A question for pharmacists..

_Whimsical_

My mum has a ling term illness and has a monthly perscrption. As of this month she'll pay €120 for it each month. In the chemist she goes to they give you 28 tablets as 1 months supply of each drug. However this works out with her having to have the prescription filled 13 times in one year. She asked the pharmacist about this and they told her it's normal practise for a months supply of drugs to be 28 days worth of tablets.

I was just wondering why this is?Would it not be fairer for a months supply to be 30 or 31 days depending on the month so the patient would not have to pay an extra €120 per year?

Killaqueen!!!

Go to another pharmacy! They should provide 30 tablets per month.

Most companys which manufacture the medicines, package the drugs in a pack of 28. It is up to the pharmacy in question to add 2 extra tablets to the pack.

I'm fairly certain this (giving 2 extra tabs) is common practice in most pharmacys

NOTE: I'm not a pharmacist but I do work in a pharmacy

anotherlostie

No way should you have to pay the €120 on thirteen occasions. Many pharmacies will dispense 30 at a time, others will give 28 days but then 5 weeks supply every couple of months to even things out. If the pharmacy you are attending says you need to pay on thirteen occasions (and your post does not directly imply that the pharmacist said this), they are ripping you off and I would follow Killaqueen's advice!

Kurtosis

This is done by some pharmacies and there is some logic to it. Technically what should happen (what used to happen at least) was that two dispensings of 28 could be put through for one month in the year for €100 if 28 tablets have been dispensed for all other months to make up for the missing days (if allowed/reimbursed by the PCRS/HSE, which is increasingly unlikely currently...). EDIT: or an extra week every few months as anotherlostie said, but yes, she shouldn't have to pay 13x120€

The main reason a pharmacy will dispense in 28's is to avoid split packs or blisters containing only a couple of tablets. These little two tablet bits cut out of other packs to make up to 30 for a month can be a hazard as usually there is no batch number or expiry date on the part of the blister cut off, and even more worryingly, there may not be enough information printed on it to identify what strength the tablets are, or even what actual product it is! On top of this, giving out 28's can make doing out your prescription quicker and also is more cost effective for a pharmacy in terms of reimbursement from the PCRS.

Having said all that, I know I've done out plenty of prescriptions of 30's in the past and there are loads of pharmacies who do, but there are reasons against it and there (maybe still) is a way of dealing with the shortfall.

Nonoperational

Steady on lads, there is some wrong information here. If you get 28s (which a lot of pharmacists do as it's quicker and safer) then you can get a 13th supply once a year. Ask your pharmacist about it. Basically you get two supplies one month and this sorts you out for the year. Basically you pay for your drugs 12 times a year.

_Whimsical_

Thank you for the replies everyone. I asked her if she might be mistaken about getting the prescription filled 13 times last year and she is adamant that she did. None of her meds come in blister packs, they're all in little brown bottles which I presume the pharmacist counts the tablets into.

I will be sure to tell her that it's not normal practice to have 13 prescriptions a year .She's not very good at complaining but once she knows it's not normal I think she'll have more confidence to raise it with the pharmacist again and leave if they aren't able to explain what's going on.

Nonoperational

If they are in little brown bottles then 30 would be no bother but 13 supplies a year is quite common. Even if you get 30 you will be a few short of a whole year. It never happens that you get the same number as the number of days in the month.

locum-motion

chilly wrote: »

My mum has a ling term illness and has a monthly perscrption. As of this month she'll pay €120 for it each month. In the chemist she goes to they give you 28 tablets as 1 months supply of each drug. However this works out with her having to have the prescription filled 13 times in one year. She asked the pharmacist about this and they told her it's normal practise for a months supply of drugs to be 28 days worth of tablets.

I was just wondering why this is?Would it not be fairer for a months supply to be 30 or 31 days depending on the month so the patient would not have to pay an extra €120 per year?

