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102-499: Most drugs are commercially made at factories and dispensed by pharmacies. Drugs that are not commercially made must be compounded from other ingredients. In 1930, 75% of medications were compounded, but by 1970 only 1% were compounded. In most countries, a premises for prescription drugs is subject to legislation; with requirements for storage conditions, staff qualifications, equipment, record keeping (especially of controlled drugs ) and other matters, all specified in legislation. It

204-671: A qualified pharmacist on-duty at all times when they are open. It is also often a requirement for the owner of a pharmacy to be a registered pharmacist, but that is not the case in all jurisdictions: where permitted, many retailers (including supermarkets and mass merchandisers ) now include a pharmacy as a department of their store. Community pharmacies offer a unique added value by building direct relationships with their customers. They are able to provide more personalized, dedicated care to local members of their community and even offer enhanced services such as Medication Therapy Management (MTM), Medication Synchronization, and compounding. With

306-461: A community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as online pharmacies) are also recommended to some patients by their physicians if they are home-bound. While most Internet pharmacies sell prescription drugs and require a valid prescription, some Internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid

408-658: A contraction of the Latin word " recipe " (an imperative form of "recipere") meaning "take". Prescription drugs are often dispensed together with a monograph (in Europe, a Patient Information Leaflet or PIL) that gives detailed information about the drug. The use of prescription drugs has been increasing since the 1960s. In Australia , the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP) governs

510-802: A deficit on their budgets at the end of the financial year. Failure to meet financial objectives could result in the dismissal and replacement of a trust's board of directors, although such dismissals are enormously expensive for the NHS. In April 2013 a new system was established as a result of the Health and Social Care Act 2012 . The NHS budget is largely in the hands of a new body, NHS England. NHS England commissions specialist services and primary care. Acute services and community care are commissioned by local clinical commissioning groups (CCGs) led by GPs. From April 2021 all CCGs have become part of Integrated Care Systems. The vast majority of NHS services are free at

612-807: A doctor. Once issued, a prescription is taken by the patient to a pharmacy, which dispenses the medicine. Most prescriptions are NHS prescriptions , subject to a standard charge that is unrelated to what is dispensed. The NHS prescription fee was increased to £9.90 for each item in England in May 2024; prescriptions are free of charge if prescribed and dispensed in Scotland , Wales and Northern Ireland , and for some patients in England, such as inpatients, children, those over 60s or with certain medical conditions, and claimants of certain benefits. The pharmacy charges

714-457: A financial disincentive due to potential legal costs) for individual hospitals to do so. The Road Traffic (NHS Charges) Act 1999 introduced a standard national scheme for recovery of costs using a tariff based on a single charge for out-patient treatment or a daily charge for in-patient treatment; these charges again ultimately fell upon insurers. This scheme did not however fully cover the costs of treatment in serious cases. Since January 2007,

816-447: A former FDA expiration-date compliance chief, said that with a handful of exceptions—notably nitroglycerin , insulin , and some liquid antibiotics (outdated tetracyclines can cause Fanconi syndrome )—most expired drugs are probably effective. The American Medical Association issued a report and statement on Pharmaceutical Expiration Dates. The Harvard Medical School Family Health Guide notes that, with rare exceptions, "it's true

918-579: A government 'promise' made in 2020 to give NHS workers a 2.1% pay rise, which was voted for in a long-term spending plan in January 2020 but the Department of Health considered to be not legally binding. Prime Minister Boris Johnson defended the 1% pay rise, stating that the government was giving workers "as much as we can" in light of the COVID-19 pandemic and that he was "massively grateful" to

1020-571: A government majority of 88 and following more than 1,000 amendments in the House of Commons and the House of Lords. The total budget of the Department of Health in England in 2017/18 was £124.7 billion. £13.8 billion was spent on medicines. The National Audit Office reports annually on the summarised consolidated accounts of the NHS. The population of England is aging, which has led to an increase in health demand and funding. From 2011 to 2018,

1122-477: A growing number of Internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to

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1224-438: A list of foundations that provide co-pay assistance programs. Co-pay assistance programs are for under-insured patients. Patients without insurance are not eligible for this resource; however, they may be eligible for patient assistance programs. Patient assistance programs are funded by the manufacturer of the medication. Patients can often apply to these programs through the manufacturer's website. This type of assistance program

1326-529: A lower strength of a drug will be approved for OTC use, but higher strengths require a prescription to be obtained; a notable case is ibuprofen , which has been widely available as an OTC pain killer since the mid-1980s, but it is available by prescription in doses up to four times the OTC dose for severe pain that is not adequately controlled by the OTC strength. Herbal preparations , amino acids , vitamins , minerals , and other food supplements are regulated by

