Government U-turn small win for patients with chronic conditions - Editorial
THE FACTS
- The Government has decided the $5 prescription co-payment fee will apply only at the first collection, reducing financial barriers for 12-month prescriptions.
- In 2023-24, about 191,000 adults did not fill a prescription because of the cost.
- The policy change will cost Health NZ between $6 million and $23m annually.
The Government’s policy U-turn on prescription co-payment fees is welcome news, especially for people with chronic medical conditions.
In February, 12-month prescriptions will come into effect. That policy was introduced in Budget 2025 as a way to reduce the cost of seeing GPs.
People would still need to collect medicines every three months, with the original intention to charge the $5 per item fee each time.
However, Health NZ documents released in late December show a Cabinet committee in September agreed with the Health Minister’s recommended change to have the $5 fee apply only at the first collection.
The paper says the co-payment is a financial barrier - in 2023-24, about 191,000 adults did not fill a prescription because of the cost.
The committee noted the policy change would mean extra yearly costs to Health NZ of between $6 million and $23m.
Many GP clinics have lengthy waits for an appointment.
With some people with chronic conditions currently having to see their GP every three months to obtain their prescription, the 12-month policy will help free up appointments for other patients.
GPs will still see patients before a prescription is issued if a health check is necessary.
But for those who can manage their chronic condition, such as asthma, high blood pressure or diabetes, with their prescribed medicine and don’t need to see their doctor each time, that will be a welcome saving in fees.
While the Health NZ paper highlights the extra annual costs, that needs to be balanced with the costs to the health system of chronic conditions and the impact of people not filling their prescriptions.
A Health NZ report, published in June 2022, says long-term conditions pose a major challenge for the system.
“The prevalence of long-term conditions is high and rising, particularly for Māori and Pacific people who experience the onset of disease at a younger age and face a higher risk of complications and early death. Long-term conditions lead to significant social and economic impacts both for individuals and their whānau and for the health system and society in general.”
The costs include direct costs of patient care, indirect costs such as productivity or labour loss due to an illness, and the intangible cost of changes in the quality of life of patients and their families.
While more investment in our health system is needed, this small win in the prescription area will make a difference for many people.