Advertisement
If you have a new account but are having problems posting or verifying your account, please email us on hello@boards.ie for help. Thanks :)
Hello all! Please ensure that you are posting a new thread or question in the appropriate forum. The Feedback forum is overwhelmed with questions that are having to be moved elsewhere. If you need help to verify your account contact hello@boards.ie
Pharmacy dispensing charge... did you know?
Comments
-
I know a guy who got a prescription for his daughter, he didn't know what it was for. Went in and the server goes over and picks up some nurofen off the shelf (i.e. OTC drug) and was asking for extra, I think €6 extra. They were probably Nurofen plus with codeine which I know some pharmacists will not give out too easily, but they are still OTC
He looks at her like shes mad and says no thanks after she confirms they are just OTC, then gets them again right away and doesn't pay the charge.
My dentist was going to write me a prescription for neurofen plus too, but I said no as I already had a load of them (generics I bought online from the UK for pittance, got the site from a nurse I know in vincents who says loads of the doctors & nurses buy all their OTC meds online.)
I later wished I had got the prescription to see if they would try the same on me.
something like this happened to me. Our GP prescribed a special lactose free baby formula for my daughter. We were first time parents at the time so we never thought to question anything what the GP and chemist was doing.
Anyway, the feckin formula was also available OTC for about €5 cheaper per tin.
Live and learn.0 -
partyatmygaff wrote: »It's not as simple as €5 per item. For medical card and many other public prescriptions it's on a sliding scale from €5 to €3.50 depending on the amount of items dispensed.
For private prescriptions and particularly OTC drugs the dispensing fee varies. In some cases, there mightn't even be a dispensing fee.
Most people would knock off the dispensing fee if the product was available OTC and sell it at the OTC price. On private prescriptions it pretty much is as simple as that. There's a dispensing fee on each item, or more accurately each time an item is dispensed. If your prescribed 100 tabs and take 50 now and 50 in 2 weeks you'll pay 2xdispensing fees. Most people do this to keep the initial cost down so they won't take the 100 straight away regardless of saving the €3-5 that they would save. Your right that it varies from €3-5 depending on a lot of stupid things that really don't make a lot of sense.Ok, thanks. But in all honesty, if you go into a chemist and ask for, say 25% of what's prescribed on an optional item, shouldn't the local pharmacist call you to one side and say . . look, it's very expensive buying it this way, why don't you get the full amount prescribed rather than buying in small 'tap-up amounts' as you are doing? Am I being naive? I have asked my local chemist in the past about purchasing items on my prescription sensibly (moneywise). Somehow, I doubt if I got the proper advice. Really, I think it's disgusting to exploit people in this way.
But, is it really €5.00 per item? That seems a bit high to me.
It varies from €3-5 depending on a number of things - If it's private or DPS, how many items have been dispensed etc etc. It's genuinely not a tactic of pharmacists to make money by splitting the quantity. Go back and ask directly and I'd be amazed if they are anything but up front about it. Just beware there are exceptions. They are not going to give more than a month of certain things like sleeping tablets, anti-depressants and painkillers. This is a safety thing and would also be the wishes of the majority of doctors that prescribe the items in the first place.
I recommend taking 6 months together especially on cheap private prescription items. The majority of people decline the offer.angeldelight wrote: »Funnily enough having the patient care fee for the high tech is considerably cheaper than if a mark-up to the product was applied. The products cost in the region of 800-2000 euro (some more, few less) per month so really I think the patient care fee is a more sensible way to go about it
Agreed, was there a mark-up on HT before? I think there was but it was before my time. Still it's quite a lucrative scheme for pharmacies. There's no denying that.run_Forrest_run wrote: »something like this happened to me. Our GP prescribed a special lactose free baby formula for my daughter. We were first time parents at the time so we never thought to question anything what the GP and chemist was doing.
Anyway, the feckin formula was also available OTC for about €5 cheaper per tin.
Live and learn.
That's poor enough and could have been someone not thinking. As I said if something is available OTC then most people would not charge extra. The exception being it you were certain to go over the €132 that month and in that case it would make no difference to the customer in the long run.