1428-471: A national level, including: In the year ending in March 2017, there were 1.187 million staff in England's NHS, 1.9% more than in March 2016. There were 34,260 unfilled nursing and midwifery posts in England by September 2017, this was the highest level since records began. 23% of women giving birth were left alone part of the time causing anxiety to the women and possible danger to them and their babies. This

1530-521: A pharmacy can assist a patient with prescription reminders and alerts about potential negative drug interactions, thereby reducing medical errors . The International Pharmaceutical Federation has declared their vision of a community-based pharmacist: Community-based pharmacists' responsibilities include: checking and dispensing of prescription drugs , providing advice on drug selection and usage to doctors and other health professionals and counseling patients in health promotion, disease prevention and

1632-605: A prescription for them to be dispensed by a pharmacy. The federal government authorizes physicians (of any specialty), physician assistants , nurse practitioners and other advanced practice nurses , veterinarians, dentists, and optometrists to prescribe any controlled substance. They are issued unique DEA numbers . Many other mental and physical health technicians, including basic-level registered nurses , medical assistants , emergency medical technicians, most psychologists, and social workers, are not authorized to prescribe legend drugs. The federal Controlled Substances Act (CSA)

1734-583: A prescription-only medicine without a prescription is legal unless it is covered by the Misuse of Drugs Act 1971 . A patient visits a medical practitioner or dentist , who may prescribe drugs and certain other medical items, such as blood glucose-testing equipment for diabetics . Also, qualified and experienced nurses, paramedics and pharmacists may be independent prescribers. Both may prescribe all POMs (including controlled drugs), but may not prescribe Schedule 1 controlled drugs, and 3 listed controlled drugs for

1836-508: A prescription. The safety and the effectiveness of prescription drugs in the US are regulated by the 1987 Prescription Drug Marketing Act (PDMA). The Food and Drug Administration (FDA) is charged with implementing the law. As a general rule, over-the-counter drugs (OTC) are used to treat a condition that does not need care from a healthcare professional if have been proven to meet higher safety standards for self-medication by patients. Often,

1938-401: A prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug. In North America, ℞ , usually printed as "Rx", is used as an abbreviation of the word "prescription". It is

2040-450: A significant reorganization of the NHS. The white paper, Equity and excellence: liberating the NHS , with implications for all health organizations in the NHS abolishing primary care trusts and strategic health authorities . It claimed to shift power from the center to GPs and patients, moving somewhere between £60 and £80 billion into the hands of clinical commissioning group to commission services. The bill became law in March 2012 with

2142-503: A single-charge pre-payment certificate that allows unlimited prescriptions during its period of validity. The high and rising costs of some medicines, especially some types of cancer treatment, means that prescriptions can present a heavy burden to the primary care trusts , whose limited budgets include responsibility for the difference between medicine costs and the low, fixed prescription charge. This has led to disputes whether some expensive drugs (e.g., Herceptin ) should be prescribed by

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2244-563: A unique role in the training of new doctors in England, with approximately 8,000 places for student doctors each year, all of which are attached to an NHS University Hospital trust. After completing medical school, these new doctors must go on to complete a two-year foundation training program to become fully registered with the General Medical Council . Most go on to complete their foundation training years in an NHS hospital although some may opt for alternative employers such as

2346-575: A wide range of necessary medicines. When purchasing a drug under the PBS, the consumer pays no more than the patient co-payment contribution, which, as of January 1, 2022, is A$ 42.50 for general patients. Those covered by government entitlements (low-income earners, welfare recipients, Health Care Card holders, etc.) and or under the Repatriation Pharmaceutical Benefits Scheme (RPBS) have a reduced co-payment, which

2448-624: Is A$ 6.80 in 2022. The co-payments are compulsory and can be discounted by pharmacies up to a maximum of A$ 1.00 at cost to the pharmacy. In the United Kingdom , the Medicines Act 1968 and the Prescription Only Medicines (Human Use) Order 1997 contain regulations that cover the supply of sale, use, prescribing and production of medicines. There are three categories of medicine: The simple possession of

2550-464: Is also heavily involved in monitoring internet pharmacies and has issued warnings against several companies who have violated the U.S. Federal Food, Drug, and Cosmetic Act that protects individuals against rogue online pharmacies. Canada is home to dozens of licensed Internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers (who must otherwise pay one of the world's highest drug prices). In recent years, many consumers in

2652-407: Is because there are too few midwives. Neonatal mortality rose from 2.6 deaths for every 1,000 births in 2015 to 2.7 deaths per 1,000 births in 2016. Infant mortality (deaths during the first year of life) rose from 3.7 to 3.8 per 1,000 live births during the same period. Assaults on NHS staff have increased, there were 56,435 recorded physical assaults on staff in 2016–2017, 9.7% more than the 51,447

