MASSIVE difference in cost of exact same prescription between pharmacies!!!

Jane5

Hi all, hope this is the right place for this thread.

I went to fill a prescription today for a relative in the pharmacy round the corner from where I work, as they were not able to get out of work to fill it themselves. It's a regular prescription that they get every month, usually in our local round the corner pharmacy.

Issue is this: In our local round the corner pharmacy, the price is always 75 euros per month, it came down last year significantly, it used to be round 120.

In the pharmacy near my work, they charge the old price, and when I said to them that it came down last year (courtesy of the introduction of reference pricing for drugs, use of generics etc) they shook their heads. So I asked for the prescription back, refused to fill it there, and going to fill it tomorrow back at our local pharmacy.

Question is this: Has there not been some sort of standardisation of drug pricing with the introduction of reference pricing? How are pharmacies getting away with this otherwise? It's insane that the price of a month's prescription could vary by up to 50-60 euro just between pharmacies!!

Is there any way of finding out what different pharmacies will charge you for a prescription other than painfully trawling around the city going into different ones? There must surely be some sort of published price lists for generics somehere. I just think, what about patients not in the best of health, with no transport, and hence no real choice of pharmacies and hence limited to the nearest one. It's a mad situation.

JTMan

Name and shame.

What are the names of the pharmacies? We need to learn together thanks to their opaque pricing.

Kurtosis

Jane5 wrote: »

In the pharmacy near my work, they charge the old price, and when I said to them that it came down last year (courtesy of the introduction of reference pricing for drugs, use of generics etc) they shook their heads. So I asked for the prescription back, refused to fill it there, and going to fill it tomorrow back at our local pharmacy.

Question is this: Has there not been some sort of standardisation of drug pricing with the introduction of reference pricing? How are pharmacies getting away with this otherwise?

Neither reference pricing or generic substitution has been introduced yet. Some pharmacies have contacted local GPs who have consented to generic substitution of their prescriptions, perhaps the second pharmacy you went to has not done so with the GP who wrote the prescription. Is the prescription written generically?

Is there any way of finding out what different pharmacies will charge you for a prescription other than painfully trawling around the city going into different ones? There must surely be some sort of published price lists for generics somehere. I just think, what about patients not in the best of health, with no transport, and hence no real choice of pharmacies and hence limited to the nearest one. It's a mad situation.

There is no standard price list for medicines and any pharmacy can charge what they like, which introduces competition to the market. Not really a mad situation, considering it's the same with different GPs, dentists etc. If you want to shop around, you have to do just that, check the price in different pharmacies.

hyperborean

penguin88 wrote: »

There is no standard price list for medicines and any pharmacy can charge what they like, which introduces competition to the market. Not really a mad situation, considering it's the same with different GPs, dentists etc. If you want to shop around, you have to do just that, check the price in different pharmacies.

Only if they are forced to advertise their prices, which they have very conveniently avoided doing for years.

The difference in the drug prices (similair dispensed) from shop to shop is huge but well hidden and is a "mad situation"

Kurtosis

hyperborean wrote: »

Only if they are forced to advertise their prices, which they have very conveniently avoided doing for years.

The difference in the drug prices (similair dispensed) from shop to shop is huge but well hidden and is a "mad situation"

Why is advertising a pre-requisite for price competition? Any pharmacy would give a price on a prescription if asked allowing for comparison and shopping around.

Jane5

Hmmm....also, when I went in, the way they put was " These cost this price."

They never said, "We charge this price for this drug, but the price may vary in other pharmacies if you would like to shop around".


No one informed me that a medically necessary product I was attmepting to obtain could be cheaper three miles up the road.

Before anyone neoliberal business heads jump in, healthcare, especially in a country where drugs over a certain amount are subsidised by the taxpayer, is not EXACTLY the same as a shop that sells a take-it-or-leave-it product.

You MUST purchase medication in order to be treated for your condition. If the meds you purchase are over a certain amount, the taxpayer MUST pick up the tab.

This to me resembles upward only rent reviews-the pharmacy can just charge whatever it wants with no limit on profit margin on medically essential products.

There should be a ceiling on the margin pharmacists can put on medications. I'm all for them making a profit, but within reason. I don't want them to make a loss, but surely a profit margin of say, 30% on a medication is MORE than reasonable?

hyperborean

penguin88 wrote: »

Why is advertising a pre-requisite for price competition? Any pharmacy would give a price on a prescription if asked allowing for comparison and shopping around.

You shouldnt have to waste time going from pharmacy to pharmacy asking people(pharmacists) what price this or that is,. its simple, a comprehensive list of drug prices to the private patient is far to much clarity for Irish pharmacists as the average customer would then come to the same conclusion as I have! the vast majority of them are living in cloud cuckoo land and think they can charge what they want beacuse they are hiding behind unclear pricing and still enjoying the cosy cartel world of Ireland in the 90s.