At the end of the day your paying people that are professionally trained to provide a service. That's not having an inflated sense of self-importance, that's the way it is. You could be at home with your antibiotic and phone up the pharmacist and have a 5 minute conversation about any questions or concerns you have and there's no problem. If they don't know the answer they'll look it up. If your granny is too old to manage meds they'll pop them all out and put them into a nice weekly pack so it's much easier to manage. If the medication you need is in a short supply and it's hard to get they'll generally spend hours sometimes trying to source it for you. If you have old medication lying around the house they'll take it back and dispose of it. A lot of places will take your blood pressure for free for you...
All of these are free services. Rightly or wrongly it's all funded by a one size fits all pricing model where private patients do pay a considerable amount for prescriptions. But the price of drugs here is falling all the time...0 -
Interesting posts, thanks. No, I wouldn't think pharmacists deliberately encourage customers to split items, but they could make them aware of the extra expense incurred by doing so.
Frequently, people having prescriptions filled are already bearing significant extra costs with their illness.
It's a pity that dispensing charges are so vague as above posts illustrate.
I do, of course, recognize that pharmacists play a responsible role in healthcare and frequently advise their patients on a variety of problems and awareness.0 -
IMHO the point of the OP was that it's a fee that's hidden and jealously protected by the industry. There wouldnt be so many overstaffed local pharmacies if it wasnt lucrative surely?
It's not easy or fair to directly compare with other juristictions, but on the whole it seems that we (the consumer) in Ireland are getting a raw deal either directly or by costs to the govt.
Lots of occupations have life critical experts in control, they mostly dont appear to have hidden costs and cosy relationships.
On a personal note, my local pharmacist is polite. The snotty underlings are a different matter though.0 -
No it's not. The public fees are available online and the private fees are much the same. In fact, the pricing for most pharmacies would be more or less the same as they use similar software. Even at that, it's not a secret you could ask if you were so inclined.ballysheil wrote: »IMHO the point of the OP was that it's a fee that's hidden and jealously protected by the industry.
I've never seen an "overstaffed" pharmacy. As for it being lucrative, it's not really all that lucrative. Pharmacies have huge running costs.There wouldnt be so many overstaffed local pharmacies if it wasnt lucrative surely?
The fees paid aren't hugely different from the fees paid in other countries.It's not easy or fair to directly compare with other juristictions, but on the whole it seems that we (the consumer) in Ireland are getting a raw deal either directly or by costs to the govt.
There's nothing hidden about the costs and I have no idea what you mean by "cosy relationships".Lots of occupations have life critical experts in control, they mostly dont appear to have hidden costs and cosy relationships.0 -
Advertisement
-
I'm confused.
I have a private prescription which costs €60 pm. Under the PCRS these drugs would be reimbursed to the value of €27.50 and there's also a small fee of around €3-5
So who makes the additional €30 profit in this case ?0 -
It depends on the contents of the prescription and the pharmacy in question. Obviously you're not going to post up the details of your prescription on a public forum (Unless you want to) but i'd say for multiple item prescriptions the dispensing fees and wholesale markup would add up. If it's extemporaneous (Which i'd doubt) it'd be even more expensive.I'm confused.
I have a private prescription which costs €60 pm. Under the PCRS these drugs would be reimbursed to the value of €27.50 and there's also a small fee of around €3-5
So who makes the additional €30 profit in this case ?0 -
I'm confused.
I have a private prescription which costs €60 pm. Under the PCRS these drugs would be reimbursed to the value of €27.50 and there's also a small fee of around €3-5
So who makes the additional €30 profit in this case ?
Is that for one item? If so is it something other than a tablet/liquid? VAT is charged on creams/sprays etc, this'd bring you upto around €60 going by a 50% markup + dispensing fee of ~€50 -
One thing that IS clear is that the payment and charging system is anything but clear.
Other professions - legal comes to mind in particular - have faced enormous public pressure to be more transparent - some have responded and some have not. But better lawyers think not only about their professional technical responsibilities but also the relative costs of transactions and advise clients of the relative costs of doing things one way or another. So even though their professional qualifications are in law they also take costs seriously.
I get my bp prescriptions regularly and also my elderly Mum's multiple prescriptions for years. No doctor or pharmacist has ever advised on the most cost efficient way of doing business with them.
