Local Pharmacies withdrawing from HSE dispensing Schemes

mr.impossible

Unregistered wrote: »

I gave you a hint, what did the chains pay individual chemists when they bought them out? You're in the business, you must know. As for five years ago, the price of houses has dropped, I'm struggling to think of any price in a chemist that has ever dropped.

I also love the constant rubbish that the department set prices for chemists, Individual chemists set their own prices for 90% of their stock.What percentage of stock in your shop has less than 100% mark-up?

Government schemes are obviously excluded.

I have no idea what chains paid, but I am pretty sure at the height of the market they paid way too much. Very little changing hands in the last 2 years. I know my chemist currently has no value and would never be bought.

Lots of prescription drugs have dropped 10% in the last year under IPHA agreement (e.g. Losec, Augmentin). A pityful amount I know and they are still overpriced compared to Spain, but that is down to manufactuerers/HSE. Front of shop check out price of Exputex (though only down as included on GMS reimbursable goods).

100% of my stock as less than 100% markup!! What planet do you live on!!
Maybe some cosmetics have high markups, but none that I stock, try BTs.


90% of my stock is OTC and Prescription medicines.

ricardo1

Suggest the previous poster contact PWC or any of the main auditors for pharmacies in Ireland and he/she will find out the price for purchasing a pharmacy is now a fraction of turnover and not a multiple like it was in days of the Celtic Tiger
By the way my brother is a pharmacist I'm a management accountant and I do not recommend you buy a pharmacy:(

mr.impossible

Anyway apologies guys for going way off-topic. I should remember this is a Long Term Illness Forum, so any moderator feel free to move this to somewhere more acceptable.

I am done taking the bait for community pharmacies and do feel bad for gate crashing a genuine forum.

I came here with the best of intentions of honestly telling it like I see it, not sugar coating the issues or hiding from uneasy topics.

Instead I have let myself get embroiled in the usual rip off Ireland knee jerk stuff. No more!!

LegacyUser

mr.impossible wrote: »

Anyway apologies guys for going way off-topic. I should remember this is a Long Term Illness Forum, so any moderator feel free to move this to somewhere more acceptable.

I am done taking the bait for community pharmacies and do feel bad for gate crashing a genuine forum.

I came here with the best of intentions of honestly telling it like I see it, not sugar coating the issues or hiding from uneasy topics.

Instead I have let myself get embroiled in the usual rip off Ireland knee jerk stuff. No more!!

I also apoligise for forcing Mr Impossible to continue to post from his jacuzzi, I'm sure he's busy, that haunch of venison won't cook it's self.

By the way, let me know when you have Berocca on sale, I'd love to buy 15 of them for less than a tenner.

Ausone

smccarrick wrote: »

Perhaps they might focus their newly honed organisational skills at getting better prices from wholesalers and manufacturers. I've had to buy test strips here when my wife misplaced her LTI card- they cost me EUR88 for 2 boxes. I've also bought an identical two boxes (same manufacturer, same product- slightly higher VAT) for EUR62 in Portugal. We're all in the Eurozone and have a common market in goods and services. If there is a difference of this scale to be exploited- surely it would be a hell of a good idea for the IPU to exploit it?

Anyone can do this- but in most cases the medications can only be sold/delivered to a pharmacist (hence my sourcing and having medications from the UK shipped to my local pharmacist that I referred to earlier in this thread).

The argument is the price won't cover the cost of the medications. The other way of looking at this is- do our EU brethern pay the same prices- and if not- why not? Is there a supply line we can exploit? Medicine is a commodity product- a 35c box of paracetamol in Spain has exactly the same ingredients and has come off the same production line as a 1.29 box in Dublin- both from Clonmel Pharmaceuticals. Why doesn't the IPU chase down these sort of issues- instead of threatening vunerable customers?

I do know a bit about drug pricing in Europe.
Firstly any medicinal products sold in this Country has to have a Product Authorisation from the IMB (www.imb.ie)
We are a small country, about the same size of greater manchester.
Neither pharmacists nor the IPU nor the wholesalers set the prices of drugs in this state. This is done through the IPHA and APMI agreements direct with the DOHC and HSE.

Patent laws were changes in southern European countries in the 70's. AFAIK it was after Franco in Spain. However drug pricing does not bear any relation to the cost of manufacture or even future resaearch and development, they charge what they think the market can bear.

Because of the different laws in Spain 40 years ago, drug prices in southern europe are lower than the north. They are however increasing in the south faster than the north.
The average drug has a patent life after marketing of about 8 years. So there has been about 5 cycles. The next in series are set by reference to the last drug.
Eg Zantac and Losec. Losec, the newer drug, was bound to be more expensive than Zantac but only by so much as a factor of the older drugs price. If Losec was ten times as expensive as Zantac, the drug would not have been approved/reimbursed!
Am I being clear? Sorry if I am not.