I guarantee you that the difference between the price paid to the wholesaler and the price the private patient pays would be enough to make Joe public sick.

sandin

Different pharmacies have different pricing models.

Some charge cost price + dispensing fee. Means more expensive items are cheaper, but cheap prescriptions are more expensive.

e.g. cost = 5.00 + dispensing fee of 7.00 = 12.00, cost = 68.00 + dispensing fee of 7.00.

Older model: Cost = 5.00 + 50% mark up (33% margin) = 7.50 (4.50 cheaper than above), Cost = 68 + 50% mark up = 102.00, a lot more expensive than above.

What you need to do is find out who prices in what way and buy the cheap prescriptions in the older model pharmacy and the expensive prescriptions in the new model pharmacies.

Kurtosis

Jane5 wrote: »

No one informed me that a medically necessary product I was attmepting to obtain could be cheaper three miles up the road.

Before anyone neoliberal business heads jump in, healthcare, especially in a country where drugs over a certain amount are subsidised by the taxpayer, is not EXACTLY the same as a shop that sells a take-it-or-leave-it product.

You MUST purchase medication in order to be treated for your condition. If the meds you purchase are over a certain amount, the taxpayer MUST pick up the tab.

This to me resembles upward only rent reviews-the pharmacy can just charge whatever it wants with no limit on profit margin on medically essential products.

There are varying prices for other private healthcare providers such as GPs, why would it be any different in pharmacies.

Also, your are incorrect regarding the taxpayer picking up the tab. There was a letter in the Irish Times from someone in the Dept of Health on that exact point.

You still didn't answer my question regarding if the prescription was written generically, if not then some of the difference in price may be due to branded vs generic medicines.

Kurtosis

hyperborean wrote: »

You shouldnt have to waste time going from pharmacy to pharmacy asking people(pharmacists) what price this or that is,. its simple, a comprehensive list of drug prices to the private patient is far to much clarity for Irish pharmacists as the average customer would then come to the same conclusion as I have! the vast majority of them are living in cloud cuckoo land and think they can charge what they want beacuse they are hiding behind unclear pricing and still enjoying the cosy cartel world of Ireland in the 90s.

This would give an Argos catalogue-size list of drug prices, when you consider different drugs, brands, stengths, once/twice/three times a day dosing, a 28 day supply or a 30 day supply...I don't think this would be simpler than asking in the pharmacy to price the prescription. I doubt any pharmacy would refuse to give a price so not sure what they're "hiding".

And would a cartel not involve identical pricing rather than variation in pricing?

Jane5

Why am I incorrect on the taxpayer picking up the tab? I'm not being disingenuous, but since anything over the Drug Payment Scheme threshold is not payable by the customer, and it is a national scheme, is the balance not coming out of public money? Or how else is it financed?

'Twas not generic-the exact same drug, branded cost exactly 76 euros in our local pharmacy, where we refilled the script today. They asked for exactly 127 euro in the pharmacy I first went to. For the same brand of the same drug.

That's actually worse, if it was generic then I might understand, as maybe the generic form they supply is more expensive than the generic my local supplies, but it was the same amount, of the same branded drug, for 51 euro extra in a different pharmacy.

Anyway you slice that, that is insane.

I'm not having a go at the pharmacists either. I have no idea why this pricing model exists. It could be to do with drug companies and suppliers, government policy, a hundred issues I have not considered or am unaware of. Regardless, it is mad and needs to be changed.

nino1

Jane5 wrote: »

Hi all, hope this is the right place for this thread.

I went to fill a prescription today for a relative in the pharmacy round the corner from where I work, as they were not able to get out of work to fill it themselves. It's a regular prescription that they get every month, usually in our local round the corner pharmacy.

Issue is this: In our local round the corner pharmacy, the price is always 75 euros per month, it came down last year significantly, it used to be round 120.

In the pharmacy near my work, they charge the old price, and when I said to them that it came down last year (courtesy of the introduction of reference pricing for drugs, use of generics etc) they shook their heads. So I asked for the prescription back, refused to fill it there, and going to fill it tomorrow back at our local pharmacy.

Question is this: Has there not been some sort of standardisation of drug pricing with the introduction of reference pricing? How are pharmacies getting away with this otherwise? It's insane that the price of a month's prescription could vary by up to 50-60 euro just between pharmacies!!

Is there any way of finding out what different pharmacies will charge you for a prescription other than painfully trawling around the city going into different ones? There must surely be some sort of published price lists for generics somehere. I just think, what about patients not in the best of health, with no transport, and hence no real choice of pharmacies and hence limited to the nearest one. It's a mad situation.

