Man holding bag of money | e-Surgery

How much does a GP really cost?

In the UK we are fortunate enough to have the support of the NHS and all of its healthcare professionals! Better yet, we can be seen by a medical professional free of charge, a luxury many in the world do not have. 

It seems like an ideal system, but as we all know the NHS is far from perfect.

The £9 NHS prescription charge

As some of you may already know, the NHS prescription charge rose to £9 per item on Monday 1st April 2019. But where exactly does this money go? And does it net the NHS extra money to put towards other departments and services, or does it run at a massive loss despite the increasing cost to you?

The bottom line is that no one really knows the exact figure. The published figures are conflicting and confusing, and many inside the NHS cannot give a direct answer. While it is thought that between 0.5% and 1.2% of the NHS budget comes from patient charges such as prescription fees, it is believed that the NHS spends far more than this percentage into paying for prescription medication. Simply put: even though you pay a £9 prescription charge, it doesn’t cover the true cost of your medication and in fact it will cost the NHS money.

How does it work in NHS pharmacies?

So you step into your local chemist and hand over the prescription charge for your medication. It might surprise you to learn that your (soon to be) £9 does not actually go to the pharmacy at all.

The pharmacy gets paid a small amount (£1.38) per prescription by the NHS and, in addition, the pharmacy gets reimbursed for the cost of the drug in accordance with a document named the Drug Tariff. This is a frequently changing catalogue of drug costs which the NHS is willing to reimburse pharmacies, and the price paid depends on which medication is given. The Drug Tariff prices exist completely independent of the prescription charge. So while you will be charged £9 per medication on your prescription, the pharmacy will likely be reimbursed a different sum entirely.

However, many pharmacies can find themselves dispensing medication at a loss, despite squeezing out extra income by sourcing your drugs from multiple wholesalers. And during medication shortages drug prices can climb rapidly while the drug tariff reimbursement remains the same. This is a reason why so many pharmacies branch out into selling chewing gum, sunglasses, or even make up and perfume to try to increase profits.

What does it cost the NHS?

According to the NHS Business Services Authority, in 2011/12 the NHS subsidised an additional £2.8 billion of prescription medication on top of all contributions paid by patients at the pharmacy kiosk. But there are many other factors to include, such as the cost to prescribe a medication in the first place and the other administration that occurs around this process.

Once we think of theses unseen costs, the true number can only get larger and larger.

Paracetamol On Prescription

The Drug Tariff reimbursement costs are only a small fraction of what a prescription actually costs to the NHS. The cost of an NHS healthcare professional to prescribe medication and the admin needed to get it ready for you will actually make up a much larger chunk of the true cost to the NHS.

Recently the NHS has released data showing that the whole cost of prescribing a box of Paracetamol amounts to £34. The drug cost makes up only 51p of this and the remaining £33.49 goes to cover the prescriber costs and associated administration. This is why the NHS is urging patients to buy over-the-counter medication whenever possible.

Surprised a simple prescription can cost so much? You’re not the only one.

What does this mean for your prescription?

The prescription charges you pay, if higher than the cost of the drug, aim to be paid back to the NHS budget once any dispensing fees and all other costs have been deducted. But in reality, your medication costs will come from the core NHS budget and cost much more despite having paid a £9 charge towards the cost of the drug. It would in fact save the NHS money for patients to get their medication elsewhere, leaving more in the budget for other departments and services.

What about going private? Is it cheaper to me and the NHS?

With the prescription charge increasing to £9, more and more people are turning to private healthcare. Because online services are able to run much lower overheads than NHS surgeries, they can keep costs down and are often much cheaper than the overall amount that it would cost the NHS.

By privately fulfilling your prescription with a reputable online service such as, you pay the price of the drug itself and a small amount towards the wages of administrative staff and healthcare professionals. Nothing is charged to the NHS. And because private services doesn’t claim back the Drug Tariff costs from the NHS, they can pass on the wholesaler savings directly to the patient.

Further Reading

  1. NHS Prescription Charge | NHS
  2. Health problems you don’t need to see your doctor about | Patient info