How your prescription drugs could be cheaper if you bought them off the shelf

On THE nHS, most prescriptions cost the patient nothing — simply because they belong to one of those groups, such as the over- 60s, who qualify for free prescriptions. But the remainder — or, at least, those in England (other countries in the UK have abolished prescription charges) — have to fork out £8.20 per medicine.

Yet, in fact, it’s cheaper to buy some medicines over-the-counter (OTC) than it is to use your prescription. Take painkillers and acid reflux treatments, for example — some of the most common prescription drugs.

Both types of drug can be bought off the shelf for far less than the prescription charge. A box of 16 paracetamol tablets costs around 25p in most supermarkets, so you can get the typical prescription amount of 100 for less than £2.

Indeed, most generic and branded options are, ‘ for all intents and purposes, the same’, says Martin Astbury, a community pharmacist and immediate past president of the Royal Pharmaceutical Society. Some are labelled ‘express’ or ‘extra’ — but this just means they kick in slightly faster, he adds.

So why do GPs prescribe medication when there are cheaper over-the-counter options? Mr Astbury suggests that, in some cases, GPs may not know what is available over-thecounter, as this can change. Another issue is that they may not want to pry into whether patients pay for prescriptions.

Savings can mainly be made where a prescription is for a short-term ailment, such as an eye infection. In many cases, patients with chronic conditions — who need regular medicine in large quantities — will likely be better off sticking to their prescription.

Here, we look at when it is cheaper to get your medication over-the- counter, rather than pay for it on prescription . . .

HEARTBURN

PRESCRIPTION MEDICINE: Gaviscon 600ml, a mixture of three active ingredients — sodium alginate, a bicarbonate and calcium carbonate to reduce stomach acid. These form a layer on the stomach contents and around the gullet to stop acid from refluxing up the gullet. BUY INSTEAD: Gaviscon 600ml from Tesco (£7). Or, in Asda, ask for their Heartburn & Indigestion Liquid, a generic version that contains the same ingredients, though is slightly lower-strength, at £4.50 for 500ml. SAVING: £1.20 to £2.80 (greater saving with Asda’s version). PRESCRIPTION MEDICINE: A week’s worth of ranitidine 150mg tablets, pack of 12. This contains a type of antihistamine, known as a histamine H2-receptor antagonist, which stops the stomach producing acid. BUY INSTEAD: Branded Zantac, pack of 12 tablets (75mg, £3.50); or generic ranitidine (75mg, £1.50) both from Tesco. Over-the-counter doses are half (75mg), but you can take two at a time.

Buying two boxes of ranitidine 75mg still works out cheaper than getting it on prescription. If you suffer long-term, and need the drug longer than a week, it will work out cheaper to stick to a prescription. SAVING: £1.20 to £5.20 (greater saving with Tesco own-version).

EYE INFECTIONS

PRESCRIPTION MEDICINE: Chloramphenicol 1 per cent eyedrops 4g. This contains a chemical that binds to the bacteria causing the infection, stopping them multiplying. BUY INSTEAD: Boots 1 per cent chloramphenicol eyedrops (4g, £5.39). SAVING: £2.81

CONSTIPATION

PRESCRIPTION MEDICINE: Senna tablets, box of 40. This contains a plant extract that irritates the bowel, inducing a laxative effect. BUY INSTEAD: The same generic senna tablets as the prescription version — a box of 24 for around £1.80 in most supermarkets, or a box of 100 for £6.59 from Boots. Senokot, a branded form of senna, is £4.50 for a box of 60 tablets (Tesco). SAVING: £5.20 to £5.56 ( greater saving if you buy the Boots box of 100 pills). PRESCRIPTION MEDICINE: Fybogel Sachets, box of 30. These are mixed with 150ml water and consumed after meals — they contain ispaghula husk, a type of fibre that absorbs liquid in the gut and increases the amount of excreted material. BUY INSTEAD: The same brand and strength Fybogel box of 30 sachets for £6.99, Boots; or boxes of ten for around £2.20, most supermarkets. SAVING: £1.21 to £1.60 (greater saving with supermarket boxes).

PILES

PRESCRIPTION MEDICINE: Anusol suppository pack of 24 or cream 43g. These contain ingredients (zinc oxide, bismuth oxide, Peru balsam) with antiseptic, shrinking and moisturising properties. BUY INSTEAD: Anusol suppository, pack of 24 (£6.99, Boots); or Anusol cream 43g (£6.29, Boots). SAVING: £1.21 for suppository; £1.91 for cream.

BLOOD-THINNING PILLS

PRESCRIPTION MEDICINE: Aspirin, usually prescribed as one or two months’ worth — boxes of 28 or 56 75mg tablets. At this dose, aspirin partly inhibits an enzyme involved in the formation of blood clots. Higher 300mg doses may be prescribed (typical prescription is 32 tablets) for pain relief or fevers as they inhibit the enzyme entirely, which effects other processes such as inflammation.

BUY INSTEAD: A box of 100 75mg tablets (£1.49, Boots), or get a box of 28 for around 85p in most supermarkets; or a box of 32 300mg aspirin (59p, Boots).

SAVING: £6.50 to £7.37 for 75mg tablets (greater saving with Boots version); £7.61 saving on 300mg aspirin.

ANGINA

PRESCRIPTION MEDICINE: Glyceryl trinitrate spray, typically a 200dose spray. It acts on the smooth muscle in blood vessels around the heart, causing them to dilate to improve blood flow, thus reducing the work the heart needs to do, and reducing pain.