How do you possibly see this as a bad thing?!!!!
A few years ago every single pharmacy charged a 50% mark up with no variation in prices anywhere so there effectively was no competition.
Now you have the likes of tesco charging 20% mark up, most independents charging 50% mark up and boots somewhere in between.
If "trawling around" a few pharmacies to get the best price is too much effort for you then you would have to question how badly you need the money. Alternatively just pick up the phone and ask for a price over the phone. You make it out like its a huge deal, its actually very easy.

Jane5

nino1 wrote: »

How do you possibly see this as a bad thing?!!!!
A few years ago every single pharmacy charged a 50% mark up with no variation in prices anywhere so there effectively was no competition.
Now you have the likes of tesco charging 20% mark up, most independents charging 50% mark up and boots somewhere in between.
If "trawling around" a few pharmacies to get the best price is too much effort for you then you would have to question how badly you need the money. Alternatively just pick up the phone and ask for a price over the phone. You make it out like its a huge deal, its actually very easy.

Point 1) Just because the situation was worse a few years ago doesn't mean the situation now is okay. It is absolute madness that a price difference of 50 euros for an essential drug exists between two different pharmacies. Whatever the reason.

Point 2) Who on earth finds "trawling around" pharmacies all day easy? What an odd thing to say! I have a job, for starters, the core hours of which are 8-5 and require me to be on site. I can pop across the road for ten minutes on my break. I can't take ages going round to a load of different pharmacies in different locations all day. I'd be fired!
Ditto for spending ages on the phone, ringing up pharmacies asking "What do you charge for this?" Additionally, not everyone can read a doctors script accurately, I can, but due to the annotation on scripts, many people start describing them and the pharmacist says "I'd have to see that myself". I've heard them say that.

Also, for someone who is ill, or elderly, that is an exhausting proposition, and not at all feasible, even if they had the private transport, which they may not do. I've had an infection, or some illness, a couple of times, and just getting from the GP to the pharmacy is an ordeal, then getting home to drop into bed. I would not have been in ANY condition to start "trawling round" looking for a better deal if the pharmacist surprised me with a crazy marked up price.

Why would you object to the idea of some sort of standardised transparent pricing for medications for the general public? It would be so much more efficient, convenient and honest than the situation we have now. Pharmacists could still make a decent profit margin if a certain mark-up threshhold was allowed. I don't understand the objection to be honest. A lot of countries have this.

Does anyone have any more info on who pays for the remainder when you pass the Drug Payment Scheme threshold? I was told I was wrong when I assumed it was coming from public/taxpayer funds, but I still don't know where it does come from, I am interested to know, it's always good to understand how these things work. Thanks.

P. Breathnach

I am on long-term medication. It has always cost more than the HSE limit, so my cost is capped at that level. My pharmacist asked me if I would be satisfied if she substituted generics, and I said that was fine by me. The upshot is that I pay the same amount as before, but the balance invoiced to the taxpayer is far lower. That is a good thing.

Kurtosis

Jane5 wrote: »

Why would you object to the idea of some sort of standardised transparent pricing for medications for the general public? It would be so much more efficient, convenient and honest than the situation we have now. Pharmacists could still make a decent profit margin if a certain mark-up threshhold was allowed. I don't understand the objection to be honest. A lot of countries have this.

Does anyone have any more info on who pays for the remainder when you pass the Drug Payment Scheme threshold? I was told I was wrong when I assumed it was coming from public/taxpayer funds, but I still don't know where it does come from, I am interested to know, it's always good to understand how these things work. Thanks.

What countries have a standardised price for private medicine purchases? Genuinely interested. I don't think such a system would work, with State intervention in a private transaction between an individual and a private business.

I stated your assertion was wrong with regards to the Drugs Payment Scheme because the taxpayer only picks up the tab if medicines pass the threshold according to the HSE's pricing structure. You suggested this was a system like upward only rent reviews for pharmacies, which is not true, regardless of pharmacies using different pricing structures, the state only pays the same for any medicines over the threshold according to their calculation.

Jane5

Ok-maybe I wasn't completely clear. The reason I said it was like upward only rent reviews wasn't an exact comparison, I meant that it was reminiscent of them, in that it was illogical, and non transparent.

You had said earlier "Also, your are incorrect regarding the taxpayer picking up the tab. There was a letter in the Irish Times from someone in the Dept of Health on that exact point." So I took from this statement that the taxpayer does NOT pick up the tab when medicine costs exceed the DPS threshold.

However, it now appears that they DO in fact pick up the tab. So, unless I am understanding something incorrectly, if I went back to that pharmacy and decided to fill a month's worth of that prescription and one other script costing 20 euro, we'll say, the taxpayer pays for my script costing 20 euro. Out of taxes. Whereas if I go to my local pharmacy, fill the month's script for 76 euro and get the other for 20, I pay for all of it out of my net income, it costs the taxpayer nothing and it's still actually cheaper for me.

Am I missing something? I'm not trying to offend anyone or upset anybody, but this just seems, well, I keep using the word, but it seems mad!

