Check your Pharmacist has an honest relationship with you the customer.

Mary Hairney

Hello Everybody!

Have you been reading the papers over the weekend: Sunday Business Post and the Sunday Independent.

It appears our local irish chemists may not have passed on the cuts Mary Harney introduced on the DPS (50% profit reduced to 20 %).
Seems they've been charging most of us 50 % and then pretending it was only 20 % if you went over the 90 euro limit.

See also http://www.independent.ie/national-news/pharmacists-face-growing-pressure-to-slash-prices-2042067.html
where it tells you what you should be paying on a link to a website
www.checkthelist.ie
or ringing lo-call 1890 876700.

Isn't it all a disgrace. Bunch of well educated professionals treating us like we're PaddyIrish Customers.

Anyone on for forming a pressure group to get our money back since September ? If so, send me a private message.

My advice is you
1) Ask your pharmacists to produce on headed paper a break down of the price you've been charged on amounts less than 90 euro and get them to sign and stamp it like your tax forms
2) Send it to Dermot Jewell in the consumer's association

Are there any Boots pharmacists online willing to offer us Mary Harney's cuts honestly or are the English as bad as the Irish Pharmacists


**** FOLKS IGNORE THIS. A nice pharmacist explained it all below****

Vorsprung

Hi Mary

Some interesting comments from you of late, and your contributions to the discussion are to be welcomed.

But...given that your namesake is the Minister for Health, and you have a handful of posts (directed at pharmacists mostly), I find myself wondering whether you post with any conflict of interest?

I apologise if I've jumped to conclusions, would just be interested to know

Mary Hairney

Vorsprung wrote: »

Hi Mary

Some interesting comments from you of late, and your contributions to the discussion are to be welcomed.

But...given that your namesake is the Minister for Health, and you have a handful of posts (directed at pharmacists mostly), I find myself wondering whether you post with any conflict of interest?

I apologise if I've jumped to conclusions, would just be interested to know

First of all, she's more of my "manesake" than my namesake if you get my pun.
Horror of horrors that we're stuck on this island with someone who is such an incompitent idiot and completely out of touch with the office she holds.
But, the focus has been on Pharmacists over the weekend and my conflict of interest is it would suit me to see a bit of bargaining over prices when I go down to me local chemist next week for my monthly.

Will I be charged cost +20 %+ fee from now on (minus my 40 %) or will you refuse to do it (presuming you are a pharmacist)?
Surely the IPU, your professional body, inforces standards of ethics on you guys or are they just a quango like all the other Mary Harney appointed health boards ?

How did you have the neck to go on overcharging me without the smallest bit of conscience ? I was shocked when I read all that stuff and it makes me wonder how fit you all are to look after people like me when money and profit seems to consume you guys

Kurtosis

Just a few points and queries Mary.

Mary Hairney wrote: »

It appears our local irish chemists may not have passed on the cuts Mary Harney introduced on the DPS (50% profit reduced to 20 %).

You are mixing up your terms. The percentages in question are mark-up (50 and 20%), yet you are referring to margin (or profit). This is incorrect. The margins in question are 33.3% and 16.7% respectively.

Seems they've been charging most of us 50 % and then pretending it was only 20 % if you went over the 90 euro limit.

What is the 90 euro limit referring to? The DPS limit is 120 euro as off 1st January 2010. It has been several years since the limit was 90 euro. These increases are controlled by the Dept of Health and Children.

Are there any Boots pharmacists online willing to offer us Mary Harney's cuts honestly or are the English as bad as the Irish Pharmacists

Why are you singling out one pharmacy chain? Any individual pharmacy or chain is free to charge any mark-up on medicines that are not being reimbursed under the community drug schemes.

Surely the IPU, your professional body, inforces standards of ethics on you guys or are they just a quango like all the other Mary Harney appointed health boards ?

Again, you are mixing up your terms. IPU = Irish Pharmaceutical Union, the representative body (or union) for pharmacists. PSI = Pharmaceutical Society of Ireland, the Pharmacy Regulator which I believe you are referring to above.

Mary Hairney

penguin88 wrote: »

Just a few points and queries Mary.



