Why is the price of Pharmasuiticals higher here than the UK and Other EU countries?

Munsterforever

Can anybody tell me why the price of most Pharmasuiticals in Ireland are so much more expensive here than in other EU countries such as Spain and the UK.

Even for example drugs made in Ireland, such as Losamel have a 1300% increase in price from here ( 60 € ) compared to Spain ( 4.50 € ).

If the government wants to cut costs then shouldn't it start by cutting the price of medication, which it will eventually be paying huge sums of money for under the medical card scheme anyway.

segaBOY

Munsterforever wrote: »

Can anybody tell me why the price of most Pharmasuiticals in Ireland are so much more expensive here than in other EU countries such as Spain and the UK.

Even for example drugs made in Ireland, such as Losamel have a 1300% increase in price from here ( 60 € ) compared to Spain ( 4.50 € ).

Well first off the cost of hiring a Pharmacist here is far higher than in the UK, the main reason for this is a greater demand than supply in the past (previously only one school of pharmacy in TCD). This is changing however and wages for Pharmacists are falling.

The medication you mentioned is probably off prescription in Spain. Here you are paid a dispensing fee and then the cost of the drug plus mark-up if something is on prescription. The reimbursement system is a bit more complicated than that but the cost of running a pharmacy in Ireland is massive and wages alone mean that said prices are commonplace.

Munsterforever wrote: »

If the government wants to cut costs then shouldn't it start by cutting the price of medication, which it will eventually be paying huge sums of money for under the medical card scheme anyway.

http://www.ipu.ie/index.php?option=com_content&task=view&id=279&Itemid=60

It's happening. There was a big dispute with the HSE last year, basically they broke the terms of their contract without consulting Pharmacists. They hid behind the competition authority to defend their stance of not negotiating prices of medication and ultimetly lost a case taken by Hickey's Pharmacies (funded by wholesaler United Drug) in the High Court.

http://www.ipu.ie/index.php?option=com_content&task=view&id=270&Itemid=221

Ironbars

Pharmaceuticals are more expensive here because of the system. Losamel is a proton pump inhibitor and is produced by clonmel here. The GMS price is set by the government and so it is not much cheaper than nexium or zoton (do the same job).
The doctor will prescribe by name(a lot of manufacturers are tight with doctors) one of the newer PPI s and therefore the chemist will dispense it.

Drugs like this can be aquired by chemists for nearly the same price as they are wholesaled in spain but the patient pays the GMS price set by the government.

The government, manufacturers,doctors and chemists are to blame for this rip off.

The HSE is impotent/ignorant (the worst run gov org) of this and will not go against the manufactures when it comes to pharmaceutical sales.



If the government pushed the doctors and chemists to prescribe and dispense generics/parralell imports and sets a reasonable price this would save us(the taxpayer) a fortune. And even thought the chemists dont think so it will make them money as well
They wont be making the margins they are of parralell imports and generics but they will be selling more

2c

Daroxtar

i watched a doc, not sure if it was Horizon or C4 but i think it was called Big Pharma or something along them lines, a few years ago about a US pharma company carrying out trials of a lukemia drug in korea, which has one of the highest rates of the disease.
The drug was hugely successful. The company then ordered that all unused samples be returned after the trial. It then set the price of the drug at $1500 per month. The korean health dept complained that this was un affordable. They then sourced the same drug generically from india at less tan $50 a month. The US foreign office then wrote to the korean govt to inform them that they would be liable to massive trade sanctions unless they accepted the drug from the US based pharma company. I wonder if this kind of thing is still going on and does it have any bearing on the prices we pay here?
Seretide 250(asthma inhaler from allen& hannbery) costs E120 here and is prescription only so thats another E50+. I bought 12 of them for that while on holiday last year in thailand, not a great example i know but it was the exact same product, not a generic. Its definately to do with price fixing

r3nu4l

A certain kidney cancer drug in development (not Sutent [sunitinib] the one recently approved by NICE this week) is actually a compound that has been in use for other diseases as an immunosuppressant for many years. The company that make this drug will be selling it to hospitals in the UK at a similar price to it's competitors in kidney cancer treatment and not at the same price it sells it for use as an immunosuppressant.

As a result, it will cost over 100 times more to use in cancer patients as it does in patients that need immunosuppression.

The reason? NICE, the UK drug approvals board insist that this new drug be priced similarly to competitors to avoid all doctors using it because it's cheaper.

This is the same approval board that regularly refuses to approve drugs because they cost too much!! It's not just Ireland that has the monopoly on absolutely stupid and ridiculous decisions, the UK are way ahead of you

segaBOY

Ironbars wrote: »

Pharmaceuticals are more expensive here because of the system. Losamel is a proton pump inhibitor and is produced by clonmel here. The GMS price is set by the government and so it is not much cheaper than nexium or zoton (do the same job).
The doctor will prescribe by name(a lot of manufacturers are tight with doctors) one of the newer PPI s and therefore the chemist will dispense it.

Drugs like this can be aquired by chemists for nearly the same price as they are wholesaled in spain but the patient pays the GMS price set by the government.

