Query re GP issuing 2 prescriptions instead of 1
Discussion
My GP increased my medication for a condition from 5mg to 7.5mg 6 months ago. Because there is not a 7.5mg tablet this is split into me taking a 5mg tablet and a 2.5mg tablet. Up until yesterday, when I picked this up from the pharmacist, it always came as one prescription, which I pay for.
However, the doctor is now saying that this should be 2 prescriptions - one for 5mg and another for 2.5mg, which costs twice as much. I have challenged the doctor on this who is saying that I should have always have been charged for 2 prescriptions.
Personally I think that for one condition, with one set of medication, that I should only be charged once. That it is split between two pills should be of no consequence.
Who is right here and are there any guidelines or president?
However, the doctor is now saying that this should be 2 prescriptions - one for 5mg and another for 2.5mg, which costs twice as much. I have challenged the doctor on this who is saying that I should have always have been charged for 2 prescriptions.
Personally I think that for one condition, with one set of medication, that I should only be charged once. That it is split between two pills should be of no consequence.
Who is right here and are there any guidelines or president?
Hi warp9, I can't answer your specific question - hopefully a resident GP will be along shortly - but if your prescriptions are only for a month (or less) of meds then you can avoid the problem by buying a 12 month PPC for £114.50 (works out at £9.55 per month) which allows you to have as many prescriptions as you want 
.
https://www.nhs.uk/nhs-services/prescriptions/save...
.https://www.nhs.uk/nhs-services/prescriptions/save...
warp9 said:
My GP increased my medication for a condition from 5mg to 7.5mg 6 months ago. Because there is not a 7.5mg tablet this is split into me taking a 5mg tablet and a 2.5mg tablet. Up until yesterday, when I picked this up from the pharmacist, it always came as one prescription, which I pay for.
However, the doctor is now saying that this should be 2 prescriptions - one for 5mg and another for 2.5mg, which costs twice as much. I have challenged the doctor on this who is saying that I should have always have been charged for 2 prescriptions.
Personally I think that for one condition, with one set of medication, that I should only be charged once. That it is split between two pills should be of no consequence.
Who is right here and are there any guidelines or president?
Based on my own experience, you are correct. I'm prescribed 3.75gm of a particular medication that is available as 2.5mg and 1.25mg. They're both on one prescription along with a further seven that I need to take daily.However, the doctor is now saying that this should be 2 prescriptions - one for 5mg and another for 2.5mg, which costs twice as much. I have challenged the doctor on this who is saying that I should have always have been charged for 2 prescriptions.
Personally I think that for one condition, with one set of medication, that I should only be charged once. That it is split between two pills should be of no consequence.
Who is right here and are there any guidelines or president?
ETA: I should have added that my prescription items are free - sorry.
However, I would strongly argue that 7.5mg of the same medication should be a single charge. I'll investigate further with my NHS contacts.
Edited by Riley Blue on Tuesday 16th September 14:04
Bill said:
It annoys me that my two asthma inhalers are in separate scripts! Push back via the practice manager if needs be.
I've been pushing and they have dug their heels in!I put the question into ChatGPT which said that in England, you don’t pay “per condition” or “per prescription slip” — you pay per item. So reluctantly, I think I'm going to have to swallow this.
Unfortunately this is a bizarre feature of how the NHS prescription system works. As mentioned above a prepayment might be your best option.
To try to clarify if you have two different strengths of a medication of the same form on the same page you would only pay one charge. However if anything is different it would be two charges
Ramipril 2.5mg capsules and Ramipril 5mg caps on the same prescription page then 1 charge currently £9.90
Ramipril 2.5mg capsules and Ramipril 5mg tablets on the same page is 2 charges currently £18.80
On separate prescription pages then one charge per item so £18.80
To try to clarify if you have two different strengths of a medication of the same form on the same page you would only pay one charge. However if anything is different it would be two charges
Ramipril 2.5mg capsules and Ramipril 5mg caps on the same prescription page then 1 charge currently £9.90
Ramipril 2.5mg capsules and Ramipril 5mg tablets on the same page is 2 charges currently £18.80
On separate prescription pages then one charge per item so £18.80
Bill said:
I know but it's still annoying. One medication split over two scripts is much more unreasonable.