There are 13 periods of four weeks in a year.
There are 12 calendar months in a year. You only have to pay once per calendar month.
If you get 4 weeks supply at a time, say starting today, then you will need to get your prescription refilled and pay as set out below:

7 Jan 2010 €120
4 Feb 2010 €120
4 Mar 2010 €120
1 Apr 2010 €120
29 Apr 2010 Nothing to pay, as you've already paid €120 for April.
27 May 2010 €120
24 Jun 2010 €120
22 July 2010 €120
19 Aug 2010 €120
16 Sep 2010 €120
13 Oct 2010 €120
11 Nov 2010 €120
8 Dec 2010 €120... and that then brings us back around to January, so the next time will be 5 Jan 2011.

Although in this situation you pick up your prescription 13 times in a year, you only pay 12 times. Once a year, it will happen that you pick up your meds twice in the same calendar month. You should not be asked to pay for it on that occasion. An exception to this is if you happened to go to two different pharmacies. In the above example, if you were to go to a different pharmacy on 29/4 to where you'd been on 1/4, then that pharmacy cannot account for the fact that you spent €120 in the first pharmacy, so you would be asked to pay again. In that case, however, you would then be in possession of receipts for a total of €240, and can claim back one of the €120s back from the HSE.

So, the upshot of it is that it doesn't cost you any more money to get 28 at a time rather than 30.

locum-motion

Killaqueen!!! wrote: »

Go to another pharmacy! They should provide 30 tablets per month.

Most companys which manufacture the medicines, package the drugs in a pack of 28. It is up to the pharmacy in question to add 2 extra tablets to the pack.

I'm fairly certain this (giving 2 extra tabs) is common practice in most pharmacys

NOTE: I'm not a pharmacist but I do work in a pharmacy

Please!!!
Working in a pharmacy will teach you about how they do things in the pharmacy you work in, not "most pharmacies". I'm a locum pharmacist. I've probably worked in over 100 pharmacies. There are definitely more that dispense in 28's not 30's.
Certainly some do as you said and pop the extra 2 tabs in the box, but not most. Most dispense 13 times a year.
So, please don't tell someone to change their pharmacy because of what you think a pharmacist should do.

locum-motion

chilly wrote: »

Thank you for the replies everyone. I asked her if she might be mistaken about getting the prescription filled 13 times last year and she is adamant that she did. None of her meds come in blister packs, they're all in little brown bottles which I presume the pharmacist counts the tablets into.

As pointed out above, there would be no problem in your mum's case for the pharmacy to give 30 days' supply, as it'd just be a case of putting 30 into the vial.
However, in the case of meds that come in a pack of 28, the practice of cutting 2 tabs out of another pack and adding them to make 30 is actually considered to be poor practice in most countries.
In fact, in many countries (Spain, France and Australia to name but 3), you will simply be given the closest number of complete packs to the amount prescribed, and packs are never split.
For example, if a prescription is for 15 antibiotic capsules (say, three times a day for five days) but the manufacturer supplies them in packs of 21 (because the most commonly prescribed treatment is three times a day for 7 days), then 21 is what you get.

chilly wrote: »

I will be sure to tell her that it's not normal practice to have 13 prescriptions a year .She's not very good at complaining but once she knows it's not normal I think she'll have more confidence to raise it with the pharmacist again and leave if they aren't able to explain what's going on.

It is normal practice. But as gpf and I both said, in your mum's case it'd be no problem to switch.

locum-motion

ps. There are several advantages to getting 28's at a time rather than 30's, but I'm only gonna point out three of them (others have pointed some out too)
1. What if one of the drugs you're on is one that has to be taken once each week? How do you give 30 days' supply of a once weekly medication? You can't. But you can give 4 weeks' supply, 13 times a year.
2. You will have to wait much less time while the pharmacist prepares your meds if they don't have to fiddle about with scissors and so on. Believe me, on a 10-item prescription, it can easily double the time required!
3. If you get 4 weeks at a time, you will always run out on the same day of the week. In my example, it's thursdays. If you get 30 days at a time, after a while you'll run out on a sunday, when the huge majority of pharmacies are closed.