Incorrect, manufacturers in Spain sell their drugs to wholesalers at a lower cost than they do to wholesalers in Ireland-how do you think Paraller Product importations work? The price in Spain/Greece is lower from wholesalers over there than in is from Wholesalers here!

Plenty of doctors prescribe generic only and my local pharmacy always gives generic only (unless brand specified which was rare) to private patients saving them money.

With regard the GMS price there are many different schemes, GMS price only applies to GMS(medical card) scripts, other schemes have different prices-the HSE refuses to allow us to negotiate prices by hiding behind the Competition Authority, pharmacists have tried their best tonegotiate with the HSE and only recently have the IPU been accepted as the Parmacists representative by the gov!

Ironbars wrote: »

The government, manufacturers,doctors and chemists are to blame for this rip off.

With the exception of the select few doctors who prescribe brand only drugs how are they to blame? Manufacturers use economics to set prices, they knew ion the past the gov and public would pay said prices for medication.
Pharmacists as stated above have been trying to negiotate a new contract since 07 however the HSE simply would not let them

Ironbars wrote: »

The HSE is impotent/ignorant (the worst run gov org) of this and will not go against the manufactures when it comes to pharmaceutical sales.

Agree

Ironbars wrote: »

Parralell importers have been importing drugs from spain,greece,italy for a few years now but they are under severe scrutiny from IMB as the manufactures have a very powerful lobby.

Disagree, the IMB have reservations about these due to adverse effects to public health. Have you ever seen packaging of parallel product imports? They are shabby and sometimes only a white box with plain black font. Labels are stuck over foreign language covering it up with shabby english ones. I personally support parallel imports however a better job must be done in labelling these.

However, the IMB comply with EU law fully and the reason it takes so long for a Parallel Product to get authorisation is that the IMB has to contact the regulator in the country in which the product is being imported from-e.g. Spain.Ask any official, it can take months and sometimes over a year for a response to be gotten fom the regulator in Spain-it is not the IMBs fault, the Spanish have 1000s of these requests from all over europe every year-they take their time getting around to any request from the likes of the IMB.

Not the IMBs fault.

Ironbars wrote: »

If the government pushed the doctors and chemists to prescribe and dispense generics/parralell imports and sets a reasonable price this would save us(the taxpayer) a fortune.

Yes they have, Harney introduced new laws making Pharmacists dispense the cheapest option when the active was written on a prescription.

Ironbars wrote: »

And even thought the chemists dont think so it will make them money as well
They wont be making the margins they are of parralell imports and generics but they will be selling more

So more people are going to buy drugs because they are cheaper? Come on with all the public schemes in place most if not all people who need medication are already getting it from pharmacies-just because a product is a few euro cheaper does not mean the private patient (who if was not able to afford the meds could get it for free under one of the schemes) will suddenly buy more of the drug. You're talking nonsense

BroomBurner

Ironbars wrote: »

The government, manufacturers,doctors and chemists are to blame for this rip off.

The HSE is impotent/ignorant (the worst run gov org) of this and will not go against the manufactures when it comes to pharmaceutical sales.

Check out the heads of pharmacuetical bodies/board members and see if one of them used to work for Fás around the time a certain Health Minister was Minister for Enterprise...

segaBOY

Daroxtar wrote: »

i watched a doc, not sure if it was Horizon or C4 but i think it was called Big Pharma or something along them lines, a few years ago about a US pharma company carrying out trials of a lukemia drug in korea, which has one of the highest rates of the disease.
The drug was hugely successful. The company then ordered that all unused samples be returned after the trial. It then set the price of the drug at $1500 per month. The korean health dept complained that this was un affordable. They then sourced the same drug generically from india at less tan $50 a month. The US foreign office then wrote to the korean govt to inform them that they would be liable to massive trade sanctions unless they accepted the drug from the US based pharma company. I wonder if this kind of thing is still going on and does it have any bearing on the prices we pay here?
Seretide 250(asthma inhaler from allen& hannbery) costs E120 here and is prescription only so thats another E50+. I bought 12 of them for that while on holiday last year in thailand, not a great example i know but it was the exact same product, not a generic. Its definately to do with price fixing

You can understand where the drug company is coming from, it costs then in excess of $1 Billion to develop a new drug. And that said, only 1 in 100 new drugs actually make it to market. The company then has around 10 years patent in which to sell the product and make the money and profit back. The generic company doesn't have to do any development or clinical trails and basically takes no risks. Korea was breaking all copyright laws imaginable.

With regard Thailand you probably bought them without a prescrition etc. That's your own business and you are quite entitled to do it.

However-was food and most other products also cheaper there??

Zynks

Munsterforever wrote: »

Can anybody tell me why the price of most Pharmasuiticals in Ireland are so much more expensive here than in other EU countries such as Spain and the UK.

Because it costs much more to send Irish doctors on luxury conferences that involve six days golfing and half a day in a conference room (the half day is so it can be explained as a tax free business trip rather than a bribe)

I'll give you an example: next time you get a prescription from your GP, first ask the GP if there is a generic that does the same job, but don't ask for the other one. Next, go to the pharmacy and ask if you can get the generic, even if the "branded" one is prescribed - I've been told twice I couldn't!