Do they think it is beneath them or what?0 -
How? For public prescriptions, all the charges and fees are available online in excruciating detail. As for private prescriptions, all that you need to do is ask.trishasaffron wrote: »One thing that IS clear is that the payment and charging system is anything but clear.
Or if you'd prefer not to ask I can tell you how it works for *most* pharmacies.
Cost price + m/up + VAT + dispensing fee (If applicable)- Products for oral consumption don't attract any VAT. All other products do.
- Most OTC products such as Calpol don't attract a dispensing fee.
- Prescription products can attract a dispensing fee of ~€5.
- Extemporaneously prepared products have a separate fee.
- As for mark up, it's by and large 20% but the software automatically prices for 10, 20, 30, 40 and 50% and allows you to choose.
Pharmacists do the exact same. Most pharmacists for example would recommend people to get tax refunds or join the DPS if they saw their patients were spending a lot on their medicines. Aside from that, I don't see what else that can be done.Other professions - legal comes to mind in particular - have faced enormous public pressure to be more transparent - some have responded and some have not. But better lawyers think not only about their professional technical responsibilities but also the relative costs of transactions and advise clients of the relative costs of doing things one way or another. So even though their professional qualifications are in law they also take costs seriously.
They're not accountants. With no offense intended, it's not really their job to economise your expenses. Obviously some pharmacists/doctors would advise their patients on certain schemes like the DPS or tax refund scheme but aside from that, it's up to you to research things.I get my bp prescriptions regularly and also my elderly Mum's multiple prescriptions for years. No doctor or pharmacist has ever advised on the most cost efficient way of doing business with them. Do they think it is beneath them or what?0 -
Advertisement
-
Maybe you could ask yourself? Most people only want one month at a time anyway.trishasaffron wrote: »One thing that IS clear is that the payment and charging system is anything but clear.
Other professions - legal comes to mind in particular - have faced enormous public pressure to be more transparent - some have responded and some have not. But better lawyers think not only about their professional technical responsibilities but also the relative costs of transactions and advise clients of the relative costs of doing things one way or another. So even though their professional qualifications are in law they also take costs seriously.
I get my bp prescriptions regularly and also my elderly Mum's multiple prescriptions for years. No doctor or pharmacist has ever advised on the most cost efficient way of doing business with them.
Do they think it is beneath them or what?0 -
partyatmygaff wrote: »How? For public prescriptions, all the charges and fees are available online in excruciating detail. As for private prescriptions, all that you need to do is ask.
Or if you'd prefer not to ask I can tell you how it works for *most* pharmacies.
Cost price + m/up + VAT + dispensing fee (If applicable)- Products for oral consumption don't attract any VAT. All other products do.
- Most OTC products such as Calpol don't attract a dispensing fee.
- Prescription products can attract a dispensing fee of ~€5.
- Extemporaneously prepared products have a separate fee.
- As for mark up, it's by and large 20% but the software automatically prices for 10, 20, 30, 40 and 50% and allows you to choose.
Pharmacists do the exact same. Most pharmacists for example would recommend people to get tax refunds or join the DPS if they saw their patients were spending a lot on their medicines. Aside from that, I don't see what else that can be done.
They're not accountants. With no offense intended, it's not really their job to economise your expenses. Obviously some pharmacists/doctors would advise their patients on certain schemes like the DPS or tax refund scheme but aside from that, it's up to you to research things.
You've clearly put a lot of effort into your post but I regret to say that for this "woman in the street" its impenetrable. I still have no idea whether the amount I'm being charged is the best value I can get. I don't have to be a food purchasing expert to know if I'm getting good value in a supermarket and I don't see why I should have to be a pharmaceutical expert to understand my medication costs.
In a way your long and technical post kind of makes my point for me!0 -
What's technical about my post?trishasaffron wrote: »You've clearly put a lot of effort into your post but I regret to say that for this "woman in the street" its impenetrable. I still have no idea whether the amount I'm being charged is the best value I can get. I don't have to be a food purchasing expert to know if I'm getting good value in a supermarket and I don't see why I should have to be a pharmaceutical expert to understand my medication costs.