2754-402: Is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities. According to IQVIA, Vietnam had 55,300 drugstores in 2016, of which 185 belonged to modern drugstore chains. In 2021, the total number of drugstores decreased to 44,600, but

2856-652: Is not directly comparable with later figures. A 2012 analysis by the BBC estimated that the NHS across the whole UK has 1.7 million staff, which made it fifth on the list of the world's largest employers (well above Indian Railways). In 2015 the Health Service Journal reported that there were 587,647 non-clinical staff in the English NHS. 17% worked supporting clinical staff. 2% in cleaning and 14% administrative. 16,211 were finance staff. The NHS plays

2958-1001: Is one of the few options available to uninsured patients. The out-of-pocket cost for patients enrolled in co-pay assistance or patient assistance programs is $ 0. It is a major resource to help lower costs of medications—however, many providers and patients are not aware of these resources. Traces of prescription drugs—including antibiotics , anti-convulsants , mood stabilizers and sex hormones —have been detected in drinking water. Pharmaceutically active compounds (PhACs) discarded from human therapy and their metabolites may not be eliminated entirely by sewage treatment plants and have been detected at low concentrations in surface waters downstream from those plants. The continuous discarding of incompletely treated water may interact with other environmental chemicals and lead to uncertain ecological effects. Due to most pharmaceuticals being highly soluble, fish and other aquatic organisms are susceptible to their effects. The long-term effects of pharmaceuticals in

3060-441: Is provided through general taxation and not a specific tax. Because the NHS is not funded by a contributory insurance scheme in the ordinary sense and most patients pay nothing for their treatment there is thus no billing to the treated person nor any insurer or sickness fund as is common in many other countries. This saves hugely on administration costs that might otherwise involve complex consumable tracking and usage procedures at

3162-505: Is regularly revised – in 2003, the Government announced major changes to NHS dentistry, giving primary care trusts (PCTs) responsibility for commissioning NHS dental services in response to local needs, and using NHS contracts to influence where dental practices were located, and in 2006 a new contract was introduced following Department of Health recommendations on how to cash limit NHS primary care dentistry. Professional bodies such as

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3264-575: Is required to own the pharmacy of which she or he is the licensee. Under this arrangement, a pharmacist can be the operator of only a single outlet. In the UK, 60% of all community pharmacies are owned by companies that own multiple pharmacies. In the United States, more than 25% of independent owners have ownership in two or more pharmacies. Most of Australia's and New Zealand's community pharmacies are owner-operated. In Australia, pharmacists recognise

3366-500: Is the publicly funded healthcare system in England , and one of the four National Health Service systems in the United Kingdom . It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde . Primarily funded by the government from general taxation (plus a small amount from National Insurance contributions), and overseen by the Department of Health and Social Care ,

3468-482: Is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin , generically known as hydrocodone ) via the Internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are instances where a practitioner issues a prescription, brokered by an Internet server, for a controlled substance to a "patient" s/he has never met. In

3570-633: The British Dental Association have complained that the 2006 contract changes introduced a remuneration system which fails to incentivize disease prevention, leading to declining patient outcomes and that radical reform was needed. NHS dentistry charges as of April 2017 were: £20.60 for an examination; £56.30 for a filling or extraction; and £244.30 for more complex procedures such as crowns, dentures, or bridges. As of 2007, less than half of dentists' income came from treating patients under NHS coverage; about 52% of dentists' income

3672-580: The Department of Health and Social Care made a non-binding recommendation that NHS staff in England should receive a 1% pay rise for 2021–2022, citing the 'uncertain' financial situation and the current low inflation. This is estimated to cost £500 million a year, as almost half of the NHS's budget goes on staffing costs (at £56.1 billion). The Trades Union Congress estimated that nurses' pay would be £2,500 less than in 2010, paramedics' pay would be £3,330 less and porters' pay would be £850 less due to inflation . The Royal College of Nursing has criticized

3774-488: The FDA showed an example with more than 52% savings of a consumer's overall costs of their prescription drugs. In the United States there are many resources available to patients to lower the costs of medication. These include copayments, coinsurance, and deductibles. The Medicaid Drug Rebate Program is another example. Generic drug programs lower the amount of money patients have to pay when picking up their prescription at

3876-574: The Institute for Fiscal Studies (IFS), compared to the increase necessary to keep up with a rising population that is also ageing, spending will fall by 1.3% from 2009–10 to 2019–20. George Stoye, senior research economist of the IFS, and said the annual increases since 2009-10 were "the lowest rate of increase over any similar period since the mid-1950s, since when the long-run annual growth rate has been 4.1%". This has led to cuts to some services, despite

