Cited by 105Pharmaceutical Economics and PolicyPharmacy and Medical PracticesHealthcare Systems and Reforms

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Access to medicines: cost as an influence on the views and behaviour of patients

Schafheutle, Ellen I., Hassell, Karen, Noyce, Peter R.·2002·Health & Social Care in the Community

DOI 10.1046/j.1365-2524.2002.00356.x

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Abstract

The present paper explores how charges for medicines incurred by patients influence their decisions for managing acute or chronic conditions, and whether prescription cost and affordability issues are discussed in the general practitioner (GP)-patient encounter. People suffering from dyspepsia, hay fever or hypertension, or those taking hormone replacement therapy, were recruited through three community pharmacies in the North-west of England. Six focus groups were conducted with a total of 31 participants, the majority of whom were non-exempt from prescription charges. The management behaviour of those participants who had to pay for their prescriptions, particularly those from less-affluent or deprived backgrounds, was influenced by cost. However, cost was not the overriding influence, with other factors, such as symptom or disease severity, effectiveness, or necessity of treatment, playing a more important part in participants' management decisions. Cost as an issue was reflected in the various strategies used by participants to reduce medication cost, such as not having some prescribed items dispensed, taking a smaller dose or buying a cheaper over-the-counter product. Despite the use of numerous strategies, participants did not talk to their GPs about issues of cost and affordability. Participants felt that paying for prescriptions was their problem. There was a belief that discussing cost issues could jeopardise the doctor-patient relationship. Although not the dominant factor, medication cost nevertheless influenced participants when deciding how to manage their condition. Awareness of the existence of prepayment certificates, which can be bought by patients who require regular medication, was low, and this should be addressed through improved information/dissemination. Despite the high level of prescription items exempt, the current level of the prescription charge is still a barrier to obtaining prescription medicines under the National Health Service to those on lower incomes.

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Authors: Schafheutle, E. I., Hassell, K., & Noyce, P. R.
Affiliations: University of Manchester (GB)
ORCID: Schafheutle, Ellen I.
Venue: Health & Social Care in the Community
Publisher: Hindawi Limited
Published: 2002-04-30
Volume: 10
Issue: 3
Pages: 187-195
ISSN: 0966-0410 (ISSN-L)
DOI: 10.1046/j.1365-2524.2002.00356.x
OpenAlex: W2076062096
Cited by: 105
References: 32
Citations by year: 2026: 2 · 2025: 1 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 2 · 2017: 7 · 2016: 2 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 1
FWCI: 13.73
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Health & Social Care in the Community (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
Keywords: prescription charges, drug affordability, patient decision-making, socioeconomic deprivation, physician-patient relationship, dyspepsia, allergic rhinitis, hypertension, hormone replacement therapy, National Health Service
MeSH terms: Adult, Aged, Aged, 80 and over, Communication, Decision Making, England, Fees, Pharmaceutical, Female, Health Services Accessibility, Humans, Male, Middle Aged, Patient Compliance, Physician-Patient Relations, Cost Sharing, Focus Groups, Drugs, Essential

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Access to medicines: cost as an influence on the views and behaviour of patients

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