Your test strips, the same company manufacturers them, probably at the same factory, at the same time. They are allowed to charge the higher price because the DoHC and HSE have not been aggressive enough in contract negotiations. This is probably due to the nature of big pharma here. However they are here because of the 12.5% rate, english speaking workforce and the EU.

I hope that explains a bit!

ricardo1

my advice for any fellow LTI patients would be to go to your pharmacy the last week of July stock up well with every medicine you should need over the following month and hopefully this dispute will be resolved in the mean time

ricardo1

from what I've heard it could be a problem down the country accessing medicines in early August and in Dublin it could be a problem for drug addicts getting Methadone

SomeDose

mr.impossible wrote: »

Anyway apologies guys for going way off-topic. I should remember this is a Long Term Illness Forum, so any moderator feel free to move this to somewhere more acceptable.

I am done taking the bait for community pharmacies and do feel bad for gate crashing a genuine forum.

I came here with the best of intentions of honestly telling it like I see it, not sugar coating the issues or hiding from uneasy topics.

Instead I have let myself get embroiled in the usual rip off Ireland knee jerk stuff. No more!!

I understand your frustration. Unfortunately, whenever pharmacy in Ireland is brought into the public eye, you will get the usual comments of "overpaid pill-counters...never met a poor pharmacist...massive profits...cosy cartel" etc etc. It's grossly misinformed, and usually comes from what gets put out by the media and Joe Duffy types. I also think it's partially due to the nature of our work - most of the good work is behind the scenes, discretely and quietly. Hence, the public don't see or know what we get paid to do, and find it hard to justify any decent kind of reward. Despite your and others' best efforts to make this dispute as transparent as possible (which the HSE press office will never do), people will still make their own mind up, rightly or wrongly. Locum-motion has linked to the askaboutmoney thread, which explains it very clearly. DrIndy has written an excellent post on the disgraceful way the HSE treats it's frontline workers. The facts are there, whether people accept them or not is a different story. As the saying goes, you can lead a horse to water but you can't make him drink.

For the record, I am an Irish pharmacist who works in the UK for the NHS. But I never, ever want to return to Ireland as a pharmacist, where my role would not be valued and my career and livelihood would be vulnerable to the HSE's incompetence and mismanagement. And just in case anyone thinks my view is one-sided, both my parents are LTI patients and may potentially suffer from this dispute, yet I (and they) will support the pharmacies' protest 110% because we know what the long-term consequences will be should Harney get her way. Harney and the HSE disgust me on a level that's hard to describe. They are dinosaurs, and I hope to god that this row is the meteor that finally wipes them out.

locum-motion

tbh wrote: »

the IPU should have consulted with patients FIRST, before they took the nuclear step of withdrawing services. From a strategical point of view, that would have made more sense - get your customers onside, and THEN take on the government.
PLEASE!

Absolutely, we should have consulted patients first. We would have loved to. But we were give 12 days notice of the cuts, which were made under a law which specifies that we must give 30 days notice if we don't wish to accept them. Even if a pharmacy had given notice on the day the press release was made, the cuts would still have come into effet 18 days before the notice period was up!

I'm sorry, but when were we supposed to find the time to set up patient consultation focus groups or whatever? And what would they have achieved anyway? We would have told you precisely what were telling you here and now, and you would have said back precisely what your saying here and now.

locum-motion

smccarrick wrote: »

Ps- what the hell is wrong with a 2002 Ford
Focus- its a decent enough car, handles well, and I've driven thousands of miles for work in it. Where are you coming from with your ascertain that the public think pharmacists are driving around in Mercs and BMWs like Dail deputies- you are delibertly trying to portray a beal bocht.

The reference to a 2002 Ford Focus came from a non-pharmacist on this thread commenting on what their pharmacist drove. That comment in turn was a response to a suggestion from another non-pharmacist why implied that the dispute was about pharmacists wanting a new BMW every year.
Nobody said there's anything wrong with your car.

ricardo1

DrIndy wrote: »

I think we need to watch the tone of this thread.

Remember that the fees to a pharmacy are not the salary of the pharmacist. There are significant overheads, staff, accountants, rent, electricity to consider too.

The increasingly desperate HSE are targetting front line services as they are the easiest ones to target rather than doing a root and branch review of the situation. Look at the behaviour towards doctors overtime - where doctors work MANDATORY overtime and get paid for this was spun instead as "greedy doctors". The Labour Relations Court has implemented EWTD as a settlement and now the chaos emerges that it is impossible to implement without reducing the health service to emergency only, cut all outpatient clinics and stop all elective surgery and procedures. It simply can't be implemented.

