Do patient charge increases reduce the use of prescription medicines? An economic perspective

Patient charges are increasingly advocated by government as a policy tool to raise revenue and regulate the utilization of primary health care. Since the Conservative government came to power in 1979, the charge for NHS prescriptions has risen sharply from 20 pence per item in 1979 to £3.05 in April 1990. Charges for sight testing were introduced in April 1989. An introduction, or increase, in patient charges often provokes fierce political and medical debate about likely effects on patients. Such debate can be informed by empirical evidence from the growing number of economic studies in the US and UK which quantify the statistical relationship between patient charges and health care utilization. This paper reviews the evidence on drug prescriptions and patient charges and presents data for the UK. The implications of patient charges for the efficiency and equity of primary health care provision are considered.