How the NHS Works, part 2 (Prescriptions)

Before I begin, let me re-iterate from my previous post that the following is based on my experience as a patient of the NHS and should not be taken as accurate!

Prescriptions

Prescriptions written by your GP may be filled at any pharmacy, and in my experience patients are not provided with free samples of drugs. Pharmacy hours tend to be quite short compared to pharmacies in the US, though that is slowly changing.

The cost of a prescription is currently £7.10, with exemptions given to people who meet certain guidelines or with certain conditions. The prescription charge seems reasonable compared to prescription charges in the US, but the caveat is that which drugs a GP may prescribe is decided by a body called NICE (the National Institute for Health and Clinical Excellence), and the list may exclude or limit drugs that are frequently prescribed in the US. Cost is a determining factor, with generics being preferred.

As an example, the only antibiotics I’ve been prescribed in over 10 years are: doxy- & tetracycline, amoxycillin & flucloxacillin, cipro and metronidazole. That’s it. And I’ve had a few infections that required antibiotics. Some of the newer antibiotics may be available on the NHS, but I’m guessing the guidelines recommend using less expensive generics where possible. (The argument for or against antibiotics is a separate issue.)

There has been quite a bit of press lately about certain drugs being unavailable under the NHS. The drugs are often very expensive drugs used to extend the lives of cancer patients. The reason NICE denies some drugs is because they do not offer value for money, as in this example.

Unfortunately, drug issues have led to public battles over mixed care (part NHS, part private), as some patients who voluntarily pay for for their own drugs are being denied further NHS treatment for their conditions. The practice of banning mixed care is currently under review.

Next, referrals.

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