This unfortunately has become a critical effort of brinkmanship by the HSE. Pharmacy costs are high because wholesale supply prices are high. Do pharmacists make a profit as it is - yes. Should they reduce in line with the rest of the workforce - yes. Should they be singled out tyranically with swinging cuts of 33% - NO!

The original plan with doctors too was simply to refuse to pay any overtime past 60 hours - this would also result in the same level of cuts - if I am taking a pay cut, I should see my hours reduce too so that I can have some sort of semblance of contact with my friends and family.

This sucks for patients, really badly - but what other options are there to face down the government? They hold a monopoly on the service and abuse it. The only way forward is to use patients to pressure the government. If all the petrol companies got together into a cabal and decided to unilaterally hike the price of petrol by 33% "because of increased expenses" there would be riots on the street. However, the pharmacists are being spun as greedy buggers by the HSE so its ok.

There are always 2 sides to a story and the HSE is very good at spin and very bad at dealing with an issue in a co-ordinated or even fair way. They do not measure patient outcome as a marker for success and fund accordingly - its all about random bits of cash and administration. Throughout all of this - how many civil servants have been reorganised? How many supernumerary former health board employees have been redeployed or given early retirement? How many job duplication employees in DoH and HSE have been given new rolls or retired?

They are untouchable because no-one really knows what they do and so cannot really say they are not needed only that collectively, the productivity is low and cost is high. However, on the front line - slash and dash. Remember too that in the end, the only people who will be affected by a cut in frontline services will be you - the patient. The long term plan anyway in the HSE is to force everyone into privatised health care anyway.

My final post before I hit the sack...
this appears to be the sole independent view on this dispute and it makes a very good point in this thread...
Yes we are pawns in this dispute this is true
and this is also true... this country is paying beyond it's means for the cost of healthcare including pharmaceuticals
The HSE are paying the pharmacists whe are paying the wholesalers who are paying the pharmaceutical companies. The root of the problem is obviously the pharmaceutical companies... saying that we cannot target one sector to make a 100million plus saving. There's going to have to be give and take on each side. The pharmacists are going to have to accept a cut the wholesalers and pharmaceutical co's likewise and last but not least the HSE will also have to accept a cut in their expectations and savings.... don't blame one professional group but maybe do target your anger at the HSE/Government/Harney for not attempting to solve this dispute the logical way.
By the way pharmacists should not be here to bore and confuse LTI patients on the complexities of medicine price structuring. We just want our medicines with as much of the professional service you can offer....Thats what you're here for and what we want you to be here for... we understand medicines are more expensive here compared to most other European countries and we also understand that you also have to purchase these medicines...tell us how you could solve this problem and more how the HSE can solve this problem.... hopefully sooner rather than later.
Okay good night

locum-motion

ixoy wrote: »

Any pharmacist here - what percentage of your profits is derived specifically from Long Term Illness medication? Any ideas?

I don't really believe that your question is strictly relevant to the dispute as a whole, but given that this is the LTI thread, it is of interest to the readers here, so I'll attempt an explanation. However, it's complex, and I'm going to try to be brief, so forgive me if I don't explain very well. Also, I don't own a pharmacy, so can't give specific numbers.

The rates of remuneration for LTI (and also for DPS, they're both calculated in the same way) are attractive. The volume of business that it accounts for is small.

As an example: at the end of the month, we have to send our paperwork off to the HSE/PCRS to get paid. You know those blue forms that we get you to sign, that's what I'm talking about. In the case of GMS, it's the actual prescription forms. In a typical, middling-busy pharmacy, the bundle at the end of the month might consist of about:
5-600 GMS and GMS Repeat Prescriptions
150-200 DPS Claim Forms
20-30 LTI Claim Forms
5-10 Hitech Medication Claim Forms
and probably less than 5 each of the other various types. (There are 12 different schemes in total under which pharmacies get paid.)

GMS is woefully underfunded, even before the currehnt cuts. The service would have collapsed years ago but for the fact that the much higher rate of pay for the DPS + LTI helped keep it afloat, and also the fact that discounts from wholesalers helped out too.

I suspect that the reason you asked the question is because you were thinking of suggesting we stop the GMS but not the LTI (if I'm wrong and you weren't thinking that, please don't jump down my throat!).
Unfortunately that's not an option, as has been explained already on this thread.

If you want to know about how much pharmacies are paid, and how much they'll be paid in Harney's brave new world, all of that information is available on other posts on this thread, and also by going to www.askaboutmoney.com > Don't askaboutmoney > Consumer Rights and Issues > "Pharmacies - Price Competition - why is there none?".