Havent worked in primary care for decades but this doesnt seem reasonable from the GP. Maybe this helps the pharmacist with their income as they can claim 2 activity fees etc but I will leave that summation to be confirmed by Paul Dishman is better versed in the intricacies of community pharmacy. If that was hospital it would be prescribed as 7.5mg daily as a single line and 28 x 5mg & 28 x 2.5mg would be dispensed without a second thought drinks said:
Unfortunately this is a bizarre feature of how the NHS prescription system works. As mentioned above a prepayment might be your best option.
To try to clarify if you have two different strengths of a medication of the same form on the same page you would only pay one charge. However if anything is different it would be two charges
Ramipril 2.5mg capsules and Ramipril 5mg caps on the same prescription page then 1 charge currently £9.90
Ramipril 2.5mg capsules and Ramipril 5mg tablets on the same page is 2 charges currently £18.80
On separate prescription pages then one charge per item so £18.80
This is a good point regarding capsules vs tables and I can appreciate that they are different items. However, my prescription is:To try to clarify if you have two different strengths of a medication of the same form on the same page you would only pay one charge. However if anything is different it would be two charges
Ramipril 2.5mg capsules and Ramipril 5mg caps on the same prescription page then 1 charge currently £9.90
Ramipril 2.5mg capsules and Ramipril 5mg tablets on the same page is 2 charges currently £18.80
On separate prescription pages then one charge per item so £18.80
Fabomed 2.5mg tablet and Fabomed 5mg tablet - total of 7.5mg of tablet, which should IMO be on the same prescription page and as you confirm one charge.
Just for clarity - It's only NHS England that works like this, in charging folks - if you were in Scotland, Wales or Northern Ireland - your prescription would be free* at point of need
- I know it all comes out of taxation and using the word "free" is usually a trigger for the hard of thinking, hence why I said at point of need
Bill said:
I'd argue that each medicine is an item, not each pill pack. If they had 7.5mg pills then it'd be one charge.
FWIW, my definition of an item would be 1 pack/bottle/tube of whatever. 2 packs/bottles/tubes of the same thing would be 2 items. But that's me just taking words literally. Words may mean something different in the pharmaceutical world.
)xx99xx said:
FWIW, my definition of an item would be 1 pack/bottle/tube of whatever. 2 packs/bottles/tubes of the same thing would be 2 items. But that's me just taking words literally. Words may mean something different in the pharmaceutical world.
Quantity is irrelevant when defining an item. One tablet or 100 tablets of a single product would attract one fee/charge generally speaking there are nuances where a single can attract different numbers of fees/charges. In the example above of Ramipril caps 2.5mg and 5mg on the same page the pharmacy would claim two fees but the patient should only pay one charge. Regardless of if there were 28 or 84 of each item.
The other option is to ask the prescriber to issue it all as 2.5mg caps and take three/day.
drinks said:
Quantity is irrelevant when defining an item. One tablet or 100 tablets of a single product would attract one fee/charge generally speaking there are nuances where a single can attract different numbers of fees/charges.
In the example above of Ramipril caps 2.5mg and 5mg on the same page the pharmacy would claim two fees but the patient should only pay one charge. Regardless of if there were 28 or 84 of each item.
The other option is to ask the prescriber to issue it all as 2.5mg caps and take three/day.
1 tablet can come in one pack, and the other 100 tablets can come in another pack. However, if the tablets differ in strength then they are 2 items, not 1. Essentially 2 different products.In the example above of Ramipril caps 2.5mg and 5mg on the same page the pharmacy would claim two fees but the patient should only pay one charge. Regardless of if there were 28 or 84 of each item.
The other option is to ask the prescriber to issue it all as 2.5mg caps and take three/day.
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