In my books this is a criminal practice. Doctors and pharmacists protecting the interests of big pharma should be stripped of their licenses, fined and even jailed.

Ah... and their luxury trips should be tax deductible as benefit in kind.

Dirty business!!!

concussion

segaBOY wrote: »

You can understand where the drug company is coming from, it costs then in excess of $1 Billion to develop a new drug. And that said, only 1 in 100 new drugs actually make it to market. The company then has around 10 years patent in which to sell the product and make the money and profit back. The generic company doesn't have to do any development or clinical trails and basically takes no risks. Korea was breaking all copyright laws imaginable.

With regard Thailand you probably bought them without a prescrition etc. That's your own business and you are quite entitled to do it.

However-was food and most other products also cheaper there??

Just a minor correction - once a pharma company has identified a new compound they apply for a patent which runs for 20 years. All the clinical trials must then be conducted - with luck it could be approved for sale within 7 years but in general it takes between 9 and 13 years before they make a cent off of it - that leaves, on average, 10 years to recoup their costs and make some money off of it. After that they will drop their prices to remain competitive with generic manufacturers and hope to continue making money on the strength of their brand name.

segaBOY

Zynks wrote: »

Because it costs much more to send Irish doctors on luxury conferences that involve six days golfing and half a day in a conference room (the half day is so it can be explained as a tax free business trip rather than a bribe)

I'll give you an example: next time you get a prescription from your GP, first ask the GP if there is a generic that does the same job, but don't ask for the other one. Next, go to the pharmacy and ask if you can get the generic, even if the "branded" one is prescribed - I've been told twice I couldn't!

In my books this is a criminal practice. Doctors and pharmacists protecting the interests of big pharma should be stripped of their licenses, fined and even jailed.

Ah... and their luxury trips should be tax deductible as benefit in kind.

Dirty business!!!

If the branded medication is prescribed under law the Pharmacist has nochoice but to dispense the branded product. If the active was written then the Pharmacist is oblidged under law to give you the cheapest one if it is in stock. Next time ask the Doctor for the generic to be prescribed and if the Pharmacist still won't give it to you (probably because it is not in stock) go to the one down the road!!

Zynks

Another two interesting questions:

1. Why is is that Ireland has one of the biggest volume per capita of prescriptions in the world - especially antibiotics?
2. Why do we have so many drugs that require prescription and in other countries they are available over the counter?

I took a branded drug for 9 years called Losec. At one stage it was costing €120 per month. I never had problems to get the prescriptions every six months. I was never told a generic alternative existed. In a trip to Spain I tried to buy Losec and I was told straight away about the generic drug (Omeprazole) and that a full year supply would cost €120. That price difference over the years would have bought me a car.

Ironbars

segaBOY wrote: »

Incorrect, manufacturers in Spain sell their drugs to wholesalers at a lower cost than they do to wholesalers in Ireland-how do you think Paraller Product importations work? The price in Spain/Greece is lower from wholesalers over there than in is from Wholesalers here!

You dont get it, if they sell it in spain at a lower cost why dont the wholesalers buy the drugs in spain?

segaBOY wrote: »

Plenty of doctors prescribe generic only and my local pharmacy always gives generic only (unless brand specified which was rare) to private patients saving them money.

Not true, a very small % of generic/parralell imported drugs are sold through chemists (as far as Im aware 2-5%) even though they are similiar to brand name drugs being prescribed.
Your chemist is rare all right.

segaBOY wrote: »

With regard the GMS price there are many different schemes, GMS price only applies to GMS(medical card) scripts, other schemes have different prices-the HSE refuses to allow us to negotiate prices by hiding behind the Competition Authority, pharmacists have tried their best tonegotiate with the HSE and only recently have the IPU been accepted as the Parmacists representative by the gov!

The price aproval system rum by the HSE sets the price of drugs to be prescribed and more often than not these drugs could easily be sold cheaper to the customer and still the margins would allow the wholesaler and chemist to make a markup. And when you look at generics and parralell imports the price reductions could be substantial.

segaBOY wrote: »

With the exception of the select few doctors who prescribe brand only drugs how are they to blame? Manufacturers use economics to set prices, they knew ion the past the gov and public would pay said prices for medication.
Pharmacists as stated above have been trying to negiotate a new contract since 07 however the HSE simply would not let them

???? how have you cme to this conclusion

The pharmacist have a big part to play in educating the public, if the HSE set a lower price on many of the drugs which can be imported from spain,italy or greece at as much as 50% cheaper then the pharmacist would have to get of his arse and explain to Joe public about the whole-the pills have the same active ingredient story.
My experience of pharmacists doesnt give me much hope for that.

segaBOY wrote: »

Agree


Disagree, the IMB have reservations about these due to adverse effects to public health. Have you ever seen packaging of parallel product imports? They are shabby and sometimes only a white box with plain black font. Labels are stuck over foreign language covering it up with shabby english ones. I personally support parallel imports however a better job must be done in labelling these.