You are mixing up your terms. The percentages in question are mark-up (50 and 20%), yet you are referring to margin (or profit). This is incorrect. The margins in question are 33.3% and 16.7% respectively.



What is the 90 euro limit referring to? The DPS limit is 120 euro as off 1st January 2010. It has been several years since the limit was 90 euro. These increases are controlled by the Dept of Health and Children.



Why are you singling out one pharmacy chain? Any individual pharmacy or chain is free to charge any mark-up on medicines that are not being reimbursed under the community drug schemes.



Again, you are mixing up your terms. IPU = Irish Pharmaceutical Union, the representative body (or union) for pharmacists. PSI = Pharmaceutical Society of Ireland, the Pharmacy Regulator which I believe you are referring to above.

Look. I'm sorry. I meant the 120 euro. I couldn't sleep last night, you know ?
I'm no accountant so I don't know what you're talking about that 50 % is really 33 % but its still money I feel I was cheated out off and that's why I want to form a pressure group to get it changed.I mean its even better if I should be charged 16% !!!!

Well, to put the right logo on the organisation so, how can this PSI let me, a member of the public, be treated this way ? If there is deception in money is there deception in my medicine ?? Probably not because I always get an excellent service but doesn't any of these concerns register with you or is the bottom line MONEY IS THE ONLY THING THAT MATTERS WHEN A CUSTOMER COMES IN THE DOOR OF THEIR PHARMACY?

All I want is to be sorted and get my meds at cost +16 %+fee like you've correctly told me I'm entitled to

This sounds more and more like a big conspiracy by the PSI to fix prices (or someone)

RobFowl

Mary Hairney wrote: »

It appears our local irish chemists may not have passed on the cuts Mary Harney introduced on the DPS (50% profit reduced to 20 %).

Firstly the cut was in payments to pharmacists. They are getting paid less to dispense medications under the DPS. I'm confused as to why you think reduced fees being paid to pharmcists should result in lower prices, if anything it should lead to increased prices for the consumer.

Mary Hairney wrote: »

All I want is to be sorted and get my meds at cost +16 %+fee like you've correctly told me I'm entitled to

Under the Drug payment thrseshold of €120 you are not entitled to cost +16% +fee. What you're suggesting here is actually price fixing and is illegal under competition law.

Kurtosis

Mary Hairney wrote: »

Look. I'm sorry. I meant the 120 euro. I couldn't sleep last night, you know ?
I'm no accountant so I don't know what you're talking about that 50 % is really 33 % but its still money I feel I was cheated out off and that's why I want to form a pressure group to get it changed.I mean its even better if I should be charged 16% !!!!

No need to apologise, I only wanted to let you know of a few points that were a bit mixed up.

I can give you an example of mark up and margin if you think it would help?
Take the example of something that is say 10 euro. If the mark-up on this is 50% (i.e. one half), then the final price is 15 euro.
The profit is 5 euro, so the margin is 5 euro out of 15 euro is 33% (i.e. one third). I hope this makes sense.

Well, to put the right logo on the organisation so, how can this PSI let me, a member of the public, be treated this way ? If there is deception in money is there deception in my medicine ?? Probably not because I always get an excellent service but doesn't any of these concerns register with you or is the bottom line MONEY IS THE ONLY THING THAT MATTERS WHEN A CUSTOMER COMES IN THE DOOR OF THEIR PHARMACY?

All I want is to be sorted and get my meds at cost +16 %+fee like you've correctly told me I'm entitled to

This sounds more and more like a big conspiracy by the PSI to fix prices (or someone)

I do not want to get too bogged down in detail.

Firstly, you were right that the DPS payment structure is cost + 20% mark-up +fee. My point was this 20% is not 20% profit, and is actually 16.7% profit, but this is really just semantics. Also the cost reimbursed by the government is actually less than cost price paid by the pharmacist.

Secondly, the "price cuts" introduced by Mary Harney last year to bring the mark-up on the DPS from 50 to 20% were exactly this, it reduced the mark-up that the government would pay to pharmacists for drug dispensed on the DPS scheme. (This is separate from the price cuts to some medicines as of today.) This reduced the amount paid to pharmacists, and so is not to do with the patient (so not a case of price cuts to be passed on). The DPS is a scheme where that the patient will only pay up to a certain amount per month for medicines and the government will pay the rest. Mary Harney decided that the government would not pay as much as before and so decreased the mark-up they would pay.