3978-892: The NHS Scotland , HSC Northern Ireland and NHS Wales , which were run by the respective UK government ministries for each home nation before falling under the control of devolved governments in 1999. In 2009, NHS England agreed to a formal NHS constitution , which sets out the legal rights and responsibilities of the NHS, its staff, and users of the service, and makes additional non-binding pledges regarding many key aspects of its operations. The Health and Social Care Act 2012 came into effect in April 2013, giving GP-led groups responsibility for commissioning most local NHS services. Starting in April 2013, primary care trusts (PCTs) began to be replaced by general practitioner (GP)-led organizations called clinical commissioning groups (CCGs). Under

4080-550: The Nicholson challenge —which involved making £20 billion in savings across the service by 2015. The principal NHS website states the following as core principles: The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. At its launch by the then minister of health, Aneurin Bevan, on 5 July 1948, it had at its heart three core principles: These three principles have guided

4182-484: The "inconvenience" of visiting a doctor, or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of medication. There also have been reports of such pharmacies dispensing substandard products. Of particular concern with Internet pharmacies

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4284-592: The FDA approval, known as off-label use . Drug companies, however, are prohibited from marketing their drugs for off-label uses. Some prescription drugs are commonly abused, particularly those marketed as analgesics , including fentanyl (Duragesic), hydrocodone (Vicodin), oxycodone (OxyContin), oxymorphone (Opana), propoxyphene (Darvon), hydromorphone (Dilaudid), meperidine (Demerol), and diphenoxylate (Lomotil). Some prescription painkillers have been found to be addictive, and unintentional poisoning deaths in

4386-462: The FDA as dietary supplements . Because specific health claims cannot be made, the consumer must make informed decisions when purchasing such products. By law, American pharmacies operated by "membership clubs" such as Costco and Sam's Club must allow non-members to use their pharmacy services and may not charge more for these services than they charge as their members. Physicians may legally prescribe drugs for uses other than those specified in

4488-434: The FDA requires for the drug to be marketed. Because drug companies have to invest more in research costs to do this, brand name drug prices are much higher when sold to consumers. When the patent expires for a brand name drug, generic versions of that drug are produced by other companies and are sold for lower price. By switching to generic prescription drugs, patients can save significant amounts of money: e.g. one study by

4590-500: The NHS is the Department of Health and Social Care , headed by the Secretary of State for Health and Social Care . The Department of Health and Social Care had a £110 billion budget in 2013–14, most of which was spent on the NHS. A. J. Cronin 's controversial novel The Citadel , published in 1937, had fomented extensive debate about the severe inadequacies of healthcare. The author's innovative ideas were not only essential to

4692-579: The NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR). Free healthcare at the point of use comes from the core principles at the founding of the National Health Service. The 1942 Beveridge cross-party report established

4794-442: The NHS the actual cost of the medicine, which may vary from a few pence to hundreds of pounds. A patient can consolidate prescription charges by using a prescription payment certificate (informally a "season ticket"), effectively capping costs at £31.25 a quarter or £111.60 for a year. Outside the NHS, private prescriptions are issued by private medical practitioner and sometimes under the NHS for medicines that are not covered by

4896-416: The NHS' 70th Anniversary then Prime Minister Theresa May announced extra funding for the NHS worth an average real terms increase of 3.4% a year, reaching £20.5 billion extra in 2023/24. Jeremy Hunt describes the process of setting the NHS budget as far too random - "decided on the back of headlines, elections and anniversaries rather than on rational calculations of demand and cost." From 2003 to 2013

4998-404: The NHS. The position of dentistry within the NHS has been contested frequently. At the inception of the NHS, three branches of dental service were established: local health authority dental service; general practitioner service; and hospital dental service. Dental treatment was initially free at the point of use; however charges were introduced in 1951 for dentures – leading to the resignation of

5100-477: The NHS. A patient pays the pharmacy the normal price for medicine prescribed outside the NHS. Survey results published by Ipsos MORI in 2008 found that around 800,000 people in England were not collecting prescriptions or getting them dispensed because of the cost, the same as in 2001. In the United States, the Federal Food, Drug, and Cosmetic Act defines what substances, known as legend drugs, require

5202-402: The NHS. They may operate in partnership with other professionals, own and operate their surgeries and clinics, and employ their staff, including other doctors, etc. However, the NHS does sometimes provide centrally employed healthcare professionals and facilities in areas where there is insufficient provision by self-employed professionals. Note that due to methodological changes, the 1978 figure

