I Can’t Afford My Prescriptions In The Cost Of Living Crisis

When Annie woke up on New Year's Day with a tightness in her chest, she wanted to believe it was down to the cold weather. But she knew exactly what was causing it: she hadn't picked up her inhalers from the chemist the previous month. Not because she'd forgotten but because she couldn't afford it.

"I was already skipping meals, not turning my heating on and walking everywhere," Annie, 26, tells R29. "I'd ordered my prescriptions online but when it came time to collect them I just couldn't do it. I didn't have the £18 and honestly didn't think it would be a big deal to stop taking them."

Annie is one of many choosing not to collect their inhalers for financial reasons. Research carried out in August 2022 by leading lung charity Asthma + Lung UK found that one in five people with asthma connect the cost of living crisis with an increase in life-threatening asthma attacks as they cut back on medicines, heating and food. An additional one in two say their condition has worsened since the crisis began, with many needing emergency treatment.

Within a few days, Annie had dizzy spells and felt tired. But she didn't connect this to not using her inhalers until the chest tightness and breathlessness started, something she experienced frequently before she started using inhalers a decade earlier. Dr Daniel Gordon, a GP with over 13 years' clinical experience who specialises in chronic disease management, tells R29 that stopping inhalers can have serious consequences. "You may start to notice a worsening of your symptoms of asthma, such as dry coughing, feeling tight-chested, fatigue and shortness of breath. You may also increase your risk of having an asthma attack, which can sometimes require hospitalisation. Sadly, poor compliance with asthma inhaler treatment has been linked with deaths, especially in teenagers and young adults."

Paying prescription charges is not just an issue for people with asthma. A small survey of 269 pharmacists published by the Royal Pharmaceutical Society (RPS) in February this year found that rising numbers of patients in England are failing to collect their medicines because they cannot afford them. Fifty-one percent of the pharmacists surveyed reported an increase in patients not collecting their medications and 67% saw a rise in patients asking if there was a cheaper, over-the-counter substitute for the medicine they’d been prescribed. The cost of prescriptions in England currently stands at £9.35 per item, with an annual rise usually occurring in April. The prescription charge was frozen in 2022 for the first time in over a decade, to help ease cost of living pressures. Prescriptions are free for those living in Scotland, Wales and Northern Ireland. 

The RPS has long campaigned to remove prescription charges for people with long-term conditions in England because of the financial barrier they create for patients. Thorrun Govind, English Pharmacy Board Chair at the RPS, tells R29 how prescription charges affect those who can't afford them. "Reducing access to medicines leads to poorer health, more time off work and can result in admissions to hospital, the cost of which must be set against any income gained from prescription charges."

She continues: "We urgently need an overhaul of the system in England to ensure it supports access to medicines for people at the sharp end of the cost of living crisis. Ultimately we want to see the prescription charge abolished for people with long-term conditions so medicines are free to access in England, just like they are in the rest of the UK."

Those with chronic conditions requiring multiple medications, like 28-year-old Michelle, who has endometriosis, are also struggling to find the money. Michelle found the mefenamic acid and dihydrocodeine that she was prescribed to help with intense pain and heavy bleeding too costly, so she switched to ibuprofen and paracetamol. The effects were noticeable almost right away.

"When I switched to paracetamol I found my pain really increased. I also felt jittery, anxious and sick from stopping the codeine medication suddenly. Now, I spend two weeks of the month with a heat pad strapped to me. My bleeding is also worse than it has been in years."

Dr Semiya Aziz has been a GP for over 20 years, specialising in women’s health. She tells R29 that stopping mefenamic acid will affect pain relief. "[Mefenamic acid] helps to ease period pain and reduce heavy bleeding by reducing hormones called prostaglandins in the lining of your uterus. Painkillers like paracetamol may be effective for those with mild endometriosis pain, though many patients complain that it is not enough, which is why medication like dihydrocodeine may be prescribed."

Michelle believes that medication for long-term conditions should be free. "It's not my fault I have endometriosis and if I can't afford to get the prescriptions, my symptoms will only get worse. Surely if I need more GP visits or hospital treatment, that will cost the NHS more than my prescriptions?"

Stopping medication because of the cost can affect more than health, as Lynsey, a 38-year-old trainee accountant, has discovered. She was diagnosed with ADHD in 2020, using a small redundancy payout for a private diagnosis. She was prescribed methylphenidate and paid for private prescriptions, costing £130 a month, until she was on the correct therapeutic dose to be transferred to her GP’s care. However, her GP and local health board refused to prescribe medication until she received a diagnosis by an NHS doctor, which could take up to five years. In October 2022, Lynsey's landlord increased her rent and she had to stop her ADHD medication or risk losing her home.

Lynsey used to love her job but now struggles to focus on simple tasks and is currently under performance review and at risk of redundancy. "My ADHD used to be under control so it never bothered my employers. Now, I'm making stupid mistakes, falling out with colleagues who have to pick up the slack and my line manager says I am like a different person. I think I am one bad week away from losing my job."

Dr Zoe Watson is a GP with over 16 years' clinical experience and a special interest in mental health and neurodiversity. She tells R29 there could be short and longer term implications for stopping ADHD medication, although these depend on the individual and the dosage. "In someone who had developed a dependence on methylphenidate and was taking large doses of it, the effect of suddenly stopping may result in depression, disturbed sleep, fatigue and mood swings. In the long term, the main effect of discontinuing methylphenidate is simply that it can cause ADHD symptoms to flare up – particularly symptoms of difficulty focusing."

Across the UK, people are cutting back to meet the rising cost of living. Cutting out vital medication hasn't, until this point, been as widely discussed as skipping meals or scaling back energy and fuel costs. But the consequences for both physical and mental health could be severe.

Faced with the threat of losing her job and rising living costs, Lynsey admits she's been struggling with depression. "I'm single and have no family support," she says. "On my darkest days I've thought that if I lose my job, there's not much point in living anymore."