Can pharmacists charge what they like?? SEE MOD NOTE - LAST POST

supremenovice

I was in a conversation with a pharmacist recently about the cutbacks etc and we got onto the new €120 limit for Drug Payment Scheme patients.

She said that a pharmacy can charge what they like under the €120 limit to patients, but after that it must be within HSE guidelines as they will only reimburse a certain amount.
Surely that cant be correct?

locum-motion

supremenovice wrote: »

I was in a conversation with a pharmacist recently about the cutbacks etc and we got onto the new €120 limit for Drug Payment Scheme patients.

She said that a pharmacy can charge what they like under the €120 limit to patients, but after that it must be within HSE guidelines as they will only reimburse a certain amount.
Surely that cant be correct?

For government reimbursed prescriptions:
The government decides how much they will pay. This was the cause of the brouhaha in the summertime.

For prescriptions that don't fall into any of the categories that the government pays for:
Not only can the pharmacy charge whatever they like, they must. What I mean by that is that any form of agreement between pharmacies as to what they charge would constitute a cartel.
If your monthly prescription comes to less than €120 when calculated by the government's formula, then it is a private transaction between you and the pharmacy and the pharmacy can charge whatever they think the market will bear. If the market would stand a figure of €1000 (which admittedly it wouldn't, it's an extreme example), then the pharmacy can charge €1000.

sesna

supremenovice wrote: »

I was in a conversation with a pharmacist recently about the cutbacks etc and we got onto the new €120 limit for Drug Payment Scheme patients.

She said that a pharmacy can charge what they like under the €120 limit to patients, but after that it must be within HSE guidelines as they will only reimburse a certain amount.
Surely that cant be correct?

Yes thank Mary Harney and the useless Competition Authority for that. Pity the government didnt focus more on regulation of banks etc.

supremenovice

locum-motion wrote: »

If your monthly prescription comes to less than €120 when calculated by the government's formula, then it is a private transaction between you and the pharmacy and the pharmacy can charge whatever they think the market will bear.

Doesnt make sense to me Locum.
If, for example, I got Zirtek worth €100 when calculated by the governments formula on a prescription, then thats what I should pay, as its under the €120 threshold.
Are you saying the pharamcist can add an extra fee on after this calculation?
I thought DPS patients would pay whatever the HSE would have to would it have been over the €120 threshold.
Excuse my ignorance on this but I want to get to the bottom of it.

locum-motion

supremenovice wrote: »

Doesnt make sense to me Locum.
If, for example, I got Zirtek worth €100 when calculated by the governments formula on a prescription, then thats what I should pay, as its under the €120 threshold.
Are you saying the pharamcist can add an extra fee on after this calculation?
I thought DPS patients would pay whatever the HSE would have to would it have been over the €120 threshold.
Excuse my ignorance on this but I want to get to the bottom of it.

The answer to your question is right there in the portion of my post that you quoted. See:

locum-motion wrote: »

...If your monthly prescription comes to less than €120 when calculated by the government's formula, then it is a private transaction between you and the pharmacy and the pharmacy can charge whatever they think the market will bear...

I put it it italics. You used the exact same phrase. In fact you put it in bold. The Govt's formula is used for prescriptions that they're going to pay for. If the Govt isn't going to pay for it, the pharmacy can use any damn formula they want!
Your medication might come to €100 when calculated by the Govt's formula, but if the pharmacy wants to use another formula that comes to, say, €150, then they may do so. It's a private matter between the pharmacy and the patient that is nobody else's business. However, as I pointed out already, the market wouldn't stand that, so therefore it's a moot point.

Also, Zirtek is a bad example. A month's supply of Zirtek comes to nowhere near €100!

In summary:

supremenovice wrote: »

Are you saying the pharamcist can add an extra fee on after this calculation?

No, they wouldn't add on an extra fee after the calculation. They just would do the calculation differently to begin with.

angeldelight

I don't have anything to add that locum-motion hasn't said already, I just wanted to say I agreed with him... as with any retail unit prices are variable between one place and another. The exception is when the Government is paying - they pay everyone the same.

bob50

angeldelight wrote: »

I don't have anything to add that locum-motion hasn't said already, I just wanted to say I agreed with him... as with any retail unit prices are variable between one place and another. The exception is when the Government is paying - they pay everyone the same.