Thanks for reading.

locum-motion

smccarrick wrote: »

Perhaps they might focus their newly honed organisational skills at getting better prices from wholesalers and manufacturers. I've had to buy test strips here when my wife misplaced her LTI card- they cost me EUR88 for 2 boxes. I've also bought an identical two boxes (same manufacturer, same product- slightly higher VAT) for EUR62 in Portugal. We're all in the Eurozone and have a common market in goods and services. If there is a difference of this scale to be exploited- surely it would be a hell of a good idea for the IPU to exploit it?

Anyone can do this- but in most cases the medications can only be sold/delivered to a pharmacist (hence my sourcing and having medications from the UK shipped to my local pharmacist that I referred to earlier in this thread).

The argument is the price won't cover the cost of the medications. The other way of looking at this is- do our EU brethern pay the same prices- and if not- why not? Is there a supply line we can exploit? Medicine is a commodity product- a 35c box of paracetamol in Spain has exactly the same ingredients and has come off the same production line as a 1.29 box in Dublin- both from Clonmel Pharmaceuticals. Why doesn't the IPU chase down these sort of issues- instead of threatening vunerable customers?

Dear smccarrick and other readers,

In answer to these questions, please find below a copy of a long post I wrote last week on www.askaboutmoney.com ; I'm copying and pasting because I'm certainly not going got type it all out again.

I think it should answer all questions about the whole 'drugs-are-cheaper-in-Europe' argument. If you feel there are still specific questions about European prices, let me know, and I'll address them if I can. However, I believe that this post is comprehensive enough that the entire European prices issue can be put to bed here and now.

Thanks for reading,
L-M.


Re: Pharmacies - Price competition - Why is there none?
Quote:
Originally Posted by gearoid
I have seen numerous instances where Greek and Italian prices are actually on the medicine.

So, is that someone actually avoiding the local wholesaler? You were very limited on the actual details.

What's happening there, Gearoid, is a case of what's called Parallel Importing. Let's say Manufacturer A makes a product B, and had licenses to sell it from the relevant authorities in the various EU countries (In Ireland, it's the IMB, and the license is called a Product Authorisation or PA. There should be a PA no printed on the packaging, if you get your prescription meds in their original box).
The manufacturer sells the product to the various wholesalers in each of the countries. Now this is the vital bit: the price is different in each country. In Ireland, that ex-factory price is set by an agreement between the manufacturers and the Government, and the wholesalers sell it to pharmacies at the ex-factory price plus a 17.66% mark-up (which is equiv to a 15% margin). This is the cost price to the pharmacy, which will have VAT added to it if appropriate. Up to now, this figure (we'll refer to it as the invoice price) is the basis upon which the Govt calculates how much it has to pay the pharmacy. Typically the pharmacy will also use this price as its base for calculating the selling price on a private prescription. My point here is that the pharmacy has NO SAY OR INPUT into what the invoice price is, only in what they do afterwards.

Now, remember I said the ex-factory price is different in each country. In Spain and Greece especially it is only a small fraction of the price here. I'm not sure why, but I believe it has something to do with different intellectual property rights laws there. So why don't we just buy from the spanish factory? It's a free European market, isn't it? Well, yes and no. Pharmacies in Ireland are required by law to purchasse their supplies from wholesalers that are licensed in Ireland. And in general, the product they supply is the product that comes direct from the manufacturer.

That is where Parallel Importing comes in. There are a small number of companies who engage in this practice. A couple of examples are PCO and Imbat. What they do is track fluctuations in prices of various meds in various countries. When they ID a product and a pair of countries where the difference in price is big enough to make it worth their while, they will:
a) Apply for a Parallel Product Authorisation (PPA) number from the IMB (or corresponding body in destination country)
b) Buy up all of the product they can get their hands on
c) Do whatever labelling/repackaging they have to do to satisfy legal conditions in destination country. This will include the PPA no printed on the packaging, similar to the PA number mentioned above
d) sell the repackaged product for the best price they can get (which, if they want it to be reimbursible on Govt-paid schemes, has to be agreed with the Govt in the same way as the 'regular' products are)
Once again, the pharmacist has no say in the price he pays.
By the way, this is all perfectly legal.
If you get a product from a pharmacy that has, for example, the days of the week printed in French, this is probably a Parallel Import. In some cases, and one that I know about is Spain, there will be a price printed on the box, beside the barcode or the expiry date. As far as I know, but I am open to correction on this, this price is what the pharmacy in Spain would buy the product from a Spanish wholesaler for, NOT the price that the consumer pays in the Spanish pharmacy.