How many packs have you seen, not many by the sound of it!

segaBOY wrote: »

However, the IMB comply with EU law fully and the reason it takes so long for a Parallel Product to get authorisation is that the IMB has to contact the regulator in the country in which the product is being imported from-e.g. Spain.Ask any official, it can take months and sometimes over a year for a response to be gotten fom the regulator in Spain-it is not the IMBs fault, the Spanish have 1000s of these requests from all over europe every year-they take their time getting around to any request from the likes of the IMB.

Not the IMBs fault.

In fact the application period has been speeded up in the past couple of years and it wasnt the regulators of spain or wherever else that was holding it up in the first place!

I understand the IMB are extremely hard worked and under staffed but this is not the point.
Generic manufacturers and parralel importers are under more scrutiny than mainline wholesalers even though no cases of cloned drugs or anything that could damage the publics health has been ever been found relating to them!

segaBOY wrote: »

Yes they have, Harney introduced new laws making Pharmacists dispense the cheapest option when the active was written on a prescription.

Then why are they not prescribing it? the options are there but the chemist wont purchase these items because they would have to interact with the customers and inform them why its not the usual Pfizer/astrazenica or whoever else brand name. This comes back to price aproval and education.

segaBOY wrote: »

So more people are going to buy drugs because they are cheaper? Come on with all the public schemes in place most if not all people who need medication are already getting it from pharmacies-just because a product is a few euro cheaper does not mean the private patient (who if was not able to afford the meds could get it for free under one of the schemes) will suddenly buy more of the drug. You're talking nonsense

Some of these products can be 50% cheaper even after the wholesalers margin but the chemists/wholesalers wont give up this golden egg laying hen that easily.

I still believe its the fault of the HSE (gov), manufacturers,wholesalers, chemists and doctors. The cosy cartel (apart from the HSE who are just incompetent)

Zynks

segaBOY wrote: »

If the branded medication is prescribed under law the Pharmacist has nochoice but to dispense the branded product. If the active was written then the Pharmacist is oblidged under law to give you the cheapest one if it is in stock. Next time ask the Doctor for the generic to be prescribed and if the Pharmacist still won't give it to you (probably because it is not in stock) go to the one down the road!!

So you are saying that the doctors have the ultimate power to decide if your drugs are going to cost €10 or €120 and that is legal? Man...my mother was right, I chose the wrong career

segaBOY

Zynks wrote: »

Another two interesting questions:

1. Why is is that Ireland has one of the biggest volume per capita of prescriptions in the world - especially antibiotics?
2. Why do we have so many drugs that require prescription and in other countries they are available over the counter?

I took a branded drug for 9 years called Losec. At one stage it was costing €120 per month. I never had problems to get the prescriptions every six months. I was never told a generic alternative existed. In a trip to Spain I tried to buy Losec and I was told straight away about the generic drug (Omeprazole) and that a full year supply would cost €120. That price difference over the years would have bought me a car.

1. I do not know where you got that from but I would believe it tbh. It's a sad state of affairs but antibiotics are being thrown out by doctors at the drop of a hat. If you pay €55+ for a consultation when you have the likes of the flu a doctor may feel under pressure to give you something. An antibiotic will do nothing for the flu virus (you need an anti viral, or lets be realistic-plenty of rest and fluids) and this adds to antibiotic resistance.

It is wrong, however it is being addressed somewhat but more needs to be done. See http://www.hse.ie/eng/News/National_Tab/Get_better_without_antibiotics.shortcut.html

http://www.ipu.ie/index.php?option=com_content&task=view&id=280&Itemid=221

2. Interesting. First off (this is a pet hate of mine) why didn't the bloody Pharmacist or Doctor get you on the DPS? Everyone is entitled to it. It's a little pink form that you fill in and send off-every pharmacy should have one. If I was the Pharmacist I would have given that to you (back in the day you shouldn't have paid more than €70 a month for prescription meds)

My own father went to the Doc for diabetes meds, he is entitled to get the drugs for free under the Long Term Illness scheme-did the doctor say anything about it? Nope, I had to ring the HSE and get all the forms myself otherwise he'd still be paying for them.

Tbh you need to get streetwise to drugs, always ask the Doctor for generics and ring the HSE helpline to ask about your entitlements 1850 24 1850

Sorry for your troubles.

segaBOY

Zynks wrote: »

So you are saying that the doctors have the ultimate power to decide if your drugs are going to cost €10 or €120 and that is legal? Man...my mother was right, I chose the wrong career

Well te Doctor should always act in your best interest....I hear they take some sort of oath!

Honestly, there are GPs and Businessmen, seperating the two is quite hard! :eek:

segaBOY

Ironbars wrote: »

You dont get it, if they sell it in spain at a lower cost why dont the wholesalers buy the drugs in spain?

Because of the terms of the Wholesalers licence. The Wholesaler is compelled to buy off of manufacturers in the Irish market which set a higher price for our market than the Spanish ones.

Ironbars wrote: »

Not true, a very small % of generic/parralell imported drugs are sold through chemists (as far as Im aware 2-5%) even though they are similiar to brand name drugs being prescribed.
Your chemist is rare all right.