In a way your long and technical post kind of makes my point for me!
The only words that would be considered "Healthcare jargon" would be OTA or extemporaneous. At that, out-the-counter is probably well known by most. Extemporaneously prepared medicines just refers to medicines that the pharmacist has to prepare from scratch such as certain pastes or emergency tablet --> liquid preparations.
Aside from that, there's absolutely nothing in the way of jargon. It's plain English.0 -
trishasaffron wrote: »
You've clearly put a lot of effort into your post but I regret to say that for this "woman in the street" its impenetrable. I still have no idea whether the amount I'm being charged is the best value I can get. I don't have to be a food purchasing expert to know if I'm getting good value in a supermarket and I don't see why I should have to be a pharmaceutical expert to understand my medication costs.
In a way your long and technical post kind of makes my point for me!
If you want the best value you can get bring your prescription into a few different pharmacies and ask for a price.
Shop around - don't need to understand any jargon in that case0 -
anyone have a link to this?How? For public prescriptions, all the charges and fees are available online in excruciating detail. As for private prescriptions, all that you need to do is ask.0
-
http://www.hse.ie/eng/staff/PCRS/Contractor_Handbooks/
Has the fees payable to both GPs and Pharmacists (And other primary care contractors).0 -
Join Date:Posts: 14100
angeldelight wrote: »If you want the best value you can get bring your prescription into a few different pharmacies and ask for a price.
Shop around - don't need to understand any jargon in that case
Which is exactly what I did. Boots and McCauley's €5 per item. Brosnan's ( a small one in Midleton) €3.16. Big difference when you're getting regular prescriptions.0 -
+1, and rather than wasting time travelling around you could just email them, or ring them.angeldelight wrote: »bring your prescription into a few different pharmacies and ask for a price.0 -
i was unaware of all this:mad:0
-
angeldelight wrote: »If you want the best value you can get bring your prescription into a few different pharmacies and ask for a price.
Shop around - don't need to understand any jargon in that case
you just dont get it. Even shopping around is made as difficult as possible.
they dont advertise their prices/markups in the store.
they dont tell you the cost till prescription is being handed over.
they dont tell you if there is a generic drug subsitute for your prescribed branded one. i believe this is because they make a bigger profit from more expensive brands.
they charge private patients a different fee that medical card ones for providing the same service.0 -
Advertisement
-
Xterminator wrote: »you just dont get it. Even shopping around is made as difficult as possible.
they dont advertise their prices/markups in the store.
they dont tell you the cost till prescription is being handed over.
they dont tell you if there is a generic drug subsitute for your prescribed branded one. i believe this is because they make a bigger profit from more expensive brands.
they charge private patients a different fee that medical card ones for providing the same service.
It's not that difficult "could you let me know how much that prescription would be please? And I'd be happy to take a generic equivalent if there is one". That would take all of 30 seconds to say, really not seeing the difficulty. Mechanics don't tend to have a full list of every service they offer up so you ask how much something will be before you hand over the keys!0 -
It's not difficult at all really. Have you even tried shopping around before saying it's difficult?Xterminator wrote: »you just dont get it. Even shopping around is made as difficult as possible.
How do you propose they advertise the prices/markup on prescription drugs considering the variation in dose and the fact they're not allowed to be on publicly accessible shelves?they dont advertise their prices/markups in the store.
Nonsensical. Without a prescription, what are they meant to price for you?they dont tell you the cost till prescription is being handed over.
Not really. The main reason pharmacists don't immediately substitute for a generic is some prescribers kick up a fuss when the exact brand they specified in the prescription isn't dispensed. It doesn't make any sense as the drug is the exact same but there's not a whole lot that can be done.they dont tell you if there is a generic drug subsitute for your prescribed branded one. i believe this is because they make a bigger profit from more expensive brands.
That's because in some cases, certain medicines on medical card prescriptions may actually make a loss. If you don't like the price, move to a pharmacy that can afford to have lower prices on private prescriptions.they charge private patients a different fee that medical card ones for providing the same service.0 -
so by your logic bars shouldnt have to advertise their prices, you should just remember to ask the barman the prices before you buy.
thats what your saying yes?0 -
A bar is nothing like a pharmacy. In a bar, it's all very simple. If you want a pint of Guinness, all you need to do is read the price beside "Pint of Guinness". In a Pharmacy, it's not quite so straightforward.Xterminator wrote: »so by your logic bars shouldnt have to advertise their prices, you should just remember to ask the barman the prices before you buy.
thats what your saying yes?
