Demand for prescription drugs in rich areas rises after abolition of charges in Wales

BMJ 2008; 336 doi: (Published 13 March 2008) Cite this as: BMJ 2008;336:577
  1. Roger Dobson
  1. 1Abergavenny

    The phasing out of prescription charges in Wales may have led to more demand for prescription drugs in richer areas.

    The percentage change in prescriptions for non-sedating antihistamines doubled during the two years after the first reduction in charges compared with the change during the two years before. In the same period rates stayed the same in parts of the south east of England, where charges remained (Health Policy 2008 Mar 6; doi: 10.1016/j.healthpol.2008.01.006).

    The researchers, who chose to investigate drugs for hay fever because of the high incidence of the condition, also found that the biggest increases in prescribing in Wales were in the richest areas.

    “This would suggest some individuals were making the decision to obtain a prescription for medication they may previously have purchased,” say the researchers. “This does not detract from the desired aim of the policy to remove a healthcare inequity. It does, however, suggest there may have been a shift in health seeking behaviour involving more visits to the doctor by those from less deprived areas to obtain a prescription and avoid the need to purchase.”

    The researchers looked at prescribing between 2001 and 2006 by local health boards in Wales and 15 primary care trusts in the south east of England.

    In Wales the percentage change in the median number of non-sedating antihistamines prescribed per 1000 people in the two years after the first reduction of the prescription charge was significantly greater than the change in the two years before this period (13.7% (interquartile range 10.9%-17.1%) v 7.3% (5.0%-10.7%), P<0.001). The number of prescription items dispensed in the English trusts did not change.

    “It is a laudable aim of the government in Wales to make medicines free for all at the point of need. It would appear, however, that the policy is having an impact on those who may otherwise have purchased a medicine over the counter. While such an approach is understandable it does not reflect the required collective, social responsibility to constrain unnecessary demand on health service resources,” say the authors.

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