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Should diabetics have to pay for their prescriptions?

It was in the news a few days ago that a tory MP and GP has suggested that diabetics should have to pay for their presciptions.

http://eoin-clarke.blogspot.co.uk/2012/11/tory-mp-says-diabetic-sufferers-should.html

http://www.telegraph.co.uk/health/elderhealth/9703423/Spending-on-medicines-must-be-cut-because-Britons-cannot-put-up-with-aches-and-pains-like-their-wartime-forebears-says-Tory-MP.html

I can see that it isn't financially viable to give out free medication to an increasing number of people, especially given the statistic quoted in the telegraph that it is estimated that by 2025, 25% of the nhs budget will be spent on diabetics alone. However, it seems a bit like Dr Lee has forgotten that not all diabetics are diabetic because of their lifestyle. In some ways it is unfair to tar everyone with the same brush so to speak, as the number of diabetes cases rises (linked to obesity increasing) it gets more expensive and so everyone has to pay. Though I can see that it could be difficult to differentiate between who pays and who doesn't. For example, do you let someone who agrees to lose weight have free treatment? If so, how do you monitor the weight loss? If it means seeing a nurse regularly, this takes up appointments and causes more problems.

So maybe they should all pay? But then, how do you explain that to diabetics who have recieved free treatments all of their lives and suddenly have to fork out £7.65 for prescriptions? Not many would be happy with this!

Treatment has been free because it is considered to be vital, something they cannot live without. Certainly, insulin-dependent diabetics cannot survive without medication. However, I'm asthmatic and I have to pay for all of my inhalers and everything that goes along with it (pf metre, spacer, antihistamines throughout the summer, antibiotics etc) yet there are times when I am dependent on my salbutamol! I'm not saying that I should have it free, and pre-pay prescriptions are great, but I'm sure you can appreciate that it does seem unfair!

Personally, I'm an advocate for pre-pay prescriptions! That way everyone contributes, but it means that it's a reduced cost. For example, last year my prescriptions worked ot at about £5 each. Obviously it's a lot of money, but I'm a student and I can afford it. Anyone on low income would fall within the income-support exemption.

What do you think tsr?

Sorry if it's a bit of a disjointed argument. My phone won't let me go back and check it!

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Reply 1

Nice.Guy

Original post by ~DayDreamer~

What do you think tsr?

I completely disagree with this idea. It's pretty well known that some people may already have a genetic predisposition to diabetes - and they may become diabetic despite a good, healthy lifestyle.

It's unfair to discriminate on something people have no control over. And it goes against the mantra of the NHS, that healthcare should be 'free at the point of use'. I read on a different thread someone suggested alcoholics should have to pay for their treatments. . . but what if the treatment wasn't necessarily down to alcohol? Where do you draw the line at who should pay and who shouldn't?
As someone said on that thread, should we start forcing people to pay for healthcare if they leave their house? Because they are technically taking a risk by doing that.

Oh and a PS: going by my logic, your asthma treatment should be free...

(edited 11 years ago)

Reply 2

ellieHA

Original post by Nice.Guy

Oh and a PS: going by my logic, your asthma treatment should be free... or, actually, perhaps you have to pay because asthma isn't a life-threatening condition - diabetes is.

I swear asthma is life-threatening? asthma attack -> suffocation -> death?

Anyway in an ideal world I don't think anyone should have to pay for their prescriptions. Maybe they should means-test it and if you can afford it, you have to pay, and if you earn below a certain amount, you should get it free.

Reply 3

Nice.Guy

Original post by ellieHA

yeah, i'm not sure, that was just a suggestion i thought of as to why maybe - you may be right, but perhaps it's just seen as a lower risk?? I don't know :dontknow:

Reply 4

~DayDreamer~

Original post by Nice.Guy

I do agree with you up to the end of the second paragraph to an extent. I don't think anyone should have to pay for anthing that is not their fault. However, there is an evident link between obesity and diabetes. Though I admit there is also evidence to suggest that obesity can have genetic influences. Similarly, I suppose that type II diabetes can be controlled with diet so perhaps it has less of a contribution to overall costs.

What you've said is probably the reason that a system where you pay depending on your illness/ injury can never work- obviously you can take anything as a risk. Also, I'm sure trying to help alcohlics, smoker etc to quit is much better than just leaving them to their own devices.