So why don't all pharmacies just use the Parallel products? A couple of reasons. Firstly, some patients don't like them or trust them. Secondly, not very many products are available in this way as it only happens if the price differentials are right. Thirdly, only a comparitively small amount of each product is available, as the Parallel Importers have to pick up what they can in the source country, without leaving a shortage of supply there. Fourthly, the price difference by the time the Parallel Importer has done his bit is really not usually very much, and it may not be worth a pharmacy's while various reasons such as he may fall beneath a target set by his main wholesaler.

Unfortunately, there do exist SOME pharmacies who exploit this for their own benefit. If your pharmacy is supplying you with a PI product, you should make sure that they're CHARGING you for the PI product, so that YOU'RE the one to benefit from this reduced cost. MOST pharmacies who supply PIs will do this as a matter of course. However, as in every barrel, there may be a couple of rotten apples.

Hope this helps. Your questions/doubts about Spanish prices etc should be answered now. Answers to other questions are for another post; this one's long anough already!

One more thing, though, and if you have read all the previous posts you'll know that yes I'm a pharmacist and no I don't own a shop. My interest has been declared. Please believe me when I tell you that there is no cosy cartel of pharmacists keeping prescription prices artificially high compared to Spain etc. The difference in prices are ALMOST ALL caused by the fact that we have to buy them at a much higher price than in other countries, and then we have to try to make a profit when we sell. And as everyone knows, that's getting harder and harder these days (and will become virtually impossible if/when the minister's cuts go ahead).

locum-motion

Unregistered wrote: »

I can't speak for pharmacies outside Dublin, but an average chemist in Dublin, who owns his own shop, will clear a minimum of 250,000 a year. That's net profit.

Before I have any whingers disagreeing, research what any of the chains paid to buy out individual shops.

An anonymous post, citing no evidence other than asking you to do your own research?

Have the balls to put at the very least a pen-name to your words like the rest of us do!

locum-motion

Unregistered wrote: »

I also love the constant rubbish that the department set prices for chemists, Individual chemists set their own prices for 90% of their stock.What percentage of stock in your shop has less than 100% mark-up?

Government schemes are obviously exclluded.

The Govt schemes are the only issue on this thread.
If you want to complain about the price of shampoo etc., go to a different thread.

And by the way: 100% of the stock, in 100% of the pharmacies I have ever worked in, has mark-ups of considerably less that 100%. I have never seen a 100% mark-up on anything, not one single item, in a pharmacy.

locum-motion

ricardo1 wrote: »

By the way pharmacists should not be here to bore and confuse LTI patients on the complexities of medicine price structuring.

Why not? Questions were asked. We came to give answers. More questions arose. We gave more answers.

Soapy Joe

Sorry for being away for the last 24 hours. There seems to be a bit of a debate since and some of it a little heated. Quite understandable. First let me say that revenue, be in mine or another pharmacists is of course not that important compared to anyones health. I can understand people getting a bit upset when the subject of money is raised in relation to this. This is where the DOHC have us - whatever we do will impact on health. However, what must be understood by patients is cash flow. If a pharmacy has no cash flow it will dry up. So what are the options, cut back on staff? Yes, wages. yes. And the pharmacist's own salary - yes. But at what stage does this maked the stress and hassle of running a business unactractive? And the amount of additional work involved? Well, as far as I can see - about now - at 35% cuts in gross reimbursement.

In relation to the fact that LTI has 50% markup. I would suggest that even with this cut the LTI will still make a profit - but not after you consider that the cost of running a business/salaries means that other parts of the equation to do. The mark up will be 20% - plus they will take off the wholesale margin on about 8% on top of that.

Why should the LTI patients suffer if their scheme still breaks even? Well, unfortunately we are obliged to fulfill all schemes or nothing - this is what the legislation says (and pharmacists are taking the legal route as invited to do by Mary Harney. In addition, it would be unpalatable for most pahrmacists to select which patients we serve - are not the elderly on the medical card of equal concern? No our aim is to ask the Minister (or even better someone who is willing within the Government) to talk to us. Let us take a cut - but keep it realistic. Even then we anticipate considerable pain.

Why have pharmacies opened recently? Well, the Minister (Mary Harney) should know this - she changed the legislation so that any registered pharmacist can open a pharmacy - so a lot of people have taken the chance/risk of doing so. The reason some newly graduated pharmacists were getting 100K salaries is historical as only certain pharmacists (Trinity Graduates) had the right to open a pharmacy so the likes of Boots decided to use them and pay them. The rest of us where not as valuable.

LegacyUser

The PR war is well underway.