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5304-621: The US (and in other countries with high drug costs), have turned to licensed Internet pharmacies in India, Israel, and the UK, which often have even lower prices than in Canada. In the United States , there has been a push to legalize the importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates FDA regulations and federal laws, enforcement

5406-495: The United States have skyrocketed since the 1990s according to the National Safety Council . Prescriber education guidelines as well as patient education, prescription drug monitoring programs and regulation of pain clinics are regulatory tactics which have been used to curtail opioid use and misuse. The expiration date, required in several countries, specifies the date up to which the manufacturer guarantees

5508-454: The United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship. The Food and Drug Administration (FDA)

5610-791: The actual cost of the medicines through NHS Prescription Services, a division of the NHS Business Services Authority. As of March 2023 the NHS prescription charge in England was £9.35 per item (in Scotland, Wales and Northern Ireland there is no charge for items prescribed on the NHS). People over sixty, children under sixteen (or under nineteen if in full-time education), patients with certain medical conditions, and those with low incomes, are exempt from charges, subject to penalties for claiming exemption when not entitled. Those who require repeated prescriptions may purchase

5712-731: The aid of pharmacy management systems and different integrated technologies, these smaller pharmacies are able to keep up with their large-scale competition. Community pharmacists’ understanding of ethics, confidentiality , patient autonomy , trustworthiness and reliability are essential in community practice and must influence their decision making should an ethical dilemma arise. In some countries, community pharmacists may be asked to compromise on their values and ethical issues may arise not only because of patient's or physician's request but may also because of their employers' intrusion. Individual factors such as age, gender, work experience, and educational level and organizational factors such as

5814-436: The amount of pharmaceutical waste in sewage and landfills. If no take-back programs are available, prescription drugs can be discarded in household trash after they are crushed or dissolved and then mixed in a separate container or sealable bag with undesirable substances like cat litter or other unappealing material (to discourage consumption). National Health Service (England) The National Health Service ( NHS )

5916-474: The amount of the subsidy. Under older legislation (mainly the Road Traffic Act 1930 ) a hospital treating the victims of a road traffic accident was entitled to limited compensation (under the 1930 Act before any amendment, up to £25 per person treated) from the insurers of driver(s) of the vehicle(s) involved, but were not compelled to do so and often did not do so; the charge was in turn covered by

6018-461: The architect of the NHS and Minister for Labour, Aneurin Bevan in March 1951 – and in 1952 for other treatments. Dentists are private contractors to the NHS, which means practitioners must purchase and maintain the practice premises, equip the surgery, and hire staff to provide an NHS dental service. The contract between the NHS and dentists determines what work is provided for under the NHS, payments to dentists, and charges to patients. The contract

6120-527: The armed forces. Most NHS staff, including non-clinical staff and GPs (although most GPs are self-employed), are eligible to join the NHS Pension Scheme —which, from 1 April 2015, is an average-salary defined-benefit scheme. Among the current challenges with recruiting staff are pay, work pressure, and difficulty recruiting and retaining staff from EU countries due to Brexit . and there are fears that doctors could also leave. In March 2021,

6222-400: The average pharmacy carried out around 19 consultations per day, averaging 5.6 minutes each - about 65 million consultations across 10,800 pharmacies in the year. To help pharmacists be able to take on extended roles, it is common for them to work as part of a team that can include pharmacy technicians, dispensing assistants and counter assistants. In parts of mainland Europe, the pharmacist

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6324-602: The conception of the NHS but in fact, his best-selling novels are said to have greatly contributed to the Labour Party's victory in 1945. A national health service was one of the fundamental assumptions in the Beveridge Report . The Emergency Hospital Service established in 1939 gave a taste of what a National Health Service might look like. Healthcare before the war had been an unsatisfactory mix of private, municipal, and charity schemes. Bevan decided that

6426-487: The development of the NHS for more than half a century and remain. However, in July 2000, a full-scale modernization program was launched and new principles were added. The main aims of the additional principles are that the NHS will: The English NHS is controlled by the UK government through the Department of Health and Social Care (DHSC), which takes political responsibility for the service. Resource allocation and oversight

6528-406: The digital hospital-to-pharmacy referral service, which was to launch in July 2020, as part of the new community pharmacy contract, was postponed to 15 February 2021 because of the COVID-19 pandemic in England . It will enable hospitals to digitally notify community pharmacies when patients are discharged and may need advice on taking new medicines, and about changes to their prescriptions. In 2022

6630-587: The effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date". The expiration date is the final day that the manufacturer guarantees the full potency and safety of a medication. Drug expiration dates exist on most medication labels, including prescription, over-the-counter and dietary supplements. U.S. pharmaceutical manufacturers are required by law to place expiration dates on prescription products prior to marketing. For legal and liability reasons, manufacturers will not make recommendations about