I do have an issue with your last paragraph though. Asthma can be fatal. Believe me, you get a pretty good sense of that during an attack.

http://asthma.org.uk/news-centre/latest-news/2012/05/one-in-three-people-with-asthma-at-highly-increased-risk-of-a-potentially-fatal-attack/

The problem is that a lot of people see asthma as a bit of a cough. They don't realise how limiting it can be to live with it. I had a cold last week. I still can walk up more than 2 flights of stairs. When my asthma is controlled I can dance for an hour no problem.

May I ask, since a lot of what the NHS does does have to be essentially down to funding at some point, how would you go about tackling the rising costs? Maybe invest in research now to save money in the future? Though we don't like to think of it, money is always the limiting factor. That's why I suggest pre-pay/ reduced costs.

Reply 5

username851717

I don't think they should, seems a bit harsh charging people to pay for something they need to live every day.

However they do charge for prescriptions that are similar e.g. blood pressure tablets for people with PKD despite the fact that if they didn't take them then the end result wouldn't be too good. This again seems harsh.

So a big fat no from me.

Reply 6

Nice.Guy

Original post by ~DayDreamer~

Yeah, I'm sorry, someone else pointed that out - I'll edit it now, I mixed it up with something else which is pretty similar to asthma... :redface:

As to what I'd do with the NHS, if anyone knew the answer to that, they should be running the country! I think, if anything, prevention should get more attention - especially with issues such as alcohol, obesity, and all their associated risks... But i could be completely wrong, what's your take on it??

Reply 7

member520746

We have socialised healthcare, and it should remain that way. It's not the business of the NHS why you need treatment, only that you need treatment and it should be given to you freely

Reply 8

~DayDreamer~

Original post by Nice.Guy

Yeah, I'm sorry, someone else pointed that out - I'll edit it now, I mixed it up with something else which is pretty similar to asthma... :redface:

Haha ok

I think I lean towards prevention, but also education. It should be compulsary for schools to teach how to make healthy, easy, tasty food right from primary school. The government should target young kids about healthy lifestyles since most of the time, little kids get what they want! Toy companies take advantage of pester power to make money, so why shouldn't the government to make people healthier?! I kind of think that if parents buy healthy stuff for their kids then they'll eat it too! Similarly, if kids want to go out and exercise then someone has to supervise! In practice though, this probably would never work!

I'm with you and Hippocrates- prevention is better than the cure!

Reply 9

hslt

Original post by Nice.Guy

Oh and a PS: going by my logic, your asthma treatment should be free... or, actually, perhaps you have to pay because asthma isn't a life-threatening condition - diabetes is.

Seriously? Asthma is a far more immediately life-threatening condition than diabetes - you can most definitely die from it.
On the other hand, how many people die from acute complications of diabetes? Very few...

Reply 10

TheSownRose

I would have no objection to diabetics not having to pay for their diabetes treatments or anything directly related, but I'd argue for the same to apply to anyone with a chronic condition that will require lifelong treatment (eg, asthmatics not paying for inhalers, people with underactive thyroids not paying for thyroxine, etc.)

However, bear in mind that a lot of the type II diabetics are likely to also be covered by 'aged 60 and over' exemptions.

Reply 11

cheetahs56

I am a type 1 Diabetic- mine is purely through no fault of my own, it is just a condition which could be linked to genetics. Why should I pay?

Reply 12

Nice.Guy

Original post by hslt

Please READ the thread before replying, especially as it's not even a page long . . . this has already been pointed out twice, and I've edited my original post.

I'd just read an article comparing asthma, to a very very similar condition in terms of mechanism which was NOT life threatening.

By the way, many more people die from diabetes than asthma.
Some statistics for you. . .
In the UK, around 75000 diabetics die per year, compared to around 4000 asthmatics.
Worldwide, around 3.4 million diabetics, compared to 0.25 million asthmatic deaths each year.

Can you not contribute anything useful to the thread?

Reply 13

Tiger Rag

Not all diabetics get free prescriptions. It's only those who can't be controlled by diet alone.

Diabetes can cause all of kinds of medical issues - such as sight loss, etc. Many may not die; but they can be left with major health issues.

Reply 14

theonefrombrum

Original post by hslt

A hell of a lot more than those who die because of asthma and so get your facts right and stop commenting on things you are clearly uninformed about.

Reply 15

lightburns

I have a genetic condition that means that I will be on medication for life. If I ever don't have access to medication, I will die (not before costing the NHS thousands of pounds trying to stop me from dying - a pointless endeavor).

I pay £7.65 a month to get my prescription.

I fail to see why diabetics get a free pass.