Todays times

http://www.irishtimes.com/newspaper/ireland/2009/0706/1224250105113.html



The 2 examples given are not normal pharmacies:

Abbey Healthcare
This is the headquarters of Abbey Healthcare who provide to large majority of nursing homes in the country. The majority of the fees does not relate to walk in customers. Ground floor is retail pharmacy while elsewhere on the site, they process the majority of their nursing home patients. Historically, local nursing homes used to be served by the local pharmacy but in recent times, the supply to nursing homes has centralised within a number of larger operators...Boots, Abbey etc. The reason for this is that pharmacy don't get any extra payment for all the additional work required for nursing homes (specialised packaging for each patient (to get away from the nurse with the large tubs of drugs on site, drug returns, delivery costs, equipment etc) so it has become a business where large volumes of patients make it viable and thus you only have a small number of service providers. One of whom would be located in Abbey branch in Monkstown. They have normal shop downstaits and massive processing operation upstairs.


Medipharm
Medipharm run a number of pharmacies, including one on-site in a private hospital in Mullingar.

Again, they also supply medicines to a number of nursing homes around the country.
However, a large proportion of their income derives from their arrangement with one or more of the major fertility clinics to supply the IVF and other fertility medications for their patients, which run into thousands of euro per patient per cycle.
This is spectacularly lucrative for them, although ethically questionable as many of these patients who hail from all around the state would prefer to obtain their medications from their own local pharmacy and are allegedly not facilitated to do so.

HSE advertising budget must be fairly substantial to get IT on board in such an unbalanced manner

Sudsy86

I actually think some of the comments on this thread are a disgrace, for the pharmacies to be blamed for this issue is un-believable...Ever since the goverment ruined this country they have found ways to blame other for there mistakes...Now to make up for there mistakes they are stealing from other ppl and those ppl again get blamed...

I have read up to page 8 and couldn't read on further without posting...For those that are stating that the post on this thread are logical and that they are reply emotionally, here is an emmotional responce for ye...I'm trying to save for a house i work long hours and save as much as my money as possible...Firstly my tax is increased cause of the recesion and secondly my girlfriend is gonna loose her job because of this row...For me this is extremely frustrating but think of the ppl in dell and banta...They lost there jobs as a result of the govt stupidity...Now for ppl on this thread to be blaming the pharmicies for not taking an income cut which would lead to no jobs and deciding to walk away from the govt and trying to stop this from happening are naive and absolute tools...

Now understandable ye need ye're medication but if all the pharmicies are forced to close because the cant make enough money then "ye dont get ye're medication" if boots are unable to make all the orders then "ye dont get ye're medication" the pharmacies like every1 else in the country are trying to make a living and my employing PPl there are creating a living for them also...If you want them to bend over and take it so other ppl loose jobs and ye get ye're medications then why should we care about ye...Ye're being jst as heartless...

Mary Harney is sitting up there on her high horse dictating everything that goes on and thrust me her wages alone could cover all ye're medical bills but ye dont care what she does to destroy other ppls lives as long as ye get ye're meds...But like ye expressed earlier, ye dont care cause ye're gonna get ye're meds anyways so what we'll do is we'll care about the little ppl that are gonna loose there jobs because of this issue...

So as ye can see ye're not the only ppl effected by this issue so stop being so selfish...I hope the pharmacies get the retribution they deserve...

Don't let them take ye're livelyhood and always remember there are plenty of us supporting ye 100%...

mike65

The IT editorial

http://www.irishtimes.com/newspaper/opinion/2009/0706/1224250106767.html

The_Conductor

Sudsy86 wrote: »

I actually think some of the comments on this thread are a disgrace, for the pharmacies to be blamed for this issue is un-believable...Ever since the goverment ruined this country they have found ways to blame other for there mistakes...Now to make up for there mistakes they are stealing from other ppl and those ppl again get blamed...

I have read up to page 8 and couldn't read on further without posting...For those that are stating that the post on this thread are logical and that they are reply emotionally, here is an emmotional responce for ye...I'm trying to save for a house i work long hours and save as much as my money as possible...Firstly my tax is increased cause of the recesion and secondly my girlfriend is gonna loose her job because of this row...For me this is extremely frustrating but think of the ppl in dell and banta...They lost there jobs as a result of the govt stupidity...Now for ppl on this thread to be blaming the pharmicies for not taking an income cut which would lead to no jobs and deciding to walk away from the govt and trying to stop this from happening are naive and absolute tools...

Now understandable ye need ye're medication but if all the pharmicies are forced to close because the cant make enough money then "ye dont get ye're medication" if boots are unable to make all the orders then "ye dont get ye're medication" the pharmacies like every1 else in the country are trying to make a living and my employing PPl there are creating a living for them also...If you want them to bend over and take it so other ppl loose jobs and ye get ye're medications then why should we care about ye...Ye're being jst as heartless...

Mary Harney is sitting up there on her high horse dictating everything that goes on and thrust me her wages alone could cover all ye're medical bills but ye dont care what she does to destroy other ppls lives as long as ye get ye're meds...But like ye expressed earlier, ye dont care cause ye're gonna get ye're meds anyways so what we'll do is we'll care about the little ppl that are gonna loose there jobs because of this issue...