Kurtosis

Jane5 wrote: »

Ok-maybe I wasn't completely clear. The reason I said it was like upward only rent reviews wasn't an exact comparison, I meant that it was reminiscent of them, in that it was illogical, and non transparent.

You had said earlier "Also, your are incorrect regarding the taxpayer picking up the tab. There was a letter in the Irish Times from someone in the Dept of Health on that exact point." So I took from this statement that the taxpayer does NOT pick up the tab when medicine costs exceed the DPS threshold.

However, it now appears that they DO in fact pick up the tab. So, unless I am understanding something incorrectly, if I went back to that pharmacy and decided to fill a month's worth of that prescription and one other script costing 20 euro, we'll say, the taxpayer pays for my script costing 20 euro. Out of taxes. Whereas if I go to my local pharmacy, fill the month's script for 76 euro and get the other for 20, I pay for all of it out of my net income, it costs the taxpayer nothing and it's still actually cheaper for me.

Am I missing something? I'm not trying to offend anyone or upset anybody, but this just seems, well, I keep using the word, but it seems mad!

I may not have explained it clearly in my last post. The taxpayer picks up the tab in some cases. The HSE will only pay a pharmacy if someone's medications exceed the €144 threshold according to the HSE's pricing structure. If the pharmacy uses a different pricing structure, medication may reach the threshold but not according to the HSE's pricing structure, and so the pharmacy will not be paid anything from the taxpayer.

It does not matter to the HSE if people shop around for their medicine, they end up paying pharmacies the same regardless under the Drugs Payment Scheme. Shopping around can save individuals money though.

P. Breathnach

So is the HSE willing to pay the same for a generic as for a named product that is out of patent?

Kurtosis

P. Breathnach wrote: »

So is the HSE willing to pay the same for a generic as for a named product that is out of patent?

No, as far as I know all generics are cheaper than the branded product, so the HSE will pay less for these. I was referring to shopping around between pharmacies for identical products, switching to generics can save money for the taxpayer and individuals.

JTMan

Is there a simple solution to this opaque pricing?

Simply, make it mandatory for pharmacies to publish their prescription prices on their websites.

Would that work? Do we need to to canvas the NCA on this?

Jane5

http://www.medicalindependent.ie/24191/prescription_needed_for_drugs_bill

Found this. Goes a little way in explaining some of the problem.

percy212

Interesting topic this one. I recently filled a prescription for a name brand drug which the pharmacist supplied as generic explaining to me that it was the "Irish version" (what?) and "cheaper". I explained that I didn't want generic drugs, was happy to pay more for name brand, and asked how much the proprietary version would cost. ONE CENT MORE was the answer.

penguin88 wrote: »

No, as far as I know all generics are cheaper than the branded product, so the HSE will pay less for these. I was referring to shopping around between pharmacies for identical products, switching to generics can save money for the taxpayer and individuals.

K.Flyer

penguin88 wrote: »

What countries have a standardised price for private medicine purchases? Genuinely interested. I don't think such a system would work, with State intervention in a private transaction between an individual and a private business.

In Spain most of the prescription medications are price controlled by the state and they are far cheaper, in some cases nearly 90% cheaper than here.

P. Breathnach

percy212 wrote: »

Interesting topic this one. I recently filled a prescription for a name brand drug which the pharmacist supplied as generic explaining to me that it was the "Irish version" (what?) and "cheaper". I explained that I didn't want generic drugs, was happy to pay more for name brand, and asked how much the proprietary version would cost. ONE CENT MORE was the answer.

Setting aside the fact that the price difference was trivial in this instance, why should anybody be prepared to pay more for a brand name if both drugs have exactly the same active ingredient?

Part of the problem is that many doctors prescribe by brand name, not by chemical formulation. I am happy to accept the substitution of generics because it results (in my case) in a saving to the taxpayer.

I wouldn't go near a regular pharmacy these days, unless I want to hand over 20 quid more (at least) than I would if I were to get my prescription in Boots. The issue regarding the cost of generics is absolutely laughable. It's nothing but monopolistic price-fixing.

So stick to Boots etc (Someone above mentioned Tesco as a cheaper alternative too) unless you really feel like paying 40-50% more for your medicines and the privilege of waiting around for 10 minutes in a poky little pharmacy.

It's a laughable situation. I'm sure there's plenty of money to be creamed somewhere from the Irish pharmacies with their (still, despite the competition) extortionately higher prices, probably from older people and people with medical cards who will just go to the closest pharmacy courtesy of the taxpayer.

percy212

Is Boots really cheaper? I didn't know that. Good info.

As for generics vs name brands - in most cases generics are the same as name brands, but there are certain drugs that are not exactly the same in generic form, and their efficacy is reduced as a result.

Rojomcdojo wrote: »

I wouldn't go near a regular pharmacy these days, unless I want to hand over 20 quid more (at least) than I would if I were to get my prescription in Boots. The issue regarding the cost of generics is absolutely laughable. It's nothing but monopolistic price-fixing.

