my TSH has only reached 5.7 at its highest). However, after a long journey I've managed to get myself put on a trial of Levothyroxine to see if it helps the long list of symptoms I've been suffering from for over 10 years.

I have just seen the doctor and had my dose upped from 50mg to 75mg as my TSH has actually gone up during my first 3 months on Levothyroxine.

However, when I just went to collect the prescription from Boots I was charged twice because they don't make it in a 75mg dose. So I was charged for 50mg and 25mg.

I've got to admit this has maybe upset me more than it should but I just feel like everything is a huge battle right now and I'm just so tired.

As I say, I know lots of people on here probably don't pay for prescriptions but does this seem right to you?

[Hidden]

you shouldn't be paying at all, the fact that your tsh has gone down means that you needs the medicine, optimally your tsh should be under one. I had a tsh of around 5 for ten years before my doctor would finally listen after it had crept up to 22. I would insist with your doctor that you get an exemption card, put your foot down with them and insist x

[Neverending63]

You can print it off the internet, fill it in and take it to the surgery and ask them to complete it. If you have to pay out anymore between applying and getting it then as long as you keep receipts you can claim it back. Hope this helps.

[Kittylitter2]

Boots had no right to charge you twice, the 50mcg and the 25mcg is to make-up the entire dosage of one item, if you have the energy, you can go back and have it out with them. Also ask the surgery for an exemption form - mine offered me one without even asking.

[SeasideSusie Remembering]

Sick-and-Tired

I can understand the double charge if there were 2 items on your prescription. What your GP should have done was increase the amount of 50mcg tablets and tell you to take 50mcg one day, 100mcg the next, to average 75mcg. Then there would only have been the one charge.

I don't know if you can do anything about it now, but if you had got a receipt, then asked for the exemption certificate, maybe you would have been able to claim the charges back (I don't know if that is the case, it's just a thought I had).

Maybe when a patient has a "trial" of Levo, perhaps an exemption certificate can't be issued until hypothyroidism is confirmed after the trial. As you've had an increase in dose I would imagine that your GP is satisfied and will diagnose hypothyroidism now and you can get your certificate. I would certainly ask.

[helvella in reply to SeasideSusie]

Afraid I think that a refund against a later-issued exemption might be impossible. I strongly suspect you would only ever stand a chance of a refund if you got the right sort of receipt. That is:

you ask for an FP57 refund receipt when you pay (you can’t get one later)

nhsbsa.nhs.uk/exemption-cer...

Even then, an exemption can only go back one month.

A refund of an invalidly levied double-charge would be different.

[SeasideSusie Remembering in reply to helvella]

you ask for an FP57 refund receipt when you pay (you can’t get one later)

Yes, that's the receipt I mean but didn't know what it was called/code number. Most people probably don't though.

[Kittylitter2]

psnc.org.uk/dispensing-supp...

[Kittylitter2 in reply to Kittylitter2]

It states that different strengths of the same drug written on the same prescription should only be charged as one item, yet further down it says 2 items of the same drug but different brands are charged twice, so for instance 50mcg of one brand and 25mcg of another brand would be classed as two separate drugs perhaps?

[helvella in reply to Kittylitter2]

I could just about understand if the patient asks for two different brands, or the doctor even prescribes two different brands, but if the prescription was written (as usual) "levothyroxine sodium" with no hint of a brand, it is hardly the patient's fault. To a large extent, it is a matter of luck and pharmacy stock.

[Sick-and-Tired in reply to helvella]

Yes, they are different brands so I suppose the are within their rights. It just seems so unfair! I should just be grateful to finally be on Levothyroxine... I think maybe I'm just feeling a bit low with all the tiredness and this has felt like a bigger blow than it really is.

[helvella in reply to Sick-and-Tired]

Don't blame you at all.

If you felt up to it, it would be worth following a formal complaint. But don't for one minute think this is meant to push you into doing so. There's probably far better things to do with whatever interior resources you have left.

[helvella in reply to Sick-and-Tired]

Thinking about it, technically you could argue they are different manufacturer's "generic" offerings and are, therefore, NOT brands, and certainly not liable to this discriminatory and unfair handling.

[helvella in reply to Sick-and-Tired]

Further down the page referred to earlier, it makes a very clear statement:

Q. I have a prescription requesting both Paroxetine 20mg tablets and Seroxat 20mg tablets, how many patient charges do I collect?

One patient charge should be collected as both items are the same generic drug and the same formulation.

The Pricing Authority does not differentiate between the generic name and brand name as they are both the same generic product.

psnc.org.uk/dispensing-supp...

[Sick-and-Tired in reply to helvella]

Thank you so much for looking into this for me! I think I will take this further, as much as my energy will allow.

[SlowDragon Administrator]

I hope the 25mcg and 50mcg are the same brand of Levothyroxine

Patients are advised to stick to the same brand

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

which brand did you have for 50mcg ?

Which is the 25mcg?

[Sick-and-Tired in reply to SlowDragon]

Hi, no they are different brands! 50mcg is Almus and 25mcg is Mercury Pharma. I've previously just been on Almus. Do you think I should raise this with my doctor?

[SlowDragon Administrator in reply to Sick-and-Tired]

See how you go

Some patients don’t notice a difference. Others do

Alums may not make 25mcg

Personally I stick entirely on Mercury Pharma. Others don’t get on with mercury

At least it wasn’t Teva brand - very large numbers of patients really don’t get on with Teva

If you notice a difference then just ask GP for more 50mcg pills. You can either cut one in half to give 25mcg or take 100mcg one day and 50mcg the next

T4 is a storage hormone, you shouldn’t notice taking different dose each day

Would recommend you get a weekly pill dispenser to keep by bed. Taking more than one pill per day, especially if different dose alternate days, it’s incredibly difficult to remember each day ...,..if you have taken it, or which dose on which day

[Sick-and-Tired in reply to SlowDragon]

Thanks! Fingers crossed the brands are ok for me. Good idea with the pill dispenser!

[Sick-and-Tired]

Hi! I just wanted to update and thank everyone on here for your replies!

I went back into boots armed with the webpage that helvella sent to me.

I ended up with the same woman I dealt with initially who spoke to me really slowly and was saying I was wrong. She ended up saying she would have to get her manager to explain it to me. And when the manager came over she immediately agreed it should be 1 charge and refunded me!

I also now have the medical exemption form which I'm hoping my doctor will sign this week.

Thank you so much again for all the advice and, most of all, moral support! Xxx

[Laundretta in reply to Sick-and-Tired]

Yay! Well done you! 👊

[SeasideSusie Remembering in reply to Sick-and-Tired]

Well done.

How cheeky of Assistant number 1 to speak to you slowly, hopefully the Manager will explain to her "slowly" the correct procedure now

[Yammie1973 in reply to Sick-and-Tired]

You go girl....cheeky assistant (and I'm being polite). I hope that the manager gave her a right talking to for her assumptions that you were hard of understanding.

[Yammie1973]

NOT right at all!! Get to the GP and get the exemption card. or rather get the GP to send off the forms for your exemption card. You DON'T pay for prescriptions regardless of how many break downs the meds come in...BOOTS are at fault, I would keep the receipt and march right back to BOOTS once you have the exemption card and demand a refund.