In my dealings with the chemist in general i ve found out they normally double plus their fee for dispensingwhat the wholsesaler charges them for drugs ie inhaler costs chemist 7.00 chemist charges 14.00 antibiotic wholesaler charges 20.00 chemist will charge you 40.00 and so on However with the DPS scheme were the punter now pays 120 the Govt since last summer has reduced the amount paid to the chemists ie instead of 50% they are now paying 40%

As regards the medical card punter the chemist only gets a fee for dispening the prescription they dont get any money for the drugs that are dispensed

Nonoperational

bob50 wrote: »

In my dealings with the chemist in general i ve found out they normally double plus their fee for dispensingwhat the wholsesaler charges them for drugs ie inhaler costs chemist 7.00 chemist charges 14.00 antibiotic wholesaler charges 20.00 chemist will charge you 40.00 and so on However with the DPS scheme were the punter now pays 120 the Govt since last summer has reduced the amount paid to the chemists ie instead of 50% they are now paying 40%

As regards the medical card punter the chemist only gets a fee for dispening the prescription they dont get any money for the drugs that are dispensed

They don't double + fee. Depending on the case its 50% (as you later said) + a fee so for cheap item ya its around double but as the cost price goes up it's not double at all.

This might seem a lot but believe a lot of pharmacies are just about surviving at the moment, wages are gone down about 40% and there are no jobs in the sector.

locum-motion

bob50 wrote: »

In my dealings with the chemist in general i ve found out they normally double plus their fee for dispensingwhat the wholsesaler charges them for drugs ie inhaler costs chemist 7.00 chemist charges 14.00 antibiotic wholesaler charges 20.00 chemist will charge you 40.00 and so on However with the DPS scheme were the punter now pays 120 the Govt since last summer has reduced the amount paid to the chemists ie instead of 50% they are now paying 40%

As regards the medical card punter the chemist only gets a fee for dispening the prescription they dont get any money for the drugs that are dispensed

Wrong wrong wrong.
Please do some research.
There's plenty of posts here on boards.ie that will tell you how much the govt pays for prescriptions.
I'm not gonna type it all out again.

bob50

ok sorry istand corrected

sesna

locum-motion wrote: »

Wrong wrong wrong.
Please do some research.
There's plenty of posts here on boards.ie that will tell you how much the govt pays for prescriptions.
I'm not gonna type it all out again.

Good job you didnt become a teacher locum-motion

locum-motion

sesna wrote: »

Good job you didnt become a teacher locum-motion

If I was a teacher, I'd be getting paid to educate people, that's the difference!
Actually I've often been told I'd make a good teacher!

bob50

Hi There re the 120 charge

a friend of mine gets there meds every month and the bill comes between 500 & 600
he told me has a deal with his chemist where the chemist charges him 90 & subsidises the other 30 because of the cost of his medicines (its like a discount to my friend ) could this be true?

locum-motion

bob50 wrote: »

Hi There re the 120 charge

a friend of mine gets there meds every month and the bill comes between 500 & 600
he told me has a deal with his chemist where the chemist charges him 90 & subsidises the other 30 because of the cost of his medicines (its like a discount to my friend ) could this be true?

Well, the HSE would argue that if the total bill is (say) 550, then if the pharmacy is willing to offer a 30 discount, then the discount should come off the top of the bill, so to speak, bringing it to 520, and then the patient would pay 120 and the government 400. Effectively, that the patient is supposed to pay the first €120 of the bill.

The pharmacist would no doubt argue that he can give a discount to whomever he likes.

Mary Hairney

You often see slight differences in price for prescriptions but nothing big like 25 % cheaper in chemist A than Chemist B.

Does that reflect that the element of competition they introduce is minimal to satisfy the Consumer Authority and its mainly the fee they are tweaking and not the profit element ?

Also, if the pharmacist can charge what they want in law below the 120 euro in the DPS aren't yee idiots not to have charged 150% profit to make up for losing the fight with Harney last summer on the first 120 euro ? Technically you could so how do you all arrive at 50 % spontaneously and independently. Is it great minds thinking alike or a cartel on pricing ?

Also- this just occured to me.
Reaching the 120 euro by your formula. Surely Harney has defined and you have agreed that 120 euro limit is defined as cost(minus deduction on discount)+20%+fee worth of medicines and not cost(minus deduction)+50%+fee because that is a totally different amount of medicines bought.

Ahh. There was a nice boy pharmacist on the other day and I understood him but now I'm confused again!!
I'm not sure you guys have a legal loophole there so much as Harney is too stupid to see she can enforce this in court?

bleg

Mary Hairney wrote: »

You often see slight differences in price for prescriptions but nothing big like 25 % cheaper in chemist A than Chemist B.

Does that reflect that the element of competition they introduce is minimal to satisfy the Consumer Authority and its mainly the fee they are tweaking and not the profit element ?