So stick to Boots etc (Someone above mentioned Tesco as a cheaper alternative too) unless you really feel like paying 40-50% more for your medicines and the privilege of waiting around for 10 minutes in a poky little pharmacy.

It's a laughable situation. I'm sure there's plenty of money to be creamed somewhere from the Irish pharmacies with their (still, despite the competition) extortionately higher prices, probably from older people and people with medical cards who will just go to the closest pharmacy courtesy of the taxpayer.

P. Breathnach

percy212 wrote: »

Is Boots really cheaper?

I read elsewhere that Boots have a different pricing structure from most other Irish pharmacies, and it results in prices being different - sometimes cheaper, sometimes dearer. But treat that as hearsay, because I don't have my own knowledge on the matter.

As for generics vs name brands - in most cases generics are the same as name brands, but there are certain drugs that are not exactly the same in generic form, and their efficacy is reduced as a result.

Surely if the chemical formulation is not the same, it can't be termed a generic.

Boots is *at least* 33.3% cheaper for me anyway. I can't understand why this isn't more common knowledge. Are they prohibited from advertising the fact in some way? Because everyone I've told has jumped at the chance to pay 2/3 of their usual prescription costs.

And they still make a profit, it's just not a huge 50%+ markup.

nino1

P. Breathnach wrote: »

I read elsewhere that Boots have a different pricing structure from most other Irish pharmacies, and it results in prices being different - sometimes cheaper, sometimes dearer. But treat that as hearsay, because I don't have my own knowledge on the matter.

Just to clear up
Boots --- no mark up but €7 dispensing fee
Tesco 20% mark up + €3.50 dispensing fee(
(Most) independent pharmacies 50% mark up + €5 dispensing fee

Example Product cost price is €5
Boots will charge €12
Tesco €9.50
Independent €12.50

P. Breathnach wrote: »

Surely if the chemical formulation is not the same, it can't be termed a generic.

This cause some confusion. Drugs for epilspsy which have a very small therapeutic window should not be interchanged. That does not mean you cannot take a generic. It means that if you were started on the branded drug you should stay on the branded drug but also if you were started on the generic you should stay on the generic.
If you don't have epilepsy it doesn't effect you.

Kurtosis

K.Flyer wrote: »

In Spain most of the prescription medications are price controlled by the state and they are far cheaper, in some cases nearly 90% cheaper than here.

Spain has a situation where some of the cost of prescription medicines is subsidised by the state, not the kind of situation being proposed here, government set price for transactions they're uninvolved in.

P. Breathnach

nino1 wrote: »

Just to clear up
Boots --- no mark up but €7 dispensing fee
Tesco 20% mark up + €3.50 dispensing fee(
(Most) independent pharmacies 50% mark up + €5 dispensing fee

Example Product cost price is €5
Boots will charge €12
Tesco €9.50
Independent €12.50
...

I have a vague recollection of reading somewhere that where a prescription covers a number of drugs, it works a bit differently - perhaps something like Boots charging the dispensing fee for each separate drug, whereas the traditional pharmacy charges only one dispensing fee. If that's the case, it becomes something of a "swings and roundabouts" situation.

Can anybody elucidate? Is my vague recollection correct?

fisher8181

P. Breathnach wrote: »

I have a vague recollection of reading somewhere that where a prescription covers a number of drugs, it works a bit differently - perhaps something like Boots charging the dispensing fee for each separate drug, whereas the traditional pharmacy charges only one dispensing fee. If that's the case, it becomes something of a "swings and roundabouts" situation.

Can anybody elucidate? Is my vague recollection correct?

yes, boots are not all they are cracked up to be!

Example:
I was getting 6 months supply of eltroxin 100mcg from them.
One box was costing me €7.64
Six months at one time was costing me €45.84

Went to Tesco pharmacy last month.
One month was €5.47 and 6 months was €15.31!!!

So Tesco charges only one dispensing fee as they only dispensed it once whereas boots charges 6 dispensing fees for 6 months supply dispite only dispensing it once!!!
Absolute rip-off!!

P. Breathnach

fisher8181 wrote: »

yes, boots are not all they are cracked up to be!

Example:
I was getting 6 months supply of eltroxin 100mcg from them.
One box was costing me €7.64
Six months at one time was costing me €45.84

Went to Tesco pharmacy last month.
One month was €5.47 and 6 months was €15.31!!!

So Tesco charges only one dispensing fee as they only dispensed it once whereas boots charges 6 dispensing fees for 6 months supply dispite only dispensing it once!!!
Absolute rip-off!!

Thanks for the response.

I'm also interested in what happens if a person has a prescription for, say, 5 different medications.

Kurtosis

P. Breathnach wrote: »

Thanks for the response.