Cannot agree with that,I don't know where you got those figures from but that is not true for the Pharmacies I do business with anyway.

Ironbars wrote: »

The price aproval system rum by the HSE sets the price of drugs to be prescribed and more often than not these drugs could easily be sold cheaper to the customer and still the margins would allow the wholesaler and chemist to make a markup. And when you look at generics and parralell imports the price reductions could be substantial.

Not disagreeing that the HSE are incompetant. However, a Pharmacist's mark-up for say the DPS is 50% of the cost-so if the meds are priced low the Pharmacist won't be making enough to cover his/her costs. Ever looked at the books of a Pharmacy? Expenses are massive.

Ironbars wrote: »

The pharmacist have a big part to play in educating the public, if the HSE set a lower price on many of the drugs which can be imported from spain,italy or greece at as much as 50% cheaper then the pharmacist would have to get of his arse and explain to Joe public about the whole-the pills have the same active ingredient story.
My experience of pharmacists doesnt give me much hope for that.

Well that's not my experience.

Ironbars wrote: »

How many packs have you seen, not many by the sound of it!

Mate I've spent 3-4 hours labelling boxes of imported Nu-Seals from Spain, they weren't well packaged at all, don't patronise me please.

Ironbars wrote: »

In fact the application period has been speeded up in the past couple of years and it wasnt the regulators of spain or wherever else that was holding it up in the first place!

There are more apps for PPAs than ever over the last few months. Ask anyone of authority in the IMB-the reason for slower authorisation is due to foreign regulators and increased volume.

Ironbars wrote: »

I understand the IMB are extremely hard worked and under staffed

Hard worked, yes, understaffed? Don't know about that, have 250 working for them, as I said it is other regulators from the countries that meds are being imported from that slow the process.

Ironbars wrote: »

Then why are they not prescribing it? the options are there but the chemist wont purchase these items because they would have to interact with the customers and inform them why its not the usual Pfizer/astrazenica or whoever else brand name. This comes back to price aproval and education.

This issue is for the prescriber, if a brand is prescribed the Pharmacist must give that brand name. It's the law.

Ironbars wrote: »

Some of these products can be 50% cheaper even after the wholesalers margin but the chemists/wholesalers wont give up this golden egg laying hen that easily.

I still believe its the fault of the HSE (gov), manufacturers,wholesalers, chemists and doctors. The cosy cartel (apart from the HSE who are just incompetent)

The Pharmacy system is one of the only part of the healthcare system that actually works. You don't fully undrstand the ins and outs of the system. From the outside what you're saying seems like sense but medications are completely different to any other products that can be imported. Apart from the Airline industry medications are the most regulated industry in the country and with current legislation in place it is impossible to just do everything you are proposing with the click of your fingers.

Daroxtar

segaBOY wrote: »

However-was food and most other products also cheaper there??

yes, everything was about 1/3 the price of here, but not 1/12th.

Zynks

segaBOY wrote: »

The Pharmacy system is one of the only part of the healthcare system that actually works.

That's just like Bertie's government. While they and the economy were swimming in money they seemed to be doing a good job (to most). Cut the funding and you certainly find out who is swimming naked.

It is an artificially cash rich area, of course it works!

dizzywizlw

Is this actually a thread wondering why things in Ireland are more expensive than abroad!?
Welcome to Ireland!

Seriously though, I remember paying 20 euro for antibiotics and 25pound for the same ones in newcastle last year (recurrign problem) I suppose it varies. The GP in engalnd also wanted me to get different more expensive tablets and tried to fob off myh travel/health insurance.
First do no harm indeed

SkepticOne

segaBOY wrote: »

Well first off the cost of hiring a Pharmacist here is far higher than in the UK, the main reason for this is a greater demand than supply in the past (previously only one school of pharmacy in TCD). This is changing however and wages for Pharmacists are falling.

The medication you mentioned is probably off prescription in Spain. Here you are paid a dispensing fee and then the cost of the drug plus mark-up if something is on prescription. The reimbursement system is a bit more complicated than that but the cost of running a pharmacy in Ireland is massive and wages alone mean that said prices are commonplace.

I don't understand. How could wages and dispensing fee account for 1300% increase in price? Something is seriously wrong.

"Even for example drugs made in Ireland, such as Losamel have a 1300% increase in price from here ( 60 € ) compared to Spain ( 4.50 € )."

Munsterforever

dizzywizlw wrote: »

Is this actually a thread wondering why things in Ireland are more expensive than abroad!?
Welcome to Ireland!

Yes I know this is Ireland, I've been living here for the majority of my life, what I really want to know are the ACTUAL reasons for the high price. I don't want a "thats just the way Ireland is" answer.:D

Whats also stupid is that you cannot take a perscription from a Doctor in the ROI and get it in pharmacy NI.. because of the MCoI or something daft! :mad:

NewApproach

Ironbars wrote: »

And even thought the chemists dont think so it will make them money as well. They wont be making the margins they are of parralell imports and generics but they will be selling more

2c

How exactly will the pharmacists sell more of a drug because it is cheaper?? Drugs, especially prescription drugs, are basically the only product that have anything close to a perfectly inelastic price/demand curve.

