44% of cancer patients in England are cutting back on food or heating to pay for the cost of their prescriptions, according to a new survey conducted by the charity Macmillan Cancer Support.

59% of the 477 cancer patients who took part in the poll also said that they have had to cut back on leisure activities such as evenings and family days out and holidays to pay for their medicines, says the charity, which claims that prescription charges are “a tax on illness” and has been campaigning for their abolition since 2005.

Improvements in cancer treatment over the past few decades mean cancer patients are increasingly using drugs for years after initial cancer treatment has ended, says Macmillan. For example, patients need to take the breast cancer treatment tamoxifen for five to 10 years after initial treatment ends to help prevent a recurrence of the disease, and this places a far higher cost on the patient, effectively charging them for life-extending treatment. Moreover, patients often need multiple prescriptions to ease side effects of cancer treatment such as nausea, fatigue, severe mouth ulcers and diarrhoea, and can spend hundreds of pounds each year paying for prescriptions, it adds.

Many charities are campaigning for England to follow Wales, which abolished prescription charges last year, and Scotland, which plans to do so by 2011; Northern Ireland is currently capping charges while it considers the options for their future. However, in England, while the government agreed to a public consultation on the issue in July 2007, the Department of Health maintains that the funds raised for the National Health Service (NHS) by the charge, which totalled £430 million in 2006-7 and are expected to raise £435 million in 2008-9, cannot be given up, and also points out that 88% of prescription items are dispensed free of charge.

For people on low incomes who are not automatically exempt there is also the NHS Low Income Scheme, while patients can get all their prescription items for less than £2 a week by purchasing a three-month or 12-month prescription prepayment certificate (PPC). However, Macmillan says that too few patients are aware of the PPC scheme.

“People must never be forced to choose between food or medication. The government must act now. Patients should be allowed to focus on getting better instead of worrying how they're going to find money for prescriptions,” said the charity’s chief executive, Ciaran Devane.