Should the NHS be paying £87 million on paracetamol?

It’s a staggering figure isn’t it? But it’s true the NHS pays £87 million pounds a year on paracetamol. Today’s headlines are full of the scandal of the price per prescription being £3.83 compared to just 25pence a box for paracetamol bought from a supermarket. To be fair we are not really comparing like with like here as a box of paracetamol bought over the counter will only contain 16 tablets, whilst your average prescription is likely to be for 100 or more, but it is still a crazy bill and one that we need to address.

Paracetamol is a very effective painkiller and for some people with chronic pain such as those with arthritis I actually think it is appropriate for GPs like myself to prescribe. It’s not just the cost – of course the tablets can be bought very cheaply but retailers will only sell you one or at most two boxes at a time, which means that my arthritic patient who finds it very difficult to get about would have to get to the chemist or the supermarket every other day or at best every fourth day.

The reason for the restriction on the sale of paracetamol is that in overdose it can cause irreversible damage to the liver and is sometimes fatal. If an individual is very serious about a suicide attempt, they could of course stock pile over time before taking an overdose or simply shop around all the pharmacies and supermarkets in the area, but restricting the numbers people can buy means it is less likely that there will be large numbers of paracetamol in a home which could be taken on impulse.

Lots of patients are entitled to free prescriptions and many more, who are on several regular medications pay a quarterly charge, which then covers all their scripts in that period. That may mean it is tempting to ask for simple painkillers such as paracetamol and ibuprofen on a script. If you have been that person, I’d like you to stop and think – £87 million could pay for 19,000 heart bypass operations. It’s a sobering thought isn’t it? In some areas GPs are being asked not to prescribe for minor self limiting illnesses such as coughs and colds, which has to be a good start. I have always encouraged patients to seek help from their pharmacist for such conditions rather than clog up the GP waiting room. Pharmacists are highly trained and very knowledgeable people and this is just another reason why we should be using their services more often.