Just because something is cheaper doesn't mean the patient will decide to overdose on it.

Zynks

Interesting article in today's Irish Independent on this subject:
http://www.independent.ie/health/latest-news/pharmacist-gets-cheque-for-836454000-after-complaint-1633118.html

In spite of being exposed, the GP still said it was her "prerogative" to choose her son's pharmacy, and said it was a "minor dispute between two pharmacists - and is of no interest or concern to the general public".

Daroxtar

Daroxtar wrote: »

i watched a doc, not sure if it was Horizon or C4 but i think it was called Big Pharma or something along them lines, a few years ago about a US pharma company carrying out trials of a lukemia drug in korea, which has one of the highest rates of the disease.
The drug was hugely successful. The company then ordered that all unused samples be returned after the trial. It then set the price of the drug at $1500 per month. The korean health dept complained that this was un affordable. They then sourced the same drug generically from india at less tan $50 a month. The US foreign office then wrote to the korean govt to inform them that they would be liable to massive trade sanctions unless they accepted the drug from the US based pharma company. I wonder if this kind of thing is still going on and does it have any bearing on the prices we pay here?
Seretide 250(asthma inhaler from allen& hannbery) costs E120 here and is prescription only so thats another E50+. I bought 12 of them for that while on holiday last year in thailand, not a great example i know but it was the exact same product, not a generic. Its definately to do with price fixing

The US pharmaceutical company developed the drug ran trial, spent 100's of millions.Thats like publishing Harry Potter in Indian and not paying Royalties to JK Rowling.

nesf

Zynks wrote: »

Interesting article in today's Irish Independent on this subject:
http://www.independent.ie/health/latest-news/pharmacist-gets-cheque-for-836454000-after-complaint-1633118.html

In spite of being exposed, the GP still said it was her "prerogative" to choose her son's pharmacy, and said it was a "minor dispute between two pharmacists - and is of no interest or concern to the general public".

That case is a bit of a joke all right but in fairness not exactly a common occurrence thankfully.




With the whole generic vs brand name, it's quite that simple as generic is always the better option. Often the brand name drugs are better and the doctor should have the prerogative in which is dispensed. This would be especially relevant with psychiatric medication but would apply to other areas as well.

Zynks

nesf wrote: »

That case is a bit of a joke all right but in fairness not exactly a common occurrence thankfully.

With the whole generic vs brand name, it's quite that simple as generic is always the better option. Often the brand name drugs are better and the doctor should have the prerogative in which is dispensed. This would be especially relevant with psychiatric medication but would apply to other areas as well.

I can't argue whether generics are better or worse. I also agree that if serious investment is made to develop a drug, the IPR owner should be entitled to seek a return on investment.

What I oppose strongly is:
- Conflicts of interest - there seem to be motivation for a doctor to prescribe more than is really necessary and at prescribing the most expensive ones
- Artificially high prices - Doctors pharmacists and the government seem to all be interested in maintaining the status quo. Who looks after the interests and needs of the public in this situation?
- Pharmacists and the public having no call on generic vs branded at point of sale - This is supposed to be an open economy. The doctor has the right NOT to prescribe a drug if found unnecessary, but why should he have the right to prescribe the expensive version and keep you in the dark about alternatives? That's worst than a monopoly, it is a blatant abuse of the public's good will.
- R&D dominated by totally profit driven companies - These companies consistently fail to recognise when they are going too far in their search for profits and not helping address severe human pain - example: HIV drugs for Africa - or just applying extortionate prices.

nesf

Zynks wrote: »

- Conflicts of interest - there seem to be motivation for a doctor to prescribe more than is really necessary and at prescribing the most expensive ones

I'd completely be with you on this one.

Zynks wrote: »

- Artificially high prices - Doctors pharmacists and the government seem to all be interested in maintaining the status quo. Who looks after the interests and needs of the public in this situation?

I'd partially agree though I think all sides have justifiable complaints at the moment.

Zynks wrote: »

- Pharmacists and the public having no call on generic vs branded at point of sale - This is supposed to be an open economy. The doctor has the right NOT to prescribe a drug if found unnecessary, but why should he have the right to prescribe the expensive version and keep you in the dark about alternatives? That's worst than a monopoly, it is a blatant abuse of the public's good will.

I'd completely disagree with you here, the public should get no say in which exact drugs they are prescribed. Pharmacists also are not always in the best position to choose which drug is best. Seriously, picking a drug is not a simple thing a lot of the time. Generics aren't always the best option and really only doctors are trained to judge which drug should be prescribed. I do agree that this is potentially very troublesome but there's no real way around it.

Zynks wrote: »

- R&D dominated by totally profit driven companies - These companies consistently fail to recognise when they are going too far in their search for profits and not helping address severe human pain - example: HIV drugs for Africa - or just applying extortionate prices.

Research is very expensive and usually unsuccessful, is there a good alternative to profit based research companies (I think there are good arguments for multiple small "start-ups" to show viability versus big pharma all the way but I don't see a way around the cost problem without providing strong profit incentives to encourage investment).