Reply 16

MancStudent098

The prescription system is a bit daft in general. If I get any one of a massive range of illnesses I have to pay for the medicine, even they're 'not my fault'. It's bizarre that a couple of illnesses, seemingly chosen at random, get an exemption. I understand that diabetics need medication on a regular basis and the cost would be prohibitive, but why not just cap yearly payments at a certain level for everyone?* Hardly seems fair that if I get a series of infections I have to pay for antibiotics every single time while a diabetic doesn't.

*this already sort of exists with PPCs.

(edited 11 years ago)

Reply 17

hslt

Original post by Nice.Guy

Well, I apologise deeply. But since you've insisted on posting some stats I will analyse them for you.

In the UK, around 75000 diabetics die per year, compared to around 4000 asthmatics.

Around 1:12 people are asthmatic, while around 1:4 >65 years are diagnosed with diabetes, a great deal more on top are undiagnosed. You stats are therefore not suitable comparisons.

They also don't relate to causes of death. People with diabetes (type II) are far more likely to be overweight, exercise less, have a poor diet, and a generally unhealthy lifestyle - this, more than anything, is why most people develop type II diabetes. This is a HUGE confounding factor, it means that people with diabetes are more likely to die from things unrelated to their diabetes.

Further, if you read my initial post you will see that I used some key words/phrases, including: 'immediately life-threatening', 'acute complications'
The only acute complication of diabetes that I can think of is diabetic ketoacidosis, and this only applies to the (relatively large) minority of type I diabetics. Other acute complications relate largely to medication misuse, rather than the diabetes itself. Very few people die of this.

The vast majority of people don't 'die' of diabetes, they die of complications that diabetes is a major risk factor for - this includes cardiovascular disease, small vessel-disease including renal disease, infections, etc. It is not, however, the only risk factor for these things, and you cannot blame their deaths entirely on the diabetes, only say that it likely played a part.

On the other hand, those with asthma can die as a result of an asthma attack, an immediately life-threatening acute complication.

So yes, more people die with diabetes. And diabetes is a major factor in more peoples' deaths. But also, more people have diabetes, and diabetes is the cause of death in these patients, just a contributory factor.

Not that I'm suggesting that diabetes isn't an extremely important condition, or that it should be taken lightly in anyway. I'm just suggesting that asthma should be taken equally seriously.

And what condition is this - the ones that come to mind are COPD (bronchitis/emphysema), which aren't that similar in mechanism really and are equally serious, bronchiolitis (which is infectious, and can be very serious, but is a DDx for asthma often), and transient wheeze of childhood (which is poorly understood, and isn't really a 'condition'). I smell BS... but I'm often wrong.

(edited 11 years ago)

Reply 18

montstar

Grrr this really annoyed me when I saw it on the news! Dr Lee did differentiate between type 1 diabetes and type 2 but I've also heard the two types lumped together in the reporting of this story.

I've got type 1, got it aged 11, and I was perfectly healthy. Type 1 can have a genetic predisposition, or can be autoimmune (in my case). Type 2 is usually because of lifestyle and mostly occurs in older or overweight people. But it is not always due to these things and it can also have a genetic element. I can understand why people might think that Type 2 diabetics should pay for their own prescriptions, but this will only dissuade them from seeking treatment. Treatment and monitoring of type 2 is already much worse than provided for type 1, for instance many of them do not test their blood sugar often enough and do not understand their condition. Whereas I have had lots of help and test my blood sugar 5 or 6 times every day.
Making them pay for their prescriptions, which would prove quite costly, could mean they take less medication and test even less regularly.

Additionally these stories, in my opinion, lead to discrimination against diabetics, both type 1 and 2. Because if people don't understand the difference between the 2 types they may also believe that type 1's are diabetics because of their lifestyle. People already have tons of misconceptions about diabetes (eg it can be caught, one type is too little sugar the other too much, or I can't eat any sugar) and this just adds to that.

People can die from diabetes, both types. And people do. The complications are also very common, things such as blindness, neuropathy, and things affecting the feet.

If you are going to target type 2 diabetics, then you should also target people with heart disease from eating unhealthily, liver disease from drinking, lung/throat cancer from smoking. Refuse to treat them unless they pay up. But that wouldn't be fair would it? And neither is this.

Reply 19

hslt

Original post by theonefrombrum

A hell of a lot more than those who die because of asthma and so get your facts right and stop commenting on things you are clearly uninformed about.

See my above (2 above this one), highly informed, post.

And read what I said - name me the acute complications of diabetes, not medication misuse, that people die of.