locum-motion wrote: »

There are 13 periods of four weeks in a year.
There are 12 calendar months in a year. You only have to pay once per calendar month.
If you get 4 weeks supply at a time, say starting today, then you will need to get your prescription refilled and pay as set out below:

7 Jan 2010 €120
4 Feb 2010 €120
4 Mar 2010 €120
1 Apr 2010 €120
29 Apr 2010 Nothing to pay, as you've already paid €120 for April.
27 May 2010 €120
24 Jun 2010 €120
22 July 2010 €120
19 Aug 2010 €120
16 Sep 2010 €120
13 Oct 2010 €120
11 Nov 2010 €120
8 Dec 2010 €120... and that then brings us back around to January, so the next time will be 5 Jan 2011.

Although in this situation you pick up your prescription 13 times in a year, you only pay 12 times. Once a year, it will happen that you pick up your meds twice in the same calendar month. You should not be asked to pay for it on that occasion. An exception to this is if you happened to go to two different pharmacies. In the above example, if you were to go to a different pharmacy on 29/4 to where you'd been on 1/4, then that pharmacy cannot account for the fact that you spent €120 in the first pharmacy, so you would be asked to pay again. In that case, however, you would then be in possession of receipts for a total of €240, and can claim back one of the €120s back.

So, the upshot of it is that it doesn't cost you any more money to get 28 at a time rather than 30.

anotherlostie

Of course what hasn't been mentioned here is that some tablets come in boxes of 30... If I had an elderly or easily confused patient I would rather give them the same amount of each drug than expect them to manage the ones in the box of 30 differently to the rest. And sometimes a prescription is for less than a full month - I remember one patient, ex-army, who demanded the exact number of tablets for each calendar month and turned up like clockwork on the first of the month . Pharmacy in Ireland is a long way from discarding the scissors and plastic ziploc bags!

locum-motion

anotherlostie wrote: »

Of course what hasn't been mentioned here is that some tablets come in boxes of 30...

True, but much more in 28s than 30s.

anotherlostie wrote: »

And sometimes a prescription is for less than a full month - I remember one patient, ex-army, who demanded the exact number of tablets for each calendar month and turned up like clockwork on the first of the month . Pharmacy in Ireland is a long way from discarding the scissors and plastic ziploc bags!

So he wanted 30 in September, April, June and November, 28 in Feb (but 29 every fourth year), and then 31 the rest of the time?
Jeez, I bet he was on loads of laxatives, cos that's about the most anally retentive thing I've ever heard!

sam34

locum-motion wrote: »

True, but much more in 28s than 30s.



So he wanted 30 in September, April, June and November, 28 in Feb (but 29 every fourth year), and then 31 the rest of the time?
Jeez, I bet he was on loads of laxatives, cos that's about the most anally retentive thing I've ever heard!

i know someone who demands that as well. i'd say his pharmacist loves him!

angeldelight

+1 on the taking much longer to dipense 30s. I'm a locum pharmacist too and honestly you'd think "ah adding two would be grand" but seriously it can take a really long time

_Whimsical_

She had a look through and found she was definitely charged on 13 occasions last year. I passed on your explanations about it so she'll get it sorted with the pharmacist. She's pretty sure it's just an error that she was charged once too often as she likes the pharmacists she deals with alot.

Thank you all for taking the time to reply and explain though. It was appreciated.

Killaqueen!!!

locum-motion wrote: »

Please!!!
Working in a pharmacy will teach you about how they do things in the pharmacy you work in, not "most pharmacies".
I'm a locum pharmacist. I've probably worked in over 100 pharmacies. There are definitely more that dispense in 28's not 30's.
Certainly some do as you said and pop the extra 2 tabs in the box, but not most. Most dispense 13 times a year.
So, please don't tell someone to change their pharmacy because of what you think a pharmacist should do.