Zynks

nesf wrote: »

I'd completely disagree with you here, the public should get no say in which exact drugs they are prescribed. Pharmacists also are not always in the best position to choose which drug is best. Seriously, picking a drug is not a simple thing a lot of the time. Generics aren't always the best option and really only doctors are trained to judge which drug should be prescribed. I do agree that this is potentially very troublesome but there's no real way around it. ).

My argument is based on my experience of Losec vs generic. As I said before, I could have bought a car with the money that went to waste. I say waste because I used both and I can say better than anyone that effect was exactly the same. But I was never informed nor was given a choice. I refuse to believe someone was not pocketing some brown envelopes on this one.

nesf wrote: »

Research is very expensive and usually unsuccessful, is there a good alternative to profit based research companies (I think there are good arguments for multiple small "start-ups" to show viability versus big pharma all the way but I don't see a way around the cost problem without providing strong profit incentives to encourage investment).

How much would you bet that the R&D "cost" of the failures is built into the succesfull ones? The state may have a role to play here through the universities. After all, they are funding the costs and the profits to a large extent anyway. Theoretically they should be able to do it cheaper when all costs are considered. You might as well create some national jobs and national patents for a change.

As a little annecdote, about twenty years ago there was an outbreak of hepatitis B in Brazil (if I am not mistaken). There was no commercial remedy available, but suprise surprise, Cuba had created a vaccine in their universities that worked. They shipped a large amount of the vaccines to Brazil as a present. Big pharma lobbied the government with a lot of scare mongering (this is untested! It is from Cuba, it can't be good, they don't have a commercially acceptable methodology of testing, and so on). Government gave in and said clinical trials would have to be done in Brazil before they were used. Cuba turned around and said fine, but in this case they will be US$100 a pop. They tested, it was good. Brazil paid a fortune thanks to big pharma's kind advice.

Zynks

An interesting article to back my point, just fresh from the Netherlands: http://www.twnside.org.sg/title2/wto.info/2009/twninfo20090203.htm

nesf

I'm going to move this to Biology/Medicine because I think it'll get more responses and debate there.

I think you should get a better reply here Zynks than anything I could write so I'll give it a while before responding to see if such a reply materialises.

anotherlostie

Could you also change the spelling of the word to Pharmaceuticals?

nesf

anotherlostie wrote: »

Could you also change the spelling of the word to Pharmaceuticals?

Not in this forum, I don't have zee power. I thought it gave the thread a bit of folksy charm.

Ausone

This is about price fixing, but not at the doctor and pharmacy level.

The DOHC and HSE with "big pharma" sets the prices of drugs entering this country. Unfortunately "big pharma" exists in all countries and can set the price for a single drug at any price it likes (especially first of class drugs).

The overriding principle is that "big pharma" will charge as much as a market will be able to pay.

Southern european countries have had weaker patent laws over the decades, "big pharma" were not able to charge as much there as here.
Patent law there has changed but it takes time for the market to change if the lifespan of a patent post marketing of a drug is about 12 years.

Regarding the Losec/ small car purchase. The DPS and its precursor the DCSS subsidised medication purchase in this country. Over the years the limit ranged from €90 over 3 months to €100 per month currently. You could reclaim tax on a MED1 form.

Madame Razz

Losec is one of the medications that has experienced price reductions and will continue to do so.

For the record, the 'junkets' that Doctors previously enjoyed are no longer in existence, there is now a code of practise which must be(and is) adhered to.

sohappy

was on a tablet for acid reflux called zoton, €73 for a months supply, got the the doctor to change it to generic brand, zotrole €48 a month.
I found out I can get zoton in spain over the counter for €22

Vorsprung

sohappy wrote: »

was on a tablet for acid reflux called zoton, €73 for a months supply, got the the doctor to change it to generic brand, zotrole €48 a month.

Fair play. In times like these, people should be informed of possible cheaper alternatives if available.

ani_mal

to show even more hilllarious site of costs of medication in UK or Ireland, I can tell you that substitutes in Poland cost from 3.5 Euro up to 6 Euro. however you need prescription
the same composition of substances.

bleg

bigjimthefirst wrote: »

Fair play. In times like these, people should be informed of possible cheaper alternatives if available.

or generic substitution by pharmacists should be allowed...

locum-motion

Hi all.

This is a subject about which I have written extensively on a very long thread on www.askaboutmoney.com.

The thread was eventually closed by the moderators because they were of the opinion that all the questions had been fully answered.

It can be found at;
http://www.askaboutmoney.com/showthread.php?t=115450

Please, go and have a read. It will take you a wee while to read it, but you will find answers to all of these questions there.

Thanks.

bleg

nicely done locum-motion. you explained the mess of the journey of a drug very clearly so that everybody could understand.

locum-motion

bleg wrote: »

nicely done locum-motion. you explained the mess of the journey of a drug very clearly so that everybody could understand.

Why, thank you!

Vorsprung

bleg wrote: »

or generic substitution by pharmacists should be allowed...

As far as I am aware, even if a doctor prescribes the generic version, the pharmacist isn't obliged to dispense the generic, as is the case in the UK.

