title: The impact of prescription charges on asthma patients is uneven and unpredictable: evidence from qualitative interviews.
abstract: OBJECTIVE
  To explore whether, and how, prescription charges affect asthma patients' disease management behaviour.
  
  
  METHODS
  Thirty qualitative interviews.
  
  
  RESULTS
  Interviewees were aged between 21 and 59, 21 were women, 24 were paying individual prescription charges, and six had prepayment certificates (PPCs). Most had a beta2-agonist 'reliever' and a steroid 'preventer' inhaler. Prescription charges posed affordability issues for some, and for two patients cost-related reduction in 'preventer' use affected asthma control negatively. Many described various ways of keeping medication cost down. Affordability issues, negative views on paying charges, and whether interviewees viewed their asthma medication as essential, were influential factors. Steroid inhalers were viewed more commonly as being less essential and affected by cost. The episodic nature of asthma meant that predicting benefit from PPCs was difficult.
  
  
  CONCLUSIONS
  This study strengthens existing evidence that medication cost is a factor in asthma patients' management decisions, with a potential cost-related impact on asthma control.
authors.affiliation: School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK. ellen.schafheutle@manchester.ac.uk
authors.forename: Ellen I
authors.initials: EI
authors.lastname: Schafheutle
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000191:economics*; D003657:Decision Making; D016527:Drug Costs; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers / Q000191:economics; D010349:Patient Compliance; D011320:Primary Health Care; D006113:United Kingdom
chemical_list: D018927:Anti-Asthmatic Agents