So as ye can see ye're not the only ppl effected by this issue so stop being so selfish...I hope the pharmacies get the retribution they deserve...

Don't let them take ye're livelyhood and always remember there are plenty of us supporting ye 100%...

I bet you haven't been diagnosed with a chronic illness and don't require ongoing daily medication for the rest of your life Sudsy. This is the Long Term Illness forum. The majority of the posters in here are seriously ill. This is not a representative random section of the community- its the people who rely on their medication to survive on a daily basis. Its the diabetics, the MS sufferers, those with chronic pain along with physical and other disabilities.

I am genuinely sorry about your girlfriend- yes, the government has bolloxed a whole lot of things up.

The point being made on this thread- is that the very ill people who rely on this scheme (for whom this forum is indeed intended), have been ignored by absolutely everyone- including the pharmacists, in this dispute.

I am grateful to the pharmacist who brought this thread to the attention of certain of the IPU's council- I have been informed that there will be an informal effort made to ensure August supplies for LTI patients are made.

Concerning Mary Harney's salary covering the LTI scheme- not a snow balls chance in hell unfortunately. I've been told the LTI costs in one random pharmacy are almost EUR900 on average for each of her 64 customers on that scheme. Thats 50k- a month, in one pharmacy. Extrapolate this across the country- and you get some idea of the figures involved. These are also the customers on which the 50% markup applies for pharmacists.......

I accept that you are worried about your girlfriend and her job- as indeed we all are about our jobs in the current climate. You are being unreasonable and unrealistic though if you really think that LTI patients are a disgrace for being legitimately concerned about how/where they are going to get their medications. It is a life and death situation for many of them- they are not the randomer wandering into the pharmacy for an antibiotic.

S.

mike65

Dunno if this has been brought up in the body of this thread, with respect to LTI scheme the pharmacist is merely the last point of a distribution chain which he/she signes up to be part of. No actual medical interaction/advice is required to dispense a prescription so why not take this task away from pharmacists and run it via, I dunno, the Post Office?

Before anyone goes mad, think about it. You know what you need, your LTI book contains the details of what you need, all the despenser needs is the ability to read, count and do paperwork. Qualities anyone behind the glass at a PO possesses.

If not the post office then maybe another outlet?

The_Conductor

mike65 wrote: »

Dunno if this has been brought up in the body of this thread, with respect to LTI scheme the pharmacist is merely the last point of a distribution chain which he/she signes up to be part of. No actual medical interaction/advice is required to dispense a prescription so why not take this task away from pharmacists and run it via, I dunno, the Post Office?

Before anyone goes mad, think about it. You know what you need, your LTI book contains the details of what you need, all the despenser needs is the ability to read, count and do paperwork. Qualities anyone behind the glass at a PO possesses.

If not the post office then maybe another outlet?

I'd suggest perhaps reassigning some of those under-employed admin staff in the HSE into a distribution unit in Swords or somewhere- and making up LTI parcels for folk- and sending them on schedule. I really don't see why not. Perhaps spend a week putting together a website where you could input what your requirements were- and voila- it gets delivered to you by courier (given many medications need to be chilled etc- it would have to be courier).

Having spent almost 90 minutes in the post office last week- waiting to get to the counter- just to post a letter- I'd be a little wary of clogging up local post offices with more non-postal related business- its totally crazy in many post offices.

ElBarco

smccarrick wrote: »

I'd suggest perhaps reassigning some of those under-employed admin staff in the HSE into a distribution unit in Swords or somewhere- and making up LTI parcels for folk- and sending them on schedule. I really don't see why not. Perhaps spend a week putting together a website where you could input what your requirements were- and voila- it gets delivered to you by courier (given many medications need to be chilled etc- it would have to be courier).

Having spent almost 90 minutes in the post office last week- waiting to get to the counter- just to post a letter- I'd be a little wary of clogging up local post offices with more non-postal related business- its totally crazy in many post offices.

Sounds like a fine idea to me. There'd have to be some form of authentication involved mind but it could certainly work.

Hell, they could leave such a system in place permanately. Even with courier costs it'd probably be cheaper than running the LTI through the pharmacies!

ixoy

Thanks to some of the pharmacists here for answering my questions - it would seem that the structure of LTI scheme makes it particularly valuable, even if the volume is small. However - if you could separate out the HSE schemes, would you still serve LTI patients? Bit of a mean question to ask, but given the forum that it is...

So should the government re-negotiate prices for wholesalers? Why does Ireland pay so much more when it comes from the same factories - there's mention of intellectual rights above, but that's all a bit vague. Is the HSE not aggressive enough - could savings be made there and thus reduce the burden on the pharmacist?

