In my ignorance, I thought that when you had a private prescription you paid for the actual cost of the drugs and when you had an NHS prescription you paid £9.65 per item.
Last week I saw a consultant privately and was given a private prescription for 84 x Amitryptaline 10 mg. The pharmacy at the private hospital was closed as it was Saturday. I took it to a pharmacy where I was charged £9.65. This is the cost of an NHS prescription (unless you have an exemption)
When I got home I looked up the cost of the drugs I’d had and they cost 0.04 p per tablet.
I later discover that if I’d taken the script to the hospital pharmacy I’d have been charged (84 x 0.04 p) £3.36. If you use a regular pharmacy for drugs which are privately prescribed, and the price of the drugs is less than the cost of an NHS script, you pay the NHS prescription charge.
Wow. 😩😩
It does bring home the fact that although many are eternally and appropriately grateful for their NHS prescriptions (if they’re not exempt), in many cases the ‘cost’ of the drugs involved is less than the prescription charge. It would help enormously if, in such cases, NHS patients could pay only for the drugs and not the prescription. That won’t happen because NHS doctors can’t write private prescriptions.
I suppose it’s swings and roundabouts.
Maybe 😳
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The pharmacy will likely have a range of possible suppliers with a range of prices. Then discounts depending on all sorts of factors. That makes it very difficult to find out.
NHS pay the pharmacy through an agreed reimbursement mechanism based on the NHS Drug Tariff.
NHS also pays a dispensing fee (something like 245.0 through 286.8 depending on prescription).
NHS Drug Tariff prices for amitriptyline range from 75 through 98 pence per 28 (depending on dosage). Actually very similar prices to most levothyroxine tablets.
The pharmacy that charged £9.65 might well simply apply a base price equal to NHS prescription charge.
For example:
For private prescriptions you've obtained from another GP, we have a minimum dispensing charge of £9.65 per item.
I've never seen anything that stops pharmacies charging whatever they want for private prescriptions. But maybe there is some sort of price control mechanism?
Find the cheapest private prescriptions
While NHS prescription prices are fixed, pharmacies can set their own for private prescriptions. These are given when you want a drug not covered by the NHS in your region, such as Malarone to prevent malaria if you're travelling and some cancer drugs.
It could be a drug for a lifestyle-enhancing purpose, such as sexual aid Viagra (although this can be on the NHS if your erectile dysfunction's caused by a medical problem, such as diabetes, prostate cancer or a kidney transplant) or anti-baldness drug Propecia.
Non-NHS doctors can't give NHS prescriptions. So go to one for emergency weekend diagnosis, or because you're a member of a scheme, and you'll get a private prescription.
Always compare prices
Unlike the world of NHS prescriptions, with private prescriptions it's an open marketplace and pharmacies can set their own prices, meaning costs vary hugely.
The table below shows how prices can vary for just one item, but it can be an even bigger difference if you ask for the generic version.
I am utterly amazed if a private hospital really would only charge £3.36. Did they simply not mention a dispensing fee (or whatever system of charging they use)?
Note: NHS prescription charges only apply in England and even then only if you do not qualify for exemption.
I am utterly amazed if a private hospital really would only charge £3.36. Did they simply not mention a dispensing fee (or whatever system of charging they use)?
I agree entirely.
The whole subject is so fraught with complexities and contradictions it’s ridiculous.
I remember one of the most useful NHS prescriptions I got was one for 2 packets of iron supplements from my GP. It wasn't what the doctor did that was so useful it was the pharmacist.
She read my prescription then got out a big book and flicked through it quite intently. I asked if there was a problem and she said something like "I was just wondering if your prescription would be cheaper if you paid for it over-the-counter or were charged NHS prices."
At the time it was cheaper paying NHS prices but not by much. But I confirmed my understanding from the pharmacist that I could buy the iron supplements without a prescription, and she said that I could.
It was really one of the best days of my life - and I'm not exaggerating. With one sentence I was freed from having to beg and plead and justify myself to doctors when I was almost dying of fatigue and was desperately anaemic. Around the same time I found out that I could pay for private testing, again without having to beg and plead with doctors to actually take me seriously. I had other major (good) things happen with my health that same year e.g. starting thyroid hormones. It still took me years to feel semi-human but at least I could take some responsibility for my own health without having to rely on doctors to help me, given that their computers always said No.
all doctors in the UK can write a private prescription as long as their GMC number is on the prescription. Many choose not too but they can, including all NHS doctors.
I’ve even had a private prescription written on a paper napkin that worked fine at the chemist. They have to take personal responsibility for the prescription so there could be insurance complications if there was a bad reaction to the drug prescribed.
Adding my two penneth, if you are diagnosed hypothyroid you can ask for an exemption card at your GP reception and all NHS prescriptions are free. Lasts 5 years I think then you renew. It’s on my record at the pharmacy and I don’t have to show it anymore. I will need to remember to renew it.
And, as you say, it does have an expiry date. And that is the individual's responsibility. Numerous patients have been fined for not being in possession of a current exemption certificate - despite still being entitled to one.
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