Abolition of prescription charges in Wales: the impact on medicines use in those who used to pay.
OBJECTIVE
patient co-payments for prescription medicines in Wales were abolished in April 2007 and there has been much speculation on the possible effects. We analysed patient-reported use of medicines before and after abolition of the prescription charge, noting changes in the number of items prescribed, number of non-prescription medicines purchased and participants not collecting all prescribed items (primary non-adherence).


METHODS
a sample of community pharmacists across Wales (n = 249) issued questionnaires to customers at the point of dispensing who were not exempt from the prescription charge. A second questionnaire was delivered by post to those who returned the first questionnaire (n = 1027) and expressed a willingness to participate further. Paired t-tests were applied to responses from those completing both questionnaires (n = 593). Further analyses were carried out according to gender, age and reported levels of household income.


RESULTS
there was a statistically significant (P = 0.03) rise in the number of items prescribed, and a statistically significant fall (P = 0.02) in the number of non-prescription medicines purchased. Primary non-adherence was also found to fall between pre- and post-abolition periods. Those most affected in terms of increase in number of prescribed items prescribed were the older age group (45-59 years), and those with household income of between £15600 and £36400. The most affected in the fall in number of medicines purchased were males, those in the lower age group (25-34 years) and those with a higher household income (>£36400).


CONCLUSIONS
although the rise in number of items prescribed and fall in number of medicines purchased was generally anticipated, there appeared to be little or no effect for those on the lowest incomes.
Health Economics and Policy Research Unit, Faculty of Health Sport and Science, University of Glamorgan, Mid Glamorgan, UK. sgroves@glam.ac.uk
Sam
S
Groves
David
D
Cohen
M Fasihul
MF
Alam
Frank D J
FD
Dunstan
Philip A
PA
Routledge
Dyfrig A
DA
Hughes
Susan
S
Myles
D000328:Adult; D017677:Age Distribution; D017047:Cost Sharing / Q000191:economics*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000191:economics / Q000627:therapeutic use; D010594:Pharmacies / Q000191:economics; D055553:Prescription Drugs / Q000191:economics* / Q000627:therapeutic use; D011306:Prescription Fees / Q000706:statistics & numerical data*; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014852:Wales; D016903:Drug Monitoring
D004366:Nonprescription Drugs; D055553:Prescription Drugs