6732-482: The environment may affect survival and reproduction of such organisms. However, levels of medical drug waste in the water is at a low enough level that it is not a direct concern to human health. However, processes, such as biomagnification , are potential human health concerns. On the other hand, there is clear evidence of harm to aquatic animals and fauna. Recent advancements in technology have allowed scientists to detect smaller, trace quantities of pharmaceuticals in

6834-439: The equal efficacy, safety, dosage, strength, stability, and quality of brand name drugs. Generics are developed after the brand name has already been established, and so generic drug approval in many aspects has a shortened approval process because it replicates the brand name drug. Brand name drugs cost more due to time, money, and resources that drug companies invest in them to conduct development, including clinical trials that

6936-617: The evenings and weekends and they are accessible without appointment. In the English NHS there were 438 million visits nationally to community pharmacies for health related reasons in 2015. More than 1.1 billion prescription items were dispensed in 2022. More than £10 billion is spent on prescribed drugs annually. Under the 2005 NHS Community Pharmacy contract all community pharmacists in England and Wales provide: Widely available Advanced Services: Enhanced Services which are not available unless locally commissioned: The introduction of

7038-547: The full breadth of critical and non-critical medical care, without payment except for some specific NHS services, for example eye tests , dental care , prescriptions and aspects of long-term care . These charges are usually lower than equivalent services provided by a private provider and many are free to vulnerable or low-income patients. The NHS provides the majority of healthcare in England, including primary care , in-patient care , long-term healthcare , ophthalmology and dentistry . The National Health Service Act 1946

7140-510: The full potency and safety of a drug. In the United States, expiration dates are determined by regulations established by the FDA. The FDA advises consumers not to use products after their expiration dates. A study conducted by the U.S. Food and Drug Administration covered over 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective far past their original expiration date. At least one drug worked 15 years after its expiration date. Joel Davis,

7242-509: The health and social care workers. Secretary of State for Health and Social Care Matt Hancock and Secretary of State for Education Gavin Williamson similarly argued that the decision was due to an assessment of what was affordable due to the pandemic and that NHS staff was excluded from a wider public sector pay freeze. Shadow Secretary of State for Health and Social Care Jon Ashworth clarified that Labour would "honour whatever

7344-413: The management of common ailments. In a survey of over 1,000 U.S. adults older than 40 years-old conducted by Propeller Insights, 67% of patients responded that they would prefer that their pharmacist discuss new prescriptions with them, rather than their physician , because they viewed their pharmacist as "better at explaining side effects and has more time to spend with them." Since about the year 2000,

7446-679: The manufacture and supply of drugs with several categories: As in other developed countries, the person requiring a prescription drug attends the clinic of a qualified health practitioner , such as a physician , who may write the prescription for the required drug. Many prescriptions issued by health practitioners in Australia are covered by the Pharmaceutical Benefits Scheme , a scheme that provides subsidised prescription drugs to residents of Australia to ensure that all Australians have affordable and reliable access to

7548-611: The need to integrate professional pharmacy services into the health system to meet the changing health care needs of the population. A survey conducted by PrescribeWellness found that almost half of Americans older than 40 years-old value pharmacies that offer preventative care services, and would be willing to transfer their prescriptions to pharmacies that offer those services. Patients also value pharmacies where they can receive medical advice concerning their prescription medications, how those medications may interact with each other, and receive over-the-counter drug recommendations for

7650-566: The new system, a new NHS Commissioning Board, called NHS England , oversees the NHS from the Department of Health . The Act has also become associated with the perception of increased private provision of NHS services. In reality, the provision of NHS services by private companies long precedes this legislation, but there are concerns that the new role of the healthcare regulator ('Monitor') could lead to increased use of private-sector competition, balancing care options between private companies, charities, and NHS organizations. NHS trusts responded to

7752-459: The ng/ml range. Despite being found at low concentrations, female hormonal contraceptives may cause feminizing effects on male vertebrate species, such as fish, frogs and crocodiles. The FDA established guidelines in 2007 to inform consumers should dispose of prescription drugs. When medications do not include specific disposal instructions, patients should not flush medications in the toilet, but instead use medication take-back programs to reduce

7854-425: The number of drugstores in modern chains increased to 1,600. According to a report by VNDIRECT Securities Company, Vietnam had about 70,000 drugstores in 2022, including 59,000 traditional retail drugstores (accounting for 84%) and 11,000 chain drugstores (accounting for 16%). The revenue of Vietnam's pharmaceutical retail market reached about 80,000 billion VND. According to a report by MBS Securities Company in 2023,