I'm also interested in what happens if a person has a prescription for, say, 5 different medications.

As far as I'm aware, all pharmacies generally apply a fee to each item on a prescription. An exception may be where two strengths of a medicine are required e.g. Eltroxin, if someone takes 50 strength every day but takes an extra 25 two days a week, a fee may not apply to the few 25 strength tablets.

Jane5

http://www.irishtimes.com/news/health/drugs-charges-a-bitter-pill-to-swallow-for-southern-patients-1.1352841/drugs-charges-a-bitter-pill-to-swallow-for-southern-patients-1.1352841

The above article is well timed-a relative of ours is now picking him up a couple of months worth of his meds in Spain for a fraction of the cost of one month here. All they needed was a copy of the prescription and the doctor's medical council reg number. In future we will likely do this or else travel North. I don't like not giving Ireland the business, but it's just not affordable here.

nino1

Jane5 wrote: »

In future we will likely do this or else travel North. I don't like not giving Ireland the business, but it's just not affordable here.

you'd be better off going to boots or tesco than travelling north.
You only get it on the nhs if you are resident there. You will be charged a private script rate which will likely be no cheaper + cost of fuel!

rubadub

Jane5 wrote: »

Additionally, not everyone can read a doctors script accurately, I can, but due to the annotation on scripts, many people start describing them and the pharmacist says "I'd have to see that myself". I've heard them say that.

You could scan it in and email them. But this will of course cause delays, and you are not going to hold off buying stuff you need right away.

It would be great if one pharmacy came out with a price match guarantee like "if you see this cheaper elsewhere we double the difference" type scheme that other shops do. So you could confidently buy from them & email your script around to double check.

Jane5

nino1 wrote: »

you'd be better off going to boots or tesco than travelling north.
You only get it on the nhs if you are resident there. You will be charged a private script rate which will likely be no cheaper + cost of fuel!

That's not actually true, if you read the linked article. I'm not saying you would get it on the NHS, but what I am saying is that the private script rate is HUGELY cheaper than here. The mark-up here is actually that big.

If you do read the linked article, you can buy several months worth of your script up North if you arrange it with the pharmacist in advance and bring all relevant documentation with you, and the savings are considerable. We are only a couple hours away from the border as we're in Dublin. If we were to fill six months worth up there, even with fuel, we'd save a fortune.

nino1

Jane5 wrote: »

That's not actually true, if you read the linked article. I'm not saying you would get it on the NHS, but what I am saying is that the private script rate is HUGELY cheaper than here. The mark-up here is actually that big.

Don't believe everything you read in the papers Jane. Two weeks ago the papers reported on a survey by the NCA where they quoted prices of drugs and they quoted pharmacist selling drugs at what turned out to be less than the cost price. The NCA admitted they made a mistake but the papers still published the story.

Besides, where does it quote the mark up in the north?
It also says that the northern pharmacist will not dispense a generic if a brand is written. Southern chemists do.
They don't have a mark up of less than 20% like Tesco do or for the very expensive drugs boots will charge you €107 for a cost price of €100 which is a 7% markup!
Do the northern chemists charge less than 7% for drugs of this price?
You can also buy 6 months supply down south which will save you more money too (except in boots)

Northern chemists DO result in savings compared to independent pharmacies here but I suppose you should never let the full facts get in the way of a good story!

rubadub

Jane5 wrote: »

The mark-up here is actually that big.

This markup might be the manufacturers markup rather than the pharmacy.

They published known wholesale prices on other items before, e.g. pampers, and the NI wholesale price was a fraction of the what retailers here pay.

I expect the same could well go on for drugs.

I know you have to pay more regardless, but might be shooting the messenger (the pharmacist).

talla

I work for a company that produces software for pharmacies. There are a couple of misconceptions in this thread. The pricing algorithms on private scripts and DPS scripts are extremely complicated.

Currently there is no generic or reference pricing is Ireland for pharmacies. The legislation to introduce this will be implemented in the coming months. It will also take a number of years post introduction for prices to filter into the real world. The IMB and HSE will focus on the drugs that currently the state pays the most for e.g. atorvastatin. While prices should come down for these drugs, if patients reject generic substitutions it will actually become more expensive.

All pharmacies in Ireland charge a dispensing fee per item, not per script.
All pharmacies in Ireland have a right to charge what they want for a private prescription or DPS prescription. A prescription dispensed under the DPS scheme is treated as private script until the family threshold has been exceeded (currently €144).

Boots have the following pricing scheme per item on a prescription for DPS and Private scripts:
Trade Price of drug + Flat Dispensing fee + 0% Markup

Tesco have the following per item on a script:
Trade Price of Drug + dispensing fee + 20% Markup

Independents / Irish owned Pharmacy Chains typically charge per item:
Trade price of drug + dispensing fee + 50%.
Some of the independents / Irish chains will configure certain certain drugs to have a smaller markup and / or smaller dispensing fee.

