Paying less for your prescription medicines

THIS WEEK saw a much-criticised 13 per cent rise in prescription charges, from pounds 3.75 to pounds 4.25 per item, writes Lindsay Knight.

Defending its actions, the Government stressed that only about one in five items dispensed on the National Health Service is paid for. But that leaves more than 40 per cent of the population who are not exempt.

However, there are certain drugs and preparations that can now be bought over the counter at the local pharmacy, without a prescription, and more cheaply. They include many commonly used products such as pessaries for thrush, antacids and creams to treat acne.

So how do you find out? There are lists, but they are not available to the public. Similarly, the doctor's guide to drugs, MIMMS, shows which drugs are available over the counter, but this is not in the public domain either.

GPs are in an interesting position. In fact, on a strict interpretation of NHS terms of service, doctors are obliged to order on NHS prescription any medicines needed for treatment, even if they are available without prescription.

'They are not obliged to tell you if a drug is available over the counter, at a cheaper price,' explained Dr Simon Smail, a Cardiff GP.

The British Medical Association points out that if a doctor does advise the patient that a drug is cheaper, he could be said to be in breach of his terms of service.

But, as BMA advice continues: 'It is a common practice unofficially condoned by the Department of Health.' And it is certainly not something patients are likely to complain about.

But GPs are not trained in the finer points of pharmacy and they cannot be expected to carry in their heads the price differentials of all pharmaceutical products. It is the friendly local chemist who is geared up to help people, and pharmacists are strongly advised to do so by the Royal Pharmaceutical Society.

The society has been campaigning for more drugs to be available over the counter, as long as they are 'simple medicines for self-limiting ailments'. Not only can this make financial sense for the consumer, it can save doctors time, too.

A prescription with two or three items is becoming very expensive, and the pharmacist can always advise if one item or more can be bought more cheaply over the counter. A prescription can be divided up in this way.

The Government is committed to streamlining the process of deregulation of drugs. Perhaps as part of its Patients' Charter, we should all be given a list of those drugs and preparations that are cheaper without a prescription.

There follows a list of drugs that can be obtained more cheaply over the counter.

Altacite Plus suspension; an antacid

Anthisan cream for treating allergies such as hay fever

Asilone liquid; an antacid

Benoxyl cream and lotion, for acne

Bonjela for mouth ulcers

Caladryl lotion for skin irritation

Dequadin lozenges for mild oral fungal infections

Ecostatin cream for vaginal thrush

Eskamel cream for treating acne

Gaviscon liquid; an antacid

Ketovite liquid, a vitamin supplement

Lacto-calamine lotion

Migraleve Duo, for migraine

Phenergan tablets for allergies such as hay fever

Selsun, a shampoo for dandruff

Transvasin for relief of muscular pain

Xylocaine gel and cream, for urethral pain such as cystitis

(Photograph omitted)