MONITORING THE IMPACT OF THE REDUCTION OF PRESCRIPTION CHARGES
Introduction
Since the introduction of the policy in April 2008, the Scottish Government has been monitoring the impact of the reduction of NHS prescription charges. The information below considers the first six months of 2008/09, after the price of a Prescription Pre-Payment Certificate (PPC) was reduced by over 50%, and the prescription charge was dropped to £5.
Aggregate figures for dispensing volume and charge income over that period are already in the public domain. However, the numbers of prescriptions dispensed by presentation of a PPC are an additional detailed analysis of management information requested by Scottish Government from the Information and Statistics Division of NHS Scotland (ISD). ISD plan to incorporate this data into their range of official statistics publications in future.
Volume of Prescriptions Dispensed/ Exemption Trends
In the first 6 months of 2008/09, the total volume of prescriptions dispensed rose by 4% compared to the same period of 2007/08; in line with long term trends. As can be seen in Table 1, this increase is broadly equivalent to the increase in numbers of items dispensed to exempt patients. This increase in the number of items dispensed to exempt patients does not relate to the policy as exempt patients are unaffected by the reduction in charges.
Table 1: Volume of prescriptions dispensed April - September each year |
| 2005/06 | 2006/07 | 2007/08 | 2008/09 |
TOTAL VOLUME (m) | 38.39 | 39.02 | 40.06 | 41.75 |
% change from previous year | 3.5% | 1.6% | 2.7% | 4.2% |
| | | | |
Exempt prescriptions (m) | 33.60 | 34.23 | 35.29 | 36.82 |
% change from previous year | n/a | 1.9% | 3.1% | 4.3% |
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Rather, the phased reduction of prescription charges affects all those patients who are not exempt from paying NHS prescription charges. Trends in non-exempt [1] prescriptions are shown in Table 2, below. The number of non-exempt items dispensed in the first 6 months of this financial year was 4.9 million, which is an increase of around 159,000 from the same period in 2007/08. This accounts for 0.38% of the overall number of items dispensed.
This increase of around 159,000 items reflects a fall in the number of items paid for in full (over 310,000) alongside a significant increase in the number of items dispensed to PPC holders (470,000). An increase in the number of items dispensed was an intended impact of the policy.
Table 2: Volume of non-exempt prescriptions dispensed in April - Sept each year |
| 2005/06 | 2006/07 | 2007/08 | 2008/09 |
PPC (m) | 1.83 | 1.90 | 1.82 | 2.29 |
% change from previous year | n/a | 4.0% | -4.2% | 25.9% |
| | | | |
Paid charge (m) | 2.96 | 2.89 | 2.95 | 2.64 |
% change from previous year | n/a | -2.4% | 2.3% | -10.6% |
| | | | |
TOTAL Non-Exempt (m) | 4.79 | 4.79 | 4.77 | 4.93 |
% change from previous year | n/a | 0.0% | -0.3% | 3.3% |
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Figure 1, below shows the numbers of items dispensed split by exemption/ non-exemption status. As can be seen, the overall change in numbers is not far out of line with the trend.
Figure 1: Balance between exempt and non-exempt items by quarter
Prescription Pre-payment Certificates (PPCs)
There has been a large increase in PPC sales (See Figure 2 below) and an associated increase in the number of prescriptions dispensed by presentation of a PPC. Sales have more than doubled.
Please note - PPC sales data is available earlier than other prescribing data as a result date below shows sales for 11 months up to the end of February 2009.
Figure 2 - PPC sales
[1] either paid for or dispensed through use of a PPC