With regards to reimbursement by the state to pharmacies, it gets extremely complicated.
The general payment rule the state uses for DPS is:
Reimbursement Price + dispensing fee + 20% markup on the total drug spend for a family within a calendar month that exceed the Family limit.

The Reimbursement price is typically the trade price less 8%.
Dispensing Fee ranges from €3.50 to €5.00 depending on how may items the pharmacy has dispensed in a month(first 1667 items are paid at a €5 fee, next €887 items paid at €4.50 with all other items paid at €3.50 dispensing fee).

Depending on the pricing used in a pharmacy, there are scenarios where once a family exceed the monthly limit does not necessarily mean the state pays anything for a drug e.g.
If a pharmacy is charging 50% markup for a drug on a DPS script, prescriptions fall into what has been termed a grey area.
Lets say a drug has a trade price of €100, 50% markup adds another €50 with a €5.00 dispensing fee so the total private cost of the prescription is €155.
If the patient was signed up the DPS scheme, they would pay €144.
However the government does not pay the pharmacy the difference. The government prices the same item as
€92(trade price less 8%) + €18.40( 20% Markup) + €5.00 = €115.4

As the patient has already paid €144 to the pharmacy, the pharmacy gets no payment from the government.

talla

One final point, you might wonder why pharmacies are paying more for a drug than what the state will reimburse them?

They don't. The pharmacy do not pay the listed trade price. Pharmacies have deals where they get a general discount off a supplier, get additional discounts for ordering specific drugs, get bonus stock for ordering in certain multiples etc.
I have seen scenarios where pharmacies are getting a 90% discount of the trade price price of a drug.

MBSnr

talla wrote: »

.
.
Lets say a drug has a trade price of €100, 50% markup adds another €50 with a €5.00 dispensing fee so the total private cost of the prescription is €155.
If the patient was signed up the DPS scheme, they would pay €144.
However the government does not pay the pharmacy the difference. The government prices the same item as
€92(trade price less 8%) + €18.40( 20% Markup) + €5.00 = €115.4

As the patient has already paid €144 to the pharmacy, the pharmacy gets no payment from the government.

Thanks for this. It explains what I suspected and mentioned in an earlier post. The pharmacy will not dispense 2x the item in one month (even though the prescription has it listed), as it would be above the €144 limit and they'd lose out on their lovely 50% markup from me that goes in their pocket!.... Unreal.

nino1

MBSnr wrote: »

Thanks for this. It explains what I suspected and mentioned in an earlier post. The pharmacy will not dispense 2x the item in one month (even though the prescription has it listed), as it would be above the €144 limit and they'd lose out on their lovely 50% markup from me that goes in their pocket!.... Unreal.

How does that explain what you suspected?
The pharmacy will not dispense 2x the item because the HSE will only pay them for one months supply.
If that was the case sure why not get 6 months supply for €144?!!

MBSnr

nino1 wrote: »

How does that explain what you suspected?
The pharmacy will not dispense 2x the item because the HSE will only pay them for one months supply.
If that was the case sure why not get 6 months supply for €144?!!

OK this is the way I figure it.

1. I think you're missing out the fact that there is more than one item. The drug in my case is €85 to buy.

This is my maths. I know the trade price of the drug is €50.

50-8% (46) + 20% (9.20) + Dispensing fee (5) = €60.20 is the price they'd get from the Gov.

€85 is what they get from me.

You see I cannot pay €144 for two otherwise the pharmacy loses out....
I'd assume they'd get €85 for the 1st item and €60.20 for the 2nd if it was on the DPS. They'd prefer the nice €24.80 extra for no hassle.... see you next month sir.

2. The prescription wasn't for 6 months so how can they dispense that?

nino1

MBSnr wrote: »

OK this is the way I figure it.

1. I think you're missing out the fact that there is more than one item. The drug in my case is €85 to buy.

This is my maths. I know the trade price of the drug is €50.

50-8% (46) + 20% (9.20) + Dispensing fee (5) = €60.20 is the price they'd get from the Gov.

€85 is what they get from me.

You see I cannot pay €144 for two otherwise the pharmacy loses out....
I'd assume they'd get €85 for the 1st item and €60.20 for the 2nd if it was on the DPS. They'd prefer the nice €24.80 extra for no hassle.... see you next month sir.

2. The prescription wasn't for 6 months so how can they dispense that?

That's not how it works!!
First of all the government only pays for the amount over ITS CALCULATION of a €144 monthly script so your figures are all wrong.
Secondly the doctor can prescribe you 3 or 4 lots for one month but the HSE will only pay the pharmacy for one and that's why you only get one for €144. You can get another as prescribed if you like but you will have to pay on top of the €144. You are asking the pharmacist to give you one for free where he will recieve no payment from you or the HSE.
Thirdly, why do you think the cost price is €50? That's highly unlikely if they are charging you €85 and if it is the case then you should find another pharmacy that charges less than the 60% mark up you claim!

