Comment: Jeremy in the Hunt for better meds behaviour #medicine

I have heard it from both sides of the Atlantic. So there must be some truth in it. We are entering the era of ‘retail Government.’ Call it the commoditisation of politics if you like. But the idea is that the bigger the numbers – £ or people – a Minister can shift with his or her decisions the better. We must get that deficit down after all.

There is something of this behind the Secretary of State, Jeremy Hunt’s, announcement yesterday that – from next year – prescription medicines costing over £20 will carry messaging about the indicative cost of producing it and a strap-line about how they have been ‘funded by the UK taxpayer.’ Although it also has a strong whiff of the pharma agenda behind it too.
http://www.theguardian.com/society/2015/jul/01/nhs-prescriptions-drugs-health-cost-waste-price

If people are reminded of this cost they might be better at taking their meds. Or so the thinking goes. Estimates put the cost of medicines waste – that is the pills we don’t take even when prescribed – at £300M. However, whether this is all down to people’s
‘non-adherence’ (horrible term) is an interesting question in itself as pointed out in The Guardian article to which I have provided a link above.

I actually think the Secretary of State’s idea is not a bad one in itself. We should all become much more aware of the cost of that which we have perhaps taken for granted in the past. And not just in terms of medicines. Although I wouldn’t want it to be taken too far.

After all, what next, the local copper having his cost to the taxpayer printed on his truncheon or panda car? Or ‘This potholed motorway cost you…’ flashing up on roadside screens as you trundle along at 10mph? How’s the saying go about ‘knowing the cost of everything and the value of nothing?’ Is this the ‘shaming state’ going to be the new ideology? No more nannies or nudges?

The more important question we should all be asking is whether it will solve the issue of people not taking their meds as Mr Hunt hopes. On this, I am not at all convinced.

The Academy of Medical Sciences (AMS) held an excellent workshop on this issue just a few months ago. The published report of that discussion illustrates just how complex the problem is and how many-stranded our response must be.
http://www.acmedsci.ac.uk/policy/policy-projects/patient-adherence-to-medicines/

We might – for instance – begin at a different point and actually ask our health research system and pharma companies to take notice of the meds that people need rather than those they think they want. The fact that we don’t reflect these patient priorities has to be a matter of concern to us all. It may be one of the root causes why public confidence could ebb away from medical research in the end. An issue that other parts of Whitehall have become concerned about.
http://www.bbc.co.uk/news/health-33127672

Or we could support our pharmacies and pharmacists further to help patients understand their medicines and manage the side-effects. For we can not rely on our time-strapped GPs to do this any more.

Messaging on packs is not a new idea of course. We have had health warnings on cigarette packaging for a long time. I am not sure what the evidence says about their effectiveness. But if we are going to go down this route shouldn’t be trialling different sorts of messages. From ones that are health focused to those that are politically inspired? Otherwise it’s a bit of a shot in the dark isn’t it?

Which might work. But then again as Capt Marko Ramius says in the 1990 submarine film ‘Hunt for Red October: ‘Ryan some things in here don’t react well to bullets.’

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