Another follow-up question: What contingencies/solutions would you advocate while this dispute goes on? What's a viable way? Refunds from the HSE after buying at full price? Go to Boots? Dispense at hospitals?

angeldelight

For contingency plans - apparently Mary Harney has a plan so you will all be ok according to her. Presumably all of you who have such a low opinion of your local pharmacist have a much greater opinion of her and believe that it's the pharmacists that are being irrational, money-grabbing and unfair. Therefore have trust in her to look after you all as well as your pharmacist has over the last number of years.

Boots will presumably be accepting all prescriptions but with only 46 pharmacies in the entire country be prepared to wait up to a week for your script so be organised.

Hospitals cannot dispense as a community pharmacy, they have no way of doing it. Even if they could, hospital pharmacies are chronically understaffed as it is and were even before the HSE recruitment freeze

You will all be fine - you seem to have a terribly low (upsettingly low actually) opinion of pharmacists so when they're gone maybe none of you will mind - Mary Harney has said she'll look after you.

ElBarco

angeldelight wrote: »

For contingency plans - apparently Mary Harney has a plan so you will all be ok according to her. Presumably all of you who have such a low opinion of your local pharmacist have a much greater opinion of her and believe that it's the pharmacists that are being irrational, money-grabbing and unfair. Therefore have trust in her to look after you all as well as your pharmacist has over the last number of years.

Boots will presumably be accepting all prescriptions but with only 46 pharmacies in the entire country be prepared to wait up to a week for your script so be organised.

Hospitals cannot dispense as a community pharmacy, they have no way of doing it. Even if they could, hospital pharmacies are chronically understaffed as it is and were even before the HSE recruitment freeze

You will all be fine - you seem to have a terribly low (upsettingly low actually) opinion of pharmacists so when they're gone maybe none of you will mind - Mary Harney has said she'll look after you.

I'm terribly sorry you're upset.

I hope we can build a bridge of peace after we've all managed to source that pesky medication we're so fond of.

LegacyUser

ElBarco wrote: »

Sounds like a fine idea to me. There'd have to be some form of authentication involved mind but it could certainly work.

Hell, they could leave such a system in place permanately. Even with courier costs it'd probably be cheaper than running the LTI through the pharmacies!

I can just see it now. Launched with all the usual HSE fanfare.

Dear Mr/Mrs Elbarco,
An Post is delighted to welcome you as a custoimer to LTI Swiftcare. We will be processing you medicines going forward. Couple of pointers just at the beginning so that we all now where we stand
- Your delivery time with be every 4th Friday between 9am and 5pm. Please ensure that you are at home during these hours to receive delivery
- In the event that you have any queries on your medicines or changes to it by your prescriber, please contact us by post and we will endeavour to reply within 5 working days
- If you require any urgent assistance or additional meds outside of Mon-Fri 9-5pm (excl lunch), please wait until within these times and call our National helpdesk (located in indian)
- Please don't ask the delivery driver any questions on your vital medicines, he is just a delivery driver. Again please refer to out postal address or indian call centre
- if you wish to return meds or have been sent the incorrect medicines or are concerned if your medicines have not been stored correctly, please contact us again by post.
- please be assured of our utmost attention within the hours of 9-5 unless its a monday when we may be off on sickie.
- Due to cut backs, we will be unable to label your meds or prepack in MDS format. We hope you understand. Any queries, please refer to manufacturers instructions in the box.

Again, we would ask that you do not delay the delivery driver as he must be at the local school by 4pm to do honours english with the junior cert class, sure its only reading from a book. Just as complicated as handing out boxes of medicines.
Rgds
Pat O Dowd
HSe SwiftPost

PS I do hope that the above doesn't cause offence to any persons but the simplificatiopn of what pharamcists do into teh fine art of box shifting is way off the mark

CathyMoran

Everyone - please keep this civil or else...

ElBarco

Unregistered wrote: »

I can just see it now. Launched with all the usual HSE fanfare.

Dear Mr/Mrs Elbarco,
An Post is delighted to welcome you as a custoimer to LTI Swiftcare. We will be processing you medicines going forward. Couple of pointers just at the beginning so that we all now where we stand
- Your delivery time with be every 4th Friday between 9am and 5pm. Please ensure that you are at home during these hours to receive delivery
.
.
.

PS I do hope that the above doesn't cause offence to any persons but the simplificatiopn of what pharamcists do into teh fine art of box shifting is way off the mark

Quite possibly true! Again, I don't believe that pharmacists are simply box shifters. I do think we need someone in the HSE/pharmaceutical sector to come up with something.

Still, LTI Swiftcare may be the only option yet.

p.s. It's Mr ElBarco btw