7956-405: The number of pharmacists in a pharmacy and location of pharmacy may affect the ethical perspectives of community pharmacists. The American Association of Colleges of Pharmacy recommends that consumers choose a pharmacy at which they can have a consulting relationship with the pharmacist. Anyone using drugs benefits when they have easier access to a pharmacist. Being timely includes both processing

8058-448: The overall increase in funding. In 2017, funding increased by 1.3% while demand rose by 5%. Ted Baker, Chief Inspector of Hospitals has said that the NHS is still running the model it had in the 1960s and 1970s and has not modernised due to lack of investment. The British Medical Association (BMA) has called for £10bn more annually for the NHS to get in line with what other advanced European nations spend on health. In June 2018 ahead of

8160-510: The patient level and concomitant invoicing, reconciliation, and bad debt processing. Eligibility for NHS services is based on having ordinary resident status , regardless of nationality. Prescriptions for medication in England and Wales are subject to a fixed charge per item for up to three months' supply, regardless of the actual cost of the medicine. Some people qualify for free prescriptions. Higher charges apply to medical appliances. Pharmacies or other dispensing contractors are reimbursed for

8262-424: The pay rise, calling it 'pitiful' and said that nurses should be getting 12.5% more; it has also agreed to set up a £35m fund to support members in the event of a strike. Other unions have threatened strike actions and warned that the proposal could lead to staff quitting their jobs, worsening staffing issues. The Labour Party similarly criticized the proposal as 'reprehensible' and claimed that it goes against

8364-427: The pharmacy. As their name implies, they only cover generic drugs. Co-pay assistance programs are programs that help patients lower the costs of specialty medications; i.e., medications that are on restricted formularies, have limited distribution, and/or have no generic version available. These medications can include drugs for HIV, hepatitis C, and multiple sclerosis. Patient Assistance Program Center ( RxAssist ) has

8466-418: The point of use. This means that people generally do not pay anything for their doctor visits, nursing services, surgical procedures or appliances, consumables such as medications and bandages, plasters, medical tests, and investigations, x-rays, CT or MRI scans, or other diagnostic services. Hospital inpatient and outpatient services are free, both medical and mental health services. Funding for these services

8568-487: The population of England increased by about 6%. The number of patients admitted to hospital in an emergency went up by 15%.   There were 542,435 emergency hospital admissions in England in October 2018, 5.8% more than in October 2017. Health spending in England is expected to rise from £112 billion in 2009/10 to £127 billion in 2019/20 (in real terms), and spending per head will increase by 3.5%. However, according to

8670-463: The principal fundholders in the NHS system were the primary care trusts (PCTs), which commissioned healthcare from NHS trusts , GPs, and private providers. PCTs disbursed funds to them on an agreed tariff or contract basis, on guidelines set out by the Department of Health. The PCTs budget from the Department of Health was calculated on a formula basis relating to population and specific local needs. They were supposed to "break-even" – that is, not show

8772-546: The principles of the NHS which was implemented by the Labour government in 1948. Labour's Minister for Health Aneurin Bevan is popularly considered the NHS's founder, despite never formally being referred to as such. In practice, "free at the point of use" normally means that anyone legitimately and fully registered with the system (i.e. in possession of an NHS number ), available to legal UK residents regardless of nationality (but not non-resident British citizens), can access

8874-427: The proper use of medicines. In most countries regulations govern how dispensaries may operate, with specific requirements for storage conditions, equipment and record keeping. It is becoming more common for pharmacists to take on extended roles that provide more clinical care directly to patients as part of a primary care team. There are around 11,400 community pharmacies in England. Many are open for extended hours in

8976-483: The request quickly and having drug stock available to fill the prescription. Some consumers need drugs delivered to their home, perhaps by mail, and may select a pharmacy that offers that service. Different pharmacies may charge different prices for the same drugs, so shopping for lower prices may identify a pharmacy offering better value. In addition to fulfilling prescriptions, a pharmacy might offer preventive healthcare services like vaccinations. Up-to-date technology at

9078-401: The review body recommends". At the end of 2021, there were 99,000 vacancies in the English NHS. 39,000 more nurses were needed, together with 1,400 more anesthetists, 1,900 more radiologists, and 2,500 more GPs. Miriam Deakin of NHS Providers stated there were 133,000 NHS vacancies in late 2022. The coalition government's white paper on health reform, published in July 2010, set out

9180-427: The size of Vietnam's pharmaceutical market is about 6-7 billion USD, with more than 3,000 modern chain drugstores. Prescription drug A prescription drug (also prescription medication , prescription medicine or prescription-only medication ) is a pharmaceutical drug that is permitted to be dispensed only to those with a medical prescription . In contrast, over-the-counter drugs can be obtained without

