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REGULATION IN UNITED STATES In the United States, the Federal Food, Drug, And Cosmetic Act defines what requires a prescription. Prescription drugs are generally authorized by doctors, though Nurse Practitioner s do an increasing amount of drug prescribing. It is generally required that a physician or a nurse practitioner write the prescription; nurses, emergency medical technicians, psychologists (but not psychiatrists, who are MDs), as examples, do not generally have the authority to prescribe drugs. Unlike many other countries, the United States does not have price controls for prescription drugs, and US drug prices are often perceived as inflated in comparison to other countries; therefore, most health insurance programs (generally partially or in full paid for by the patient's employer) have prescription payment plans where the patient pays only a small Copayment and the pharmacy is reimbursed for the rest of the cost by the insurance company. REGULATION IN UNITED KINGDOM In the United Kingdom, a patient visits a doctor (usually a General Practitioner in the first instance) who is able to prescribe medicines. If given an NHS prescription, this can be taken to a pharmacy to be dispensed. From 2006, some nurses and pharmacists will be permitted to prescribe medicines directly. Each item on the prescription is liable to a ''prescription charge'' of £6.65 ( As Of April 2006 ), although many patients are exempt from this charge. This includes those over 60, under 16, patients with certain medical conditions and those on certain benefits. Those requiring regular prescriptions may make a saving by purchasing a ''pre-payment certificate'' which covers the cost of all prescriptions required for four months or a year. This charge is paid entirely to the NHS through the pharmacy, while the pharmacy claims the cost of the medicine dispensed. Each "item" can cover any prescribed item in a very large or very small quantity according to the doctor's prescription. This means that the patients perceived "value" of the charge varies enormously - the actual cost of the medicine given out will routinely vary from a few pence to hundreds of pounds. The majority of items dispensed on NHS prescription are exempt from charges. This is because of the large number of medicines needed by, for example, the elderly or those with medical exemptions. NHS prescriptions can also be written for certain items by dentists and nurses. Some patients also receive private prescriptions, typically either from a doctor seen privately or for medicine not permitted on the NHS. For these, the patient will pay the pharmacy directly for the cost of the medicine and the pharmacy's markup. The devolved legislature in Wales has decided to phase out prescription charges altogether; this process is expected to be completed during 2007. In January 2006, similar proposals were made by the health committee of the Scottish Parliament ; however, these were rejected by Health Minister Andy Kerr on the grounds that " Executive policy remains that it is right that patients who can afford to should continue to contribute towards NHS dispensing costs". FURTHER READING
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