However unless medicines go over the DPS threshold, then business is between the pharmacy and the patient and the government does not pay anything. For this reason, no one is entitled to be charged/charge a certain price/mark-up for medicines that are not dispensed under the drug schemes. The Dept of Health/HSE cannot dictate what pharmacies should charge as this would amount to price fixing as no competition would be allowed.

Sorry, that was more rambling than I tried to make it. Also apologies if any of this seems dismissive, I am not trying to be, I'm just trying to explain the situation, as the Sindo article actually made it quite confusing. Any other questions or queries or anything, then fire away!

bleg

Mary Hairney wrote: »

This sounds more and more like a big conspiracy by the PSI to fix prices (or someone)

PSI is there to protect the public, not pharmacists. The majority of people on the council are not pharmacists. They act like any other regulator e.g. financial regulator.

If you havea problem with a retail pharmacy business or an individual pharmacist you can contact them.

Mary Hairney

penguin88 wrote: »

No need to apologise, I only wanted to let you know of a few points that were a bit mixed up.

I can give you an example of mark up and margin if you think it would help?
Take the example of something that is say 10 euro. If the mark-up on this is 50% (i.e. one half), then the final price is 15 euro.
The profit is 5 euro, so the margin is 5 euro out of 15 euro is 33% (i.e. one third). I hope this makes sense.



I do not want to get too bogged down in detail.

Firstly, you were right that the DPS payment structure is cost + 20% mark-up +fee. My point was this 20% is not 20% profit, and is actually 16.7% profit, but this is really just semantics. Also the cost reimbursed by the government is actually less than cost price paid by the pharmacist.

Secondly, the "price cuts" introduced by Mary Harney last year to bring the mark-up on the DPS from 50 to 20% were exactly this, it reduced the mark-up that the government would pay to pharmacists for drug dispensed on the DPS scheme. (This is separate from the price cuts to some medicines as of today.) This reduced the amount paid to pharmacists, and so is not to do with the patient (so not a case of price cuts to be passed on). The DPS is a scheme where that the patient will only pay up to a certain amount per month for medicines and the government will pay the rest. Mary Harney decided that the government would not pay as much as before and so decreased the mark-up they would pay.

However unless medicines go over the DPS threshold, then business is between the pharmacy and the patient and the government does not pay anything. For this reason, no one is entitled to be charged/charge a certain price/mark-up for medicines that are not dispensed under the drug schemes. The Dept of Health/HSE cannot dictate what pharmacies should charge as this would amount to price fixing as no competition would be allowed.

Sorry, that was more rambling than I tried to make it. Also apologies if any of this seems dismissive, I am not trying to be, I'm just trying to explain the situation, as the Sindo article actually made it quite confusing. Any other questions or queries or anything, then fire away!

Actually, that's not rambling. That's actually very good.
What your saying is just because I have a DPS card doesn't mean its price structure comes into effect until I reach 120 euros ? This is the only bit the HSE pays you so you are free to charge me as private member of public up unto then ? Only part of the priceing has been fixed by Mary harney.

Well that sort of weakens my case for a discount I guess. Sounds like you're not ripping me off !
I guess I'd better apologise then and try and try and erase me comments.

Who in their right mind made putting a label on a box of medicine so complex and labour intensive a process ?Its a wonder we have any drugs in Ireland the process is so confused and involves so many people like Ocuco, PSI, IPU,HSE,Uniphar,POSI,generics,EU importers, Mary harney fixing the price for her bit but not my bit. How do you figure out if you're even making a profit with all these middlemen ? Sounds like the banks are the only ones do.

Well, once again I apologise and I see your point alright. You must be good at talking to customers and explaining their tablets.Pity Mary Harney hadn't such excellent skills and manners

Kurtosis

Mary Hairney wrote: »

Actually, that's not rambling. That's actually very good.
What your saying is just because I have a DPS card doesn't mean its price structure comes into effect until I reach 120 euros ? This is the only bit the HSE pays you so you are free to charge me as private member of public up unto then ? Only part of the priceing has been fixed by Mary harney.