Also, if the pharmacist can charge what they want in law below the 120 euro in the DPS aren't yee idiots not to have charged 150% profit to make up for losing the fight with Harney last summer on the first 120 euro ? Technically you could so how do you all arrive at 50 % spontaneously and independently. Is it great minds thinking alike or a cartel on pricing ?

Just reflects the cost prices to the pharmacies, which don't vary much. The 50% mark-up is pretty standard for any retail AFAIK.

locum-motion

On a private prescription, everybody used to just charge the amount that the Govt would pay if it was a DPS script over the threshold, or at least an amount quite close to that. That is; invoice price + 50% markup + a dispensing fee.

The reason that everyone charged (approx) the same was because everyone considered that that was an appropriate amount, and when the DPS was set up, that's the level of payment that was negotiated. So basically, not a cartel, just history.

Things have changed now. The Govt no longer negotiate. They dictate. And last year they dictated that they would in future pay pharmacists (invoice price - 6.5%) + (a 20% markup) + a dispensing fee. According to calculations done by PriceWaterhouseCoopers (one of the most respected accountancy firms in the country) this amounted to a cut of 34% in the average pharmacy's gross profit for dispensing.

The Govt has the right, aparently, to decide it will pay less for the transactions that it pays for. It does not have the right to dictate the prices that apply in a private transaction between two other parties. ie you and me.

You asked: Why not charge 150%?
Coz if anyone did, they'd immediately lose all their business to their neighbours who still charge 50%.

But why don't they all charge 150%?
Because that would require collusion, which would be illegal.

To take it further: Why not charge 10%, and undercut all your local opposition?
Because that isn't enough to make a viable profit.

To try to address your query about the two different formulae:
Take three patients with different medication requirements:

Pat A gets meds that come to €115 by the pharmacy's formula. They would come to less than that by the Govt's formula. It's a private transaction, and no claim arises under the DPS.

Pat B gets meds that come to say €140 (pharmacy's calculation) or €110 (Govt's calculation). This is also a private transaction. What will probably happen in this case is that the pharmacy will charge the patient €120, and accept the smaller profit rather than have an argument with the customer. Despite that, the pharmacist could actually charge €140, or for that matter they could charge €2,375 if they thought the patient would pay it. As long as it's less than €120 by the Govt's calculation, it remains a private transaction, so once again, no claim arises.

Pat C is on stuff that comes to say €210 or €150. In this case, the patient pays €120 and the pharmacy claims €30 for the Govt. The pharmacy's €210 calculation is irrelevant.

Mary Hairney wrote: »

You often see slight differences in price for prescriptions but nothing big like 25 % cheaper in chemist A than Chemist B.

Does that reflect that the element of competition they introduce is minimal to satisfy the Consumer Authority and its mainly the fee they are tweaking and not the profit element ?

Also, if the pharmacist can charge what they want in law below the 120 euro in the DPS aren't yee idiots not to have charged 150% profit to make up for losing the fight with Harney last summer on the first 120 euro ? Technically you could so how do you all arrive at 50 % spontaneously and independently. Is it great minds thinking alike or a cartel on pricing ?

Also- this just occured to me.
Reaching the 120 euro by your formula. Surely Harney has defined and you have agreed that 120 euro limit is defined as cost(minus deduction on discount)+20%+fee worth of medicines and not cost(minus deduction)+50%+fee because that is a totally different amount of medicines bought.

Ahh. There was a nice boy pharmacist on the other day and I understood him but now I'm confused again!!
I'm not sure you guys have a legal loophole there so much as Harney is too stupid to see she can enforce this in court?

nailan

locum-motion wrote: »

On a private prescription, everybody used to just charge the amount that the Govt would pay if it was a DPS script over the threshold, or at least an amount quite close to that. That is; invoice price + 50% markup + a dispensing fee.


Pat A gets meds that come to €115 by the pharmacy's formula. They would come to less than that by the Govt's formula. It's a private transaction, and no claim arises under the DPS.

Pat B gets meds that come to say €140 (pharmacy's calculation) or €110 (Govt's calculation). This is also a private transaction. What will probably happen in this case is that the pharmacy will charge the patient €120, and accept the smaller profit rather than have an argument with the customer. Despite that, the pharmacist could actually charge €140, or for that matter they could charge €2,375 if they thought the patient would pay it. As long as it's less than €120 by the Govt's calculation, it remains a private transaction, so once again, no claim arises.

