Knowledge and attitudes to prescription charges in New Zealand and England

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BackgroundPrescription charge regimes vary between countries but there is little research on how much people know about these or support values underlying them.ObjectiveTo explore, in New Zealand (NZ) and England, the public's knowledge of, and attitudes to, charges and whether knowledge and attitudes varied by demographic characteristics or by values about entitlement to public goods.MethodA questionnaire was developed and administered to people over 18 recruited in public places in NZ and England.Results451 people in NZ and 300 people in England participated. Less than half in each country knew the current prescription charge. In each country 62% of people were unaware of arrangements to protect people from excessive annual charges. Support for free or lower cost medicines for children, people over 65, people on low incomes, people on benefits, and people with chronic health problems was higher in England than in NZ. Support varied by participants’ demographic characteristics and, in the case of people on low incomes and people on benefits, by values about universal entitlements.DiscussionGaps in knowledge, particularly about mechanisms to protect people from high costs, are concerning and may lead to people paying excessive charges. There was consensus about the elderly, children and the chronically ill being “deserving” of lower prescription charges, but people who did not believe in universal access to public goods appeared to see people on low incomes or benefits as less “deserving”. In general, public views resembled those underlying the prescription charge regime in their country.HighlightsIn both countries, most people did not know the usual prescription charge, or measures to protect people from excessive charges.Compared to those in NZ, people in England were more likely to support free or cheaper prescriptions for some groups.Support for lower charges for these groups varied by demographic characteristics and, for some groups, by values.

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