When financial pressures pinch, many households cut back on medical expenses in an effort to better balance the budget.

Repeat prescriptions are often delayed until the month-end, medicines are rationed to last just a little longer, or more dangerously, treatment is stopped due to an improvement in symptoms.

This may seem like a sensible means of saving money, but according to Medshield Medical Scheme, these tactics could result in more costly medical expenses, putting your physical and financial health at risk.

“Not all medicines work the same way. Some provide short-term relief when you are sick, while others protect your health daily, even when you feel perfectly well,” said Lilane Swanepoel, Medshield’s manager: brand and communication.

“Understanding the difference can help individuals make safer healthcare decisions, avoid costly complications and ensure they are accessing the medical scheme benefits they are entitled to.”

Understanding medicinal terms

There are three distinct terms which are commonly used to describe medication categorisation, this describes the aspects of how medicines are used and supplied.

• Prescription or acute medication

This refers to any medicine that legally requires a doctor’s prescription before it can be dispensed by a pharmacist.

It includes medicines that need medical supervision because of their strength, potential side effects or the condition they are used to treat.

Acute medication treats short-term illnesses or injuries to relieve symptoms while your body recovers and is usually taken for only a few days.

This could include antibiotics, pain medication, allergy treatment and medicines for stomach upsets.

• Chronic medication

These include medicines used to manage long-term health conditions such as high blood pressure, diabetes, asthma, HIV, epilepsy or high cholesterol.

Most chronic medicines require a prescription, but not every prescription medicine is chronic.

“Antibiotics require a prescription but are usually taken for only a few days to treat an infection. Blood pressure medication also requires a prescription, but it is designed to be taken every day for years, often for life,” reminded Swanepoel.

“The key difference is not whether a prescription is needed; it is whether the medicine treats a temporary illness or manages an ongoing health condition.

“Chronic medication is designed to keep long-term conditions under control. These medicines often work quietly in the background, preventing damage that cannot always be seen or felt.”

Using high blood pressure as an example, Swanepoel said most patients living with hypertension feel completely healthy, yet untreated high blood pressure steadily damages blood vessels, the heart and kidneys while increasing the risk of stroke and heart disease.

“The same applies to diabetes. When blood sugar levels are only slightly out of range, it can over time damage the eyes, nerves and kidneys,” she said.

“Many chronic conditions develop silently; stopping medication simply because you feel better could allow the disease to progress unnoticed.”

Medicines that should never be rationed

Healthcare professionals warn that certain medicines become less effective, or even dangerous, when doses are skipped, or treatment is stopped without medical advice.

These include:

• Blood pressure medication, which helps prevent strokes, heart attacks and kidney disease.

• Diabetes medication, which protects against long-term organ damage.

• HIV antiretroviral therapy, where treatment interruptions can lead to drug-resistant virus strains.

• Certain mental health medicines, which often require gradual adjustment and should not be stopped suddenly.

• Blood thinners, where missed doses increase the risk of dangerous blood clots.

• Antibiotics, where stopping treatment early can contribute to antibiotic resistance.

“If side effects, affordability or other concerns make it difficult to continue treatment, it is advised to speak to your healthcare provider or pharmacist before making changes. Alternative medicines, generic options or different treatment plans may be available,” said Swanepoel.

Understanding medicine schedules

Medicines are classified according to their safety, potential for misuse and the level of medical supervision required.

• Schedule 0 (S0)

Medicines considered safe enough for general sale and include many vitamins, supplements and complementary medicines.

• Schedule 1 and Schedule 2 (S1 and S2)

These medicines are available over the counter (OTC) from pharmacies without a prescription and include many cough remedies, antihistamines, as well as some pain medicines, although pharmacists may still provide advice and record certain sales.

• Schedule 3 to Schedule 5 (S3-S5)

It is required that a valid prescription is presented before being dispensed.

These include antibiotics, blood pressure medication, cholesterol medication and many medicines used to treat chronic diseases.

Schedule 6 and above (S6+)

These substances are tightly regulated because of their potential for dependence, abuse or serious side effects.

These include certain opioid pain medicines, ADHD medication and sedatives.

“Schedules describe how a medicine is regulated, but they do not determine whether it is used for an acute or chronic condition,” explained Swanepoel.

She, however, cautions that OTC medications are not necessarily risk-free.

“Medicines available without a prescription are often viewed as harmless because they are easy to buy,” she said.

“Some OTC pain medication may increase blood pressure or affect kidney function, while certain cold and flu products may not be suitable for people with heart disease or diabetes. Here the expert knowledge of pharmacists is needed in helping customers choose appropriate treatments and checking for potential interactions with existing medication.”

For those who are members of medical aid schemes, Swanepoel advises that they understand their policy’s chronic medication benefits and how it could ease any budgetary constraints.

“Under the Medical Schemes Act, all registered medical schemes are required to cover a defined package of Prescribed Minimum Benefits (PMBs),” said Swanepoel.

“This includes treatment for the 26 conditions on the Chronic Disease List (CDL), as well as a range of other prescribed conditions and emergency care.”

To access these benefits, members need to register their diagnosed chronic condition with their medical scheme before these benefits can be activated.

“Many medical aid members are unaware that once their chronic condition has been approved, qualifying medication is often funded from their chronic medicine benefit instead of their day-to-day benefits or medical savings account,” she said.

“Registering the condition and using the scheme-approved formulary and designated pharmacy network can help members avoid unnecessary out-of-pocket costs.”

“Patients can reduce medical costs without compromising their health by further discussing generic equivalents with their doctor or pharmacist, using your medical aid scheme’s designated pharmacy network and checking your medical aid’s medicine formulary and discussing covered alternatives with your healthcare provider if necessary.”