If the average person was given a prescription with the words "Rx - Flucloxacillin caps 500mg stat, 250mg qds x 10/7", do you think they'd be able to convert that to a specific product and quantity? It's not hugely difficult but not something the average person would know how to do.
Most (but obviously not all people) would not know how to price their own prescriptions if just given a price list.
Obviously, pharmacies could just put a big book of prices out at the front of the pharmacy for interested people to peruse but seeing as how the sizable majority will end up asking the pharmacist to price it for them anyway it ends up being not worth the effort.0 -
again that where pharmacists just dont get it. They provide a service. It is like any other service provider in that the principles are the same.
i know that if the barman pulls a pint badly it doesnt matter in the scheme of things. but why do pharmacies think that good consumer practices do not apply to their industry?
Is it unreasonable to ask for clear individual prices all non prescription goods, or for a clear pricing policy to be displayed clearly in shop? how about a clear breakdown on your receipt? this is what the drugs cost, this is our and our markup.
many stores do not. they have items locked in glass cabinets, without clear pricing. At least that way i can compare 2 pharmacies and decide which one i want to shop in.
doctors can do it!
Why cant they advise you when there is a cheaper option? i didnt say substitute, just advise.
Why should the private customers be subsidising the public customers? Under what guise do you think thats acceptable?
TBH things are changing slowly. Pharmacies are being exposed to competition, and reducing margins. what i don't like is the unwillingness to be transparent about what they charge you for.
i had one example of purchasing a bottle of betnesol ear/eye drops. the wholesaler price was under 3 euro,the pharmacist put a sticker on it, and charged me 12 euro.0 -
Pharmacies provide a service and are commercial retailers. They buy goods from a wholesaler and sell them to the public while ensuring the safety and suitability of the products. Do you know the cost price of a loaf of bread in Dunnes and what mark-up they put on it. Do you know the cost price of a shirt in Next and what mark-up they put on it? Pharmacies across the range have a mark-up of between 0-50%, and a dispensing fee normally between €2-€7. The differences are down to competition. The pharmacy is free to set the price at what they want, same way all retailers can set the price of their products at what they think the market will bear! As has been said in this thread numerous times, you have to shop around and if you think a pharmacy is over charging, tell them so and don't go back, it really is as simple as that.0
-
Xterminator wrote: »again that where pharmacists just dont get it. They provide a service. It is like any other service provider in that the principles are the same.
i know that if the barman pulls a pint badly it doesnt matter in the scheme of things. but why do pharmacies think that good consumer practices do not apply to their industry?
Is it unreasonable to ask for clear individual prices all non prescription goods, or for a clear pricing policy to be displayed clearly in shop? how about a clear breakdown on your receipt? this is what the drugs cost, this is our and our markup.
many stores do not. they have items locked in glass cabinets, without clear pricing. At least that way i can compare 2 pharmacies and decide which one i want to shop in.
doctors can do it!
Why cant they advise you when there is a cheaper option? i didnt say substitute, just advise.
Why should the private customers be subsidising the public customers? Under what guise do you think thats acceptable?
TBH things are changing slowly. Pharmacies are being exposed to competition, and reducing margins. what i don't like is the unwillingness to be transparent about what they charge you for.
i had one example of purchasing a bottle of betnesol ear/eye drops. the wholesaler price was under 3 euro,the pharmacist put a sticker on it, and charged me 12 euro.
Items like your betnesol are outliers in terms of markup under the current system - the low cost price means a disp fee will cause the %markup to rise dramatically.
Added to that €2 of the 12 is vat
(incidentally under boots new system of 0 markup and flat €7 fee the cost would be almost identical (3+7) + 21% vat0 -
Xterminator wrote: »angeldelight wrote: »If you want the best value you can get bring your prescription into a few different pharmacies and ask for a price.