Which is why I said 'fairly certain' and also why I made it clear that I'm not a pharmacist. Obviously, a pharmacists advice would be the most ideal in this circumstance, but nobody had replied to this thread yet so I thought I would give the OP information to the best of my knowledge, and I think the OP was grateful enough for it. So get off your high horse please. There's no need to be rude.

amjon

I'm not sure how things work in Ireland but surely it's not up to the pharmacist to add the extra 2 pills. If the patient has a problem with their prescription they should discuss it with their doctor and get him to change the amount to 30. Lets say a patient is on Arimidex, if my pharmacy was to pop an extra 2 pills into each months supply then we would be out of pocket 60 odd pounds every year. That’s just one item for one patient per year, so you can see how the cost adds up. Look at it this way: let’s say you went into Tescos and bought a 4 pack of Kit Kats for lunch at work, but then you thought I'll run out on Thursday with just 4. Would you go up to the manager and start asking him for a free Kit Kat? Pharmacies are here to make a profit not throw away their money topping up prescriptions.

locum-motion

Killaqueen!!! wrote: »

Which is why I said 'fairly certain' and also why I made it clear that I'm not a pharmacist. Obviously, a pharmacists advice would be the most ideal in this circumstance, but nobody had replied to this thread yet so I thought I would give the OP information to the best of my knowledge, and I think the OP was grateful enough for it. So get off your high horse please. There's no need to be rude.

You jumped right in with both feet and your (limited) knowledge and told the OP's mum to change her pharmacy, and added a few exclamation marks afterwards. You've gotta expect a reaction if you do that.
And I wasn't rude. The word 'please' appeared twice in my post!

locum-motion

amjon wrote: »

I'm not sure how things work in Ireland but surely it's not up to the pharmacist to add the extra 2 pills. If the patient has a problem with their prescription they should discuss it with their doctor and get him to change the amount to 30. Lets say a patient is on Arimidex, if my pharmacy was to pop an extra 2 pills into each months supply then we would be out of pocket 60 odd pounds every year. That’s just one item for one patient per year, so you can see how the cost adds up. Look at it this way: let’s say you went into Tescos and bought a 4 pack of Kit Kats for lunch at work, but then you thought I'll run out on Thursday with just 4. Would you go up to the manager and start asking him for a free Kit Kat? Pharmacies are here to make a profit not throw away their money topping up prescriptions.

Don't worry, if the pharmacy dispenses 30, they get paid for 30. If they dispense 28, they get paid for 28.

Rob87

Just to add one more thing, i read quickly through the thread and saw that the thread starter's mom was charged 13 times in 12 months. As a locum pharmacist over the last few weeks coming up to christmas i was in a couple of different pharmacies who never seemed to give the two supplies in the one calender month each year. I was surprised at this but maybe it's quite common. I would imagine it should be the customers responsibility to know that they are entitled to this extra supply which could potentially save them 120 euro a year though i'm not sure how easy it is for the them to access this information.

locum-motion

Rob87 wrote: »

... As a locum pharmacist over the last few weeks coming up to christmas i was in a couple of different pharmacies who never seemed to give the two supplies in the one calender month each year...

I have to say, that wouldn't be my experience at all.
All pharmacies I know make sure that people get their 2nd "free" supply. In any event, the dispensary computer keeps track of the payments.

Rob87

locum-motion wrote: »

I have to say, that wouldn't be my experience at all.
All pharmacies I know make sure that people get their 2nd "free" supply. In any event, the dispensary computer keeps track of the payments.

Thats true and definately the norm. I'll clarify myself saying that it was in two pharmacies and that they weren't ran very well to say the least. I don't think that they will be still open in a couple of years. No surprise there.

Alicat

In the pharmacy that I work in, we're generally 30-day-suppliers for the DPS. Works easier that way for us. Fiddling around with the 13th supply of the year is actually kinda messy, I dunno about everywhere else but a lot of our customers are always going on holidays, going down the country, come in late etc. so it can get very confusing for them (and us on occasion!)