EDIT - Thanks for that link locum-motion, learnt a lot there.

Lassiecomehome

I am constantly amazed that Irish doctors do not better inform their patients as to the existance of generic meds. I recently got a prescription for 3 months supply of the anti-malarial Doxycycline in the north. Seeing my GP was free and the prescription cost £3 to fill in the pharmacy and in a few months it will cost £0 to fill as the NHS is abolishing fees for everyone for generic drugs. My boyf asked for the same medication here, GP visit €50, prescription for Malarone for 1 month cost €78 to fill in the pharmacy. When he asked about the generic (and he understood the risk of more side-effects etc) the GP refused to prescribe it as it 'wasn't as good'. He decided not to buy it and we shared mine and were both fine. In the north we are obliged to prescribe generic if a generic drug is available.

locum-motion

Lassiecomehome wrote: »

I am constantly amazed that Irish doctors do not better inform their patients as to the existance of generic meds. I recently got a prescription for 3 months supply of the anti-malarial Doxycycline in the north. Seeing my GP was free and the prescription cost £3 to fill in the pharmacy and in a few months it will cost £0 to fill as the NHS is abolishing fees for everyone for generic drugs. My boyf asked for the same medication here, GP visit €50, prescription for Malarone for 1 month cost €78 to fill in the pharmacy. When he asked about the generic (and he understood the risk of more side-effects etc) the GP refused to prescribe it as it 'wasn't as good'. He decided not to buy it and we shared mine and were both fine. In the north we are obliged to prescribe generic if a generic drug is available.

FYI, Malarone and Doxycycline are two different drugs. One is not a generic version of the other.

DrIndy

Malaria resistance and species are different all over the world and even within one country.

Doxycycline may be appropriate in one place, but you need malarone in another.

They are different drugs and are for different areas (or the same area the next year!)

Most travellers are on a budget so the cheapest is the most preferable.

Lassiecomehome

We were both going to the same countries and areas, I had checked with my NHS GP and Doxycycline was appropriate. He asked for Doxycycline and wasn't prescribed it with no discussion as to what the reason for this was. I realise they are different drugs but the point I was making was that the Irish GP opted for the branded drug despite the patient making a request for a cheap generic which he was happy to take.

RobFowl

Lassiecomehome wrote: »

We were both going to the same countries and areas, I had checked with my NHS GP and Doxycycline was appropriate. He asked for Doxycycline and wasn't prescribed it with no discussion as to what the reason for this was. I realise they are different drugs but the point I was making was that the Irish GP opted for the branded drug despite the patient making a request for a cheap generic which he was happy to take.

TBF malarone does have some significant advantages (you don't have to take it a s long and there is not the risk of hypersensitity to sunlight as with doxycycline)
PS the charge in the UK is a "prescription charge" and has no relation at all to the actual cost of the drug

DrIndy

Don't forget oesophageal ulceration (food pipe ulcers) if you don't swallow it completely.

its not possible on an internet forum to appreciate the clinical decision making steps that a GP took in prescribing one drug over the other. There are different travel advisory boards for each country and also different travel health guidelines from different agencies.

If your friend is not happy, he can go to a different GP/ travel health service.

greenwell

locum-motion wrote: »

Hi all.

This is a subject about which I have written extensively on a very long thread on www.askaboutmoney.com.

The thread was eventually closed by the moderators because they were of the opinion that all the questions had been fully answered.

It can be found at;
http://www.askaboutmoney.com/showthread.php?t=115450

Please, go and have a read. It will take you a wee while to read it, but you will find answers to all of these questions there.

Thanks.

I have read the thread and i feel it does not go far enough to explain why we have a branded generic industry in ireland. why are there for exapmle 6 branded generic versions of prozac (fluoxetine) one of which is priced at €15.02 compared to Prozac at €15.03 a saving og 0.01 cents. How the HSE gave this a price is beyond me, a saving of 0.01 cents, who is benefiting??
It was only until i looked into this further that i saw the light.. branded generic prozac is available in Ireland to buy by a Pharmacist at approx. €0.50!
And now i see why we have a branded generic market, a profit at GMS level of 13.02-0.50 and this is further increased by 50% for private scripts

Wal Mart charge $5 for any generic product wahy cant have same here..anyone from Tesco???

deepimpact

greenwell wrote: »

I have read the thread and i feel it does not go far enough to explain why we have a branded generic industry in ireland. why are there for exapmle 6 branded generic versions of prozac (fluoxetine) one of which is priced at €15.02 compared to Prozac at €15.03 a saving og 0.01 cents. How the HSE gave this a price is beyond me, a saving of 0.01 cents, who is benefiting??
It was only until i looked into this further that i saw the light.. branded generic prozac is available in Ireland to buy by a Pharmacist at approx. €0.50!And now i see why we have a branded generic market, a profit at GMS level of 13.02-0.50 and this is further increased by 50% for private scripts

Wal Mart charge $5 for any generic product wahy cant have same here..anyone from Tesco???

Do you have a reference for that?

(and no, seeing the light doesn't count)