PHP160 - PRESCRIPTION CHARGES IN SCOTLAND: THE IMPACT OF FREE PRESCRIPTIONS

Abstract

Seven years after the introduction of free prescriptions in the devolved administration of Scotland, the purpose of the paper is to review the impact of free prescriptions in terms of drug volume, overall pharmaceutical spending and to understand what benefits free prescriptions brought to the individual, the healthcare system and society. We analysed the official publications from the Information Services Division (ISD) of NHS Scotland from 2006 through to 2016; reviewing total prescriptions dispensed, prescriptions per head of population and the cost of prescription medicines. In the period prior to the introduction of free prescriptions (2006-2011) the compound annual growth rate (CAGR) of total prescriptions dispensed was 3.5% to 91.4 million items in 2011, while in the period after the introduction of free prescriptions (2011-2016) the CAGR was 1.5% to a total of 1022 million items in 2016. At its height, the financial year 2007/2008, prescription charges brought in £49.5 million to NHS Scotland. Similarly, the prescriptions per head of population in the 2006-2011 period was 2.9% (CAGR) versus 1.2% in the 2011-2016 period. At the same time the net cost of prescription items dispensed rose by 2.5% (CAGR 2006-2016). One justification put forward as the need for prescriptions charges is that they act as a deterrent to frivolous or inappropriate drug consumption. If this were true we would expect to see a rise in the rate of dispensing in Scotland as prescription charges were withdrawn, instead we see slowing of that rate. What is clear however, is that NHS Scotland could gather in excess of £50 million of additional revenue through the reintroduction of prescription charges which could be redistributed into other areas of the NHS.