MBSnr

nino1 wrote: »

That's not how it works!!
First of all the government only pays for the amount over ITS CALCULATION of a €144 monthly script so your figures are all wrong.
Secondly the doctor can prescribe you 3 or 4 lots for one month but the HSE will only pay the pharmacy for one and that's why you only get one for €144. You can get another as prescribed if you like but you will have to pay on top of the €144. You are asking the pharmacist to give you one for free where he will recieve no payment from you or the HSE.
Thirdly, why do you think the cost price is €50? That's highly unlikely if they are charging you €85 and if it is the case then you should find another pharmacy that charges less than the 60% mark up you claim!

OK you're saying that if I get 2 off the same item, the Gov only pays the pharmacy for one. But if I get two differing items the Gov will pay for both. Wow really? Fair enough, that explains it, but that's crazy.

Why do you question the cost price though? I can guarantee you the price is €50 as I have independently asked a pharmacist. I don't claim - this is FACT. I bet as well that the pharmacy doesn't actually pay that €50 but gets it cheaper. Why then does the Gov on the DPS only pay cost-8%? Probably due to the fact that the pharmacy is getting it MUCH less than cost in the 1st place!

I live in a rural location. My DPS is with one pharmacy. All the other pharmacies in the surrounding area charge the same price. Yes the markup is 60%. Yes I am being ripped off. No, I cannot find another pharmacy that sells it for less within easy travelling distance. Seems to me it's a cartel. Amazing how there's always more than a few pharmacies in every town - all seemingly doing well? No surprise with the 50-60% markup....

kdowling

MBSnr wrote: »

OK you're saying that if I get 2 off the same item, the Gov only pays the pharmacy for one. But if I get two differing items the Gov will pay for both. Wow really? Fair enough, that explains it, but that's crazy.

usually yes, but depends on the item. if the item is two inhalers for example you can get two of them. What is the item you are talking about?

MBSnr wrote: »

Why do you question the cost price though? I can guarantee you the price is €50 as I have independently asked a pharmacist. I don't claim - this is FACT.

Highly unlikely to be FACT as you put it!
I am a locum pharmacist and have worked in hundreds of pharmacies and never came across a pharmacy that charges more than 50% of trade price. Maybe the pharmacist made a mistake on the price he told you.

MBSnr wrote: »

I bet as well that the pharmacy doesn't actually pay that €50 but gets it cheaper. Why then does the Gov on the DPS only pay cost-8%? Probably due to the fact that the pharmacy is getting it MUCH less than cost in the 1st place!

They do get it cheaper, around 8%!! its no secret!

MBSnr wrote: »

I live in a rural location. My DPS is with one pharmacy. All the other pharmacies in the surrounding area charge the same price. Yes the markup is 60%. Yes I am being ripped off. No, I cannot find another pharmacy that sells it for less within easy travelling distance. Seems to me it's a cartel. Amazing how there's always more than a few pharmacies in every town - all seemingly doing well? No surprise with the 50-60% markup....

Get a presrciption repeated for 6 months from your doctor, then order 6 months supply from Tesco pharmacy. Then you only have to make one trip (or if its too far you may have a relative or friend that could collect and send them to you in the post) then on top of getting it at a 20% mark-up you save €17.50 for every item on your script for buying 6 months at a time!
(i.e. you have 6 drugs you save a futher €105.

Cianos

Hi folks, stumbled across this thread and it got me wondering whether there'd be any use in me building a website that works as a price comparison for different pharmacies?

It may not be of much use since there seems to be 3 clear brackets; Tesco, Boots and independents.

It would also need a lot of input from users to provide enough useful information, since there are so many drugs and so many pharmacies.

Anyway, just some thoughts. A site that would be similar is pumps.ie for petrol pricing.

vincentdunne

Cianos wrote: »

Hi folks, stumbled across this thread and it got me wondering whether there'd be any use in me building a website that works as a price comparison for different pharmacies?

It may not be of much use since there seems to be 3 clear brackets; Tesco, Boots and independents.

It would also need a lot of input from users to provide enough useful information, since there are so many drugs and so many pharmacies.

Anyway, just some thoughts. A site that would be similar is pumps.ie for petrol pricing.

I'd use it.

nino1

Cianos wrote: »

Hi folks, stumbled across this thread and it got me wondering whether there'd be any use in me building a website that works as a price comparison for different pharmacies?

It may not be of much use since there seems to be 3 clear brackets; Tesco, Boots and independents.

It would also need a lot of input from users to provide enough useful information, since there are so many drugs and so many pharmacies.

Anyway, just some thoughts. A site that would be similar is pumps.ie for petrol pricing.

why would pharmacists want to give you their pricing structure for your website that would potentially lead to lower prices due to there being more transperance?