Pat C is on stuff that comes to say €210 or €150. In this case, the patient pays €120 and the pharmacy claims €30 for the Govt. The pharmacy's €210 calculation is irrelevant.

hi, interesting post. this must be very confusing for pharmmacists. how would keep track of all the different figures, %s etc etc.
i understand that if i was on dps and get meds worth €110, that this could include a 50% markup. then towards end of month, i get more meds costing €11 (again with 50% markup). now as i have reached €121 (calculated on 50% markup), this figure should actually drop considerably, as it should be based on 20% as laid out by the gov.
i haven't done the maths, but lets say this €121 now becomes €80 as it is now calculated with 20% markup.
this now back to 'private' status as is under €120 !! so again we go around in a loop. if the pharmacy insist on me paying the €121, this should be illegal?? if they calculate based on the 20% markup, then my example above costs me €80.
but the 20% markup only applies to 'over' €120.
so we are stuck in the middle ... the pharmacy wont calculate on 20% markup .... they cannot charge me €121 as is over the threshold and they used 50% markup (illegal) ....so what happens ???

i just hope the computer software they use can do all the maths for them .... this sounds insane to me.

hope i didn't bore you all, and if i missed something or stated incorrectly, please correct.

naila :rolleyes:

bob50

Hi there can i ask a question

I get my monthly medicenes always in 1 particular chemist

But i want to know could i go to another chemist a get the same medicines on a different month

scanlant

bob50 wrote: »

Hi there can i ask a question

I get my monthly medicenes always in 1 particular chemist

But i want to know could i go to another chemist a get the same medicines on a different month

Anywhere you like, just make sure you have an original prescription.

Bring your DPS card with you, if you have it.

locum-motion

nailan wrote: »

hi, interesting post. this must be very confusing for pharmmacists. how would keep track of all the different figures, %s etc etc.
i understand that if i was on dps and get meds worth €110, that this could include a 50% markup. then towards end of month, i get more meds costing €11 (again with 50% markup). now as i have reached €121 (calculated on 50% markup), this figure should actually drop considerably, as it should be based on 20% as laid out by the gov.
i haven't done the maths, but lets say this €121 now becomes €80 as it is now calculated with 20% markup.
this now back to 'private' status as is under €120 !! so again we go around in a loop. if the pharmacy insist on me paying the €121, this should be illegal?? if they calculate based on the 20% markup, then my example above costs me €80.
but the 20% markup only applies to 'over' €120.
so we are stuck in the middle ... the pharmacy wont calculate on 20% markup .... they cannot charge me €121 as is over the threshold and they used 50% markup (illegal) ....so what happens ???

i just hope the computer software they use can do all the maths for them .... this sounds insane to me.

hope i didn't bore you all, and if i missed something or stated incorrectly, please correct.

naila :rolleyes:

Read my post again.
You are Patient B.
You don't have any entitlement to any assistance from the govt until your bill reaches €120 when calculated by the Government's formula.
It doesn't matter if your meds come to 121, 140, 150, or even 1500 by whatever formula the chemist might be using. The Govt don't start paying until it hits 120 by their formula.
As I said, though, it is highly unlikely that the pharmacy would charge you any more than €120.

bealfeirste5

Pharmacies should not be allowed to charge. End of!

scanlant

bealfeirste5 wrote: »

Pharmacies should not be allowed to charge. End of!

Communist China is that-a-way.

-> -> ->

Tell them capitalism sent you. End of!

amjon.

Communist UK is also that-a-way. Every time I dispense an item I want to vomit.

DrIndy

To be fair to everyone - I think that ripoff pharmacists has been done to death as a topic on this forum now.

There has been a lot of media spin and a lot of soapboxing that skilled professionals should not have a monopoly despite the fact that government law through a regulated profession causes that.

We have explored the competition authority view. We have explored the monopolistic view of the HSE which has forced a nose dive of the profession and forced almost every single newly qualified pharmacist out of ireland to work overseas through their policies.

We have had many, many posters come on here to attack the profession (often with great vitriol) but little information or facts for the matter and at the same time had the pharmacists here being forced to counter this often on the backfoot repeatedly across many threads stating the same thing over and over. This is often without the fundamental point being appreciated as the attacks are based simply on vitriol and the perceived notion that pharmacists are a greedy monopoly rather than like everyone else simply trying to put food on the table and maintain their business in a recession.

As such I am taking the view as the longest standing mod of this forum as well as being a doctor rather than a pharmacist to put a lid on these threads as they no longer serve any purpose here apart from going in circles.

There will be no further discussion on this subject unless new information is released. Anciliary topics regarding pharmacies and pharmacists MAY be tolerated but with very careful scrutiny. There will also be no more flame wars or trolling on the subject.