Prof Pauline Norris, of the University of Otago, is
highlighting problems with the 20-item prescription subsidy
system. Photo by Craig Baxter.
Many New Zealanders are not getting free prescriptions
they are entitled to and the most vulnerable are likely to be
hardest hit when prescription charges rise next year,
University of Otago researchers warn.
Most people pay $3 per medicine when they collect their
prescription from the pharmacy.
After members of any one family have paid for 20 prescription
items in a year, all those people are supposed to be exempt
from the charge.
But Pharmac data shows 180,000 people throughout the country
are paying for prescriptions after becoming exempt.
This costs patients about $2.5 million a year.
Those affected are likely to include some of the country's
most vulnerable people, a continuing study into equity in
prescription use undertaken by researchers at Otago
University and at Victoria University of Wellington
indicates.
Using anonymous data from community pharmacy computers,
researchers identified individuals who had more than 20 items
dispensed to them in a year and found most were from the most
socioeconomically deprived areas.
A total of 40% of patients still paid the prescription fee
for 90% of the medicines they received, despite being exempt.
Standard charges for prescription medicines are due to rise
from $3 to $5 next January.
The overall study is being led by Prof Pauline Norris, of the
Otago School of Pharmacy and other participants include Dr
Simon Horsburgh, of Otago University, and Associate Prof
Jackie Cumming, of Victoria University of Wellington.
Prof Norris said the exemption meant families should not be
required to pay more than $100 a year after next year's
increased charge.
But she was "very worried" some patients with multiple health
problems, and using a lot of prescription medicines, would
pay much more, given the exemption often did not seem to work
in practice.
Exemption from the charges required people to have a
Prescription Subsidy Card, to have one main pharmacy, to
collect receipts from any other pharmacies they visited, and
take these to their main pharmacy.
Many people might not know about the card, and might visit
multiple pharmacies, and pharmacists might not be aware of
family relationships.
She favoured improving the system to make it more effective
for vulnerable people, including the elderly.
The Servants Health Centre, in Dunedin, provides free health
care for "lower income" patients.
Centre practice manager Jo Rowe said many people using the
service were unaware of the subsidy scheme.
More efforts should be made to inform people in at-risk
groups about the scheme, which should be reformed to make it
"more portable and accessible".
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