9282-488: The stability of drugs past the original expiration date. Prices of prescription drugs vary widely around the world. Prescription costs for biosimilar and generic drugs are usually less than brand names, but the cost is different from one pharmacy to another. To lower prescription drug costs, some U.S. states have sought federal approval to buy drugs in Canada , as of 2022. Generics undergo strict scrutiny to meet

9384-431: The then legally required element of those drivers' motor vehicle insurance (commonly known as Road Traffic Act insurance when a driver held only that amount of insurance). As the initial bill went to the driver rather than the insurer, even when a charge was imposed it was often not passed on to the liable insurer. It was common to take no further action in such cases, as there was no practical financial incentive (and often

9486-404: The time. In the 1980s, Thatcherism represented a systematic, decisive rejection and reversal of the post-war consensus , wherein the major political parties largely agreed on the central themes of Keynesianism , the welfare state, the mixed economy, supplies both of public and private housing and close regulation of the economy. There was one major exception: the National Health Service, which

9588-468: The treatment of addiction; which is similar to doctors, who require a special licence from the Home Office to prescribe schedule 1 drugs. Schedule 1 drugs have little or no medical benefit, hence their limitations on prescribing. District nurses and health visitors have had limited prescribing rights since the mid-1990s; until then, prescriptions for dressings and simple medicines had to be signed by

9690-465: The way forward was a national system rather than a system operated by local authorities. He proposed that each resident of the UK would be signed up to a specific General Practice (GP) as the point of entry into the system, building on the foundations laid in 1912 by the introduction of National Insurance and the list system for general practice. Patients would have access to all medical, dental, and nursing care they needed without having to pay for it at

9792-705: The year before. Low staffing levels and delays in patients being treated are blamed for this. Nearly all hospital doctors and nurses in England are employed by the NHS and work in NHS-run hospitals, with teams of more junior hospital doctors (most of whom are in training) being led by consultants , each of whom is trained to provide expert advice and treatment within a specific specialty. From 2017, NHS doctors must reveal how much money they make from private practice. General practitioners , dentists, optometrists (opticians), and other providers of local health care are almost all self-employed and contract their services back to

9894-776: Was delegated to NHS England , an arms-length body, by the Health and Social Care Act 2012 . NHS England commissions primary care services (including GPs ) and some specialist services, and allocates funding to 211 geographically based clinical commissioning groups (CCGs) across England. The CCGs commission most services in their areas, including hospital and community-based healthcare. Several types of organizations are commissioned to provide NHS services, including NHS trusts and private sector companies. Many NHS trusts have become NHS foundation trusts , giving them an independent legal status and greater financial freedoms. The following types of NHS trusts and foundation trusts provide NHS services in specific areas: Some services are provided at

9996-442: Was enacted in 1970. It regulates manufacture, importation, possession, use, and distribution of controlled substances, which are drugs with potential for abuse or addiction. The legislation classifies these drugs into five schedules, with varying qualifications for each schedule. The schedules are designated schedule I , schedule II , schedule III , schedule IV , and schedule V . Many drugs other than controlled substances require

10098-506: Was enacted on 5 July 1948. Private health care has continued parallel to the NHS, paid for largely by private insurance: it is used by about 8% of the population, generally as an add-on to NHS services. The NHS is largely funded from general taxation, with a small amount being contributed by National Insurance payments and from fees levied by recent changes in the Immigration Act 2014 . The UK government department responsible for

10200-654: Was from treating private patients. From 1 April 2024, the NHS Sight Test Fee (in England) was £23.53, and there were 13.1 million NHS sight tests carried out in the UK. For those who qualify through need, the sight test is free, and a voucher system is employed to pay for or reduce the cost of lenses. There is a free spectacles frame and most opticians keep a selection of low-cost items. For those who already receive certain means-tested benefits, or who otherwise qualify, participating opticians use tables to find

10302-456: Was once the case that pharmacists stayed within the premises compounding/dispensing medications, but there has been an increasing trend towards the use of trained pharmacy technicians , with the pharmacist spending more time communicating with patients. Pharmacy technicians are now more dependent upon automation to assist them in their new role dealing with patients' prescriptions and patient safety issues. Pharmacies are typically required to have

10404-551: Was widely popular and had wide support inside the Conservative Party. In 1982, Prime Minister Margaret Thatcher promised Britons that the NHS is "safe in our hands." The NHS was established within the differing nations of the United Kingdom through differing legislation, and as such there has never been a singular British healthcare system, instead there are 4 health services in the United Kingdom; NHS England,

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