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Feature Data Briefing

Prescription charges: are they worth it?

BMJ 2014; 348 doi: (Published 17 June 2014) Cite this as: BMJ 2014;348:g3944
  1. John Appleby, chief economist
  1. 1King’s Fund, London, UK
  1. j.appleby{at}

John Appleby assesses whether the policy of charging for prescriptions in England is helping or harming the NHS

While Wales, Northern Ireland, and Scotland have abandoned charges for prescriptions, in April the English saw prescription charges rise once again, to £8.05 (€10; $13.5) per prescribed item. Labour peer David Lipsey has suggested that the charges are, “a dog’s dinner lacking any basis in fairness or logic and stuffed with anomalies and inconsistencies.”1 But apart from unfairness, illogicality, and anomalies, is there a fundamental problem with such charges?

Although prescription charges have been rising, the latest data show that the number of pharmaceutical items prescribed in England reached its highest level yet—over one billion in 2012—equivalent to nearly 19 per person and an increase of 62% since 2002 (fig 1).2 But as fig 1 also shows, the proportion of prescribed items that attracted a charge was small (around 10%) because …

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