BUY INSTEAD: nitrolingual (branded glyceryl trinitrate), 200 dose packet (£6.19, Boots); or a generic glyceryl trinitrate spray (180 doses), £3.42, Boots pharmacies: you have to ask for it because it causes significant blood vessel dilation, which can cause a drop in blood pressure and headache.

SAVING: £2.01 for nitrolingual; £4.40 for the generic spray.

HAY FEVER

PRESCRIPTION MEDICINE: Once-a-day loratadine, pack of 30 tablets. This antihistamine stops the chemical released during allergic reactions from binding to its receptors, reducing symptoms such as watery eyes and sneezing. BUY INSTEAD: Pack of 30 generic once-a- day loratadine tablets, £ 2.50, most supermarkets. (Compare this with branded Clarityn, £8.99 for 30, Boots). SAVING: £5.70

ORAL HEALTH

Gum disease PRESCRIPTION MEDICINE: Chlorhexidine digluconate mouthwash, 300ml. This contains an antimicrobial solution, which inhibits the formation of dental plaque. BUY INSTEAD: Corsodyl 300ml mouthwash (contains chlorhexidine digluconate), around £5.20, supermarkets and Boots, or generic chlorhexidine mouthwash with the same active ingredients (250ml, £3.05, Boots). SAVING: £3 for Corsodyl or £4.54 if you go for the generic version. Cold sores PRESCRIPTION MEDICINE: Aciclovir cold sore 2g cream. This kills the viruses causing the cold sore, most commonly herpes simplex. BUY INSTEAD: Zovirax, branded aciclovir, 2g cream, £4.45, most supermarkets; or 2g own-brand aciclovir cream (£3.50, Tesco). SAVING: £3.75 to £4.70 (greater saving with Tesco version).

SKIN CONDITIONS

Dermatitis/eczema PRESCRIPTION MEDICINE: Hydrocortisone 1 per cent cream 15g —

a steroid that reduces symptoms such as redness and itching. BUY INSTEAD: Boots Dermacare (15g, £3.49), or generic 1 per cent hydrocortisone cream (around £3, most supermarkets). SAVING: £4.71 to £5.20 (greater saving with supermarket versions). PRESCRIPTION MEDICINE: Hydrocortisone 1 per cent combined with miconazole 15g cream for severe inflamed eczema with fungal infection. BUY INSTEAD: Daktacort (contains antifungal miconazole nitrate and hydrocortisone 1 per cent), £5.39 for 15g, Boots. SAVING: £2.81 PRESCRIPTION MEDICINE: Aqueous cream, 500g tub. This is used as a handwash for people with sensitive dry skin. BUY INSTEAD: 500g tub, around £2.50, most supermarkets; or £4.09, Boots. SAVING: £4.11 to £5.70 (greater saving with supermarket versions).

Warts

PRESCRIPTION MEDICINE: gel containing salicylic acid (12 per cent) and lactic acid (4 per cent), 5g tube. The salicylic acid breaks down hardened skin, while lactic acid boosts this breakdown and acts as an antiseptic. BUY INSTEAD: Bazuka gel containing lactic acid and salicylic acid (same percentage doses as prescription version) is around £5 from most supermarkets and £5.29 from Boots. Or you can buy Salatac gel — £5.36 for an 8g tube from Boots pharmacies. SAVING: £2.91 to £3.20 for Bazuka, or £4.85 if you buy Salatac.

Thrush

PRESCRIPTION MEDICINE: Canesten Combi with 500mg clotrimazole pessary and a Canesten 2 per cent clotrimazole cream. This will count as two prescription charges, so will cost £16.40. Clotrimazole is an antifungal, which breaks down the cell wall of the fungi species that cause thrush infections. BUY INSTEAD: The same Canestan Combi, £11.99, Boots. SAVING: £4.41

P.S. WHAT IS CHEAPER ON PRESCRIPTION Heartburn

PRESCRIPTION MEDICINE: Esomeprazole 20mg, pack of 28. This is a ‘proton pump inhibitor’, which suppresses acid secretion in the stomach. OVER-THE-COUNTER PRICE: Nexium (esomeprazole), 20mg pack of 14, £11.99. EXTRA COST: £15.78

Painful joints and muscles

PRESCRIPTION MEDICINE: Diclofenac gel, 100g. Prevents production of prostaglandins, chemicals that cause inflammation and pain. OVER-THE-COUNTER PRICE: Voltarol gel (with diclofenac), around £12 for 100g tube in most supermarkets, or £12.50 from Boots. EXTRA COST: £3.80 to £4.30

Dry skin

PRESCRIPTION MEDICINE: Cetraben cream, 475ml. Made from a mixture of paraffins and water, this forms an oily layer on the surface of the skin to prevent water evaporating. OVER-THE-COUNTER PRICE: Cetraben, 475ml, £12.99 from Boots; 200ml bottle, around £8 in most supermarkets. EXTRA COST: £4.79 in Boots; £10.80 in supermarkets. PRESCRIPTION MEDICINE: Diprobase emollient cream, 500ml. This is similar to Cetraben and helps retain moisture. OVER-THE-COUNTER PRICE: 50ml for £4.99, or 500ml for around £12.50, from pharmacies. EXTRA COST: £41.70 if you bought ten 50ml tubes; £4.30 for 500ml.