Shop around - don't need to understand any jargon in that case
you just dont get it. Even shopping around is made as difficult as possible.
they dont advertise their prices/markups in the store.
they dont tell you the cost till prescription is being handed over.
they dont tell you if there is a generic drug subsitute for your prescribed branded one. i believe this is because they make a bigger profit from more expensive brands.
they charge private patients a different fee that medical card ones for providing the same service.
Advertising of prescription products is highly regulated - a pharmacy putting up a sign mentioning a specific product and its price could be reprimanded by the PSI.
Also the amount of tablets required will vary from patient to patient. for example, augmentin would commonly be prescribed either 2 or 3 times daily for a period of 5,7 or upto 10 days - this would mean 6 different prices for one strength of one product - to list all possible combinations of all medicines would require a phone book sized price list. You could list a price per tablet and state the dispensing fee but then youd have people giving out about it being confusinh. also for nonoral products VAT would be added on to the final price, confusing things more.
Regarding generics - your assumption about markups is wrong, generally discounts are far, far greater on generics so the markup is way larger than on brandname products. Patients and prescribers can also be fussy about changing brands so thats why some places wont suggest it without being asked
With GMS vs private pricing - this is the case in every walk of life, the people offering a major contract can demand better terms than an individual, hence why Hertz will pay less fir a car than you will, Google will pay less for keyboards and hospitals pay less for hand sanitizer.
(Admittedly this hasnt always been true in celtic tiger Ireland due to waste & poorly negotiated contracts)0 -
Xterminator wrote: »Is it unreasonable to ask for clear individual prices all non prescription goods, or for a clear pricing policy to be displayed clearly in shop? how about a clear breakdown on your receipt? this is what the drugs cost, this is our and our markup.
Yes it is unreasonable to expect that.
Have a look at some of your receipts in your wallet. How many of them have a break down of cost price, % mark-up etc?
Why would you expect a pharmacy to go into such detail?
There are plenty of pharmacies in every town some cheaper than others if you are too lazy to simply ring around and ask what the price will be for a prescription then you can't be too worried about it.0 -
Advertisement
-
In short, yes it is unreasonable. In fact, Pharmacies are far more transparent about these things than other retail businesses. If you want to know the breakdown of the cost of your drugs, just ask your pharmacist.Xterminator wrote: »Is it unreasonable to ask for clear individual prices all non prescription goods, or for a clear pricing policy to be displayed clearly in shop? how about a clear breakdown on your receipt? this is what the drugs cost, this is our and our markup.
Although I am loath to use the comparison as they're two very dissimilar types of business, good luck trying to get a barman to give you a breakdown of the cost of your pint.
Doctors almost exclusively provide a service (Save for rare circumstances in which they also provide a good).doctors can do it!
Pharmacists on the other hand provide both a service and (In the vast majority of cases) a good.
Simply because some doctors kick up a fuss when the exact brand of medicine they prescribed isn't dispensed.Why cant they advise you when there is a cheaper option? i didnt say substitute, just advise.
Not only that but if a particular additive or excipient included in the generic but not present in the particular brand was to cause an adverse reaction in the patient the pharmacist would end up getting the blame.
You're not subsidising anyone. The government sets the price of public prescriptions and the pharmacy sets the price of private prescription. As would any business, a retail pharmacy will charge the maximum the market can bear. If you don't like their prices, move on.Why should the private customers be subsidising the public customers? Under what guise do you think thats acceptable?
I wasn't aware that they weren't already exposed to competition. Were Pharmacies state-owned for the past few years without me noticing?TBH things are changing slowly. Pharmacies are being exposed to competition, and reducing margins. what i don't like is the unwillingness to be transparent about what they charge you for.
As for transparency, I think you'll find the opposite is the case. Pharmacies are far more transparent than other retail businesses in their pricing.
And your GP looked at you for five minutes, wrote a few words on a piece of paper and charged you €50.i had one example of purchasing a bottle of betnesol ear/eye drops. the wholesaler price was under 3 euro,the pharmacist put a sticker on it, and charged me 12 euro.
By your way of thinking the GP has a margin of €50.
As I said earlier, a pharmacy first and foremost provides a service.0
Advertisement