September 13, 1913
The National Insurance Act, under which hundreds of thousands of people in Great Britain are now receiving what practically amounts to free medical service, has had one wholesome result. It has greatly diminished the sale of “patent medicines” and the prescribing of proprietaries. Under the rules adopted for the working of the act, the amount of money set aside for the payment of drugs works out at two shillings (forty-eight cents) for each insured person. To promote economy in prescribing, an arrangement has been devised by which one-fourth of this amount may be set aside to form a fund, which the doctors on the panel share, in case the twelve cents mentioned have not been required in the payment of druggists’ bills. This has been called the “Suspense Fund,” or, more popularly, the “floating sixpence.” This, and the further fact that an official record is kept of all prescriptions written for insured persons, has naturally discouraged the prescribing of expensive proprietaries in cases in which the cheaper and equally efficient official drugs answer the same purpose.
Proprietary Prescribing in Great Britain. JAMA. 2013;310(10):1078. doi:10.1001/jama.2013.5302