Prescription Drug - Regulation in United Kingdom

Regulation in United Kingdom

In the United Kingdom the Medicines Act 1968 governs the manufacture and supply of three categories of medicine:

• Prescription-only medicines (POM) which can be sold by a pharmacist if prescribed by a prescriber
• Pharmacy medicines (P) which may be sold by a pharmacist without prescription
• General sales list (GSL) medicines which may be sold without a prescription in any shop

Possession of prescription-only medicines without a prescription is not a criminal offence unless it falls under the Misuse of Drugs Act.

A patient visits a medical practitioner who is authorised to prescribe drugs and certain other medical items, such as blood glucose testing equipment for diabetics. Similarly, suitably qualified and experienced nurses and pharmacists may be independent prescribers. Both can prescribe all POMs but pharmacists are not allowed to prescribe controlled drugs. District nurses and health visitors have had limited prescribing rights since the mid-nineties, before which prescriptions for dressings and simple medicines would have had to have been signed by a doctor.

Most prescriptions in the UK are NHS prescriptions, which can be taken to a pharmacy to be dispensed. The NHS prescription fee is £7.65 per item in England (as of 1 April 2012), however prescription charges have been completely abolished in Scotland, Wales and Northern Ireland.

Prescription charges are paid entirely to the NHS through the pharmacy, while the pharmacy claims back from the NHS the cost of the medicine dispensed. Many of the prescriptions dispensed on the NHS are exempt from charges. Patients are exempt from the standard per-item charge if they are over 60, under 16 (or under 19 if in full-time education), have certain long-term chronic conditions such as myasthenia gravis, are on certain income-related benefits, or have a low income and qualify for an HC2 certificate. Those requiring regular prescriptions may make a saving by purchasing a pre-payment certificate which covers the cost of all prescriptions required for three months or a year. In 2012, these were £104 for 12 months, or £29.10 for 3 months.

The per-item fee applies regardless of the quantity of each item prescribed by the doctor, and regardless of the underlying cost of the medicine to the NHS. This means that the financial impact on the patient of this system of fees can vary enormously - the actual cost of the medicine given out may vary from a few pence to hundreds of pounds. However, medical practitioners can prescribe a maximum three months supply of the medicine for it to be covered under the NHS. If a medical practitioner wishes to prescribe a supply in excess of three months, the prescriber must write a separate private prescription for the balance of the medicine supply in excess of three months, for which the patient must pay the actual price as charged by the pharmacist. Private prescriptions are also issued by medical practitioners seen privately or sometimes for medicines not covered on the NHS. For these, the patient will pay the pharmacy directly for the cost of the medicine and the pharmacy's dispensing fee.

In 2007, a survey conducted by Ipsos Mori found that 800,000 people failed to collect a prescription during 2007 due to the cost.