That's it in a nutshell.

Well that sort of weakens my case for a discount I guess. Sounds like you're not ripping me off !
I guess I'd better apologise then and try and try and erase me comments.

Who in their right mind made putting a label on a box of medicine so complex and labour intensive a process ?Its a wonder we have any drugs in Ireland the process is so confused and involves so many people like Ocuco, PSI, IPU,HSE,Uniphar,POSI,generics,EU importers, Mary harney fixing the price for her bit but not my bit. How do you figure out if you're even making a profit with all these middlemen ? Sounds like the banks are the only ones do.

Well, once again I apologise and I see your point alright. You must be good at talking to customers and explaining their tablets.Pity Mary Harney hadn't such excellent skills and manners

Again, no need to apologise! The system is quite complex as you rightly said at with many sources giving their interpretation of it (newspapers, HSE etc.) it just makes it even more complicated. It's hard for anyone to know what is going on.

You're right there's a lot more to it than just putting a label on the box. Apart from all the clinical/pharmacological considerations, a huge amount of time is spend administering the drug schemes also.

And thank you very much for the compliment, but I'm not actually a pharmacist, just on my way to becoming one in a couple of years hopefully!

meditraitor

penguin88 wrote: »

No need to apologise, I only wanted to let you know of a few points that were a bit mixed up.

I can give you an example of mark up and margin if you think it would help?
Take the example of something that is say 10 euro. If the mark-up on this is 50% (i.e. one half), then the final price is 15 euro.
The profit is 5 euro, so the margin is 5 euro out of 15 euro is 33% (i.e. one third). I hope this makes sense.



I do not want to get too bogged down in detail.

Firstly, you were right that the DPS payment structure is cost + 20% mark-up +fee. My point was this 20% is not 20% profit, and is actually 16.7% profit, but this is really just semantics. Also the cost reimbursed by the government is actually less than cost price paid by the pharmacist.

Secondly, the "price cuts" introduced by Mary Harney last year to bring the mark-up on the DPS from 50 to 20% were exactly this, it reduced the mark-up that the government would pay to pharmacists for drug dispensed on the DPS scheme. (This is separate from the price cuts to some medicines as of today.) This reduced the amount paid to pharmacists, and so is not to do with the patient (so not a case of price cuts to be passed on). The DPS is a scheme where that the patient will only pay up to a certain amount per month for medicines and the government will pay the rest. Mary Harney decided that the government would not pay as much as before and so decreased the mark-up they would pay.

However unless medicines go over the DPS threshold, then business is between the pharmacy and the patient and the government does not pay anything. For this reason, no one is entitled to be charged/charge a certain price/mark-up for medicines that are not dispensed under the drug schemes. The Dept of Health/HSE cannot dictate what pharmacies should charge as this would amount to price fixing as no competition would be allowed.

Sorry, that was more rambling than I tried to make it. Also apologies if any of this seems dismissive, I am not trying to be, I'm just trying to explain the situation, as the Sindo article actually made it quite confusing. Any other questions or queries or anything, then fire away!

Did you take into account the wholesalers discount given to Pharmacies when you made these calculations?

I do not know of a single drug that is dispensed for less than what the pharmacist actually pays for it...

Im not a pharmacist either so be gentle

Mary Hairney

penguin88 wrote: »

That's it in a nutshell.



Again, no need to apologise! The system is quite complex as you rightly said at with many sources giving their interpretation of it (newspapers, HSE etc.) it just makes it even more complicated. It's hard for anyone to know what is going on.

You're right there's a lot more to it than just putting a label on the box. Apart from all the clinical/pharmacological considerations, a huge amount of time is spend administering the drug schemes also.

And thank you very much for the compliment, but I'm not actually a pharmacist, just on my way to becoming one in a couple of years hopefully!

Well you have a very clear mind and I hope when you become fully fledged you try and bring clarity to all the idiots who thought up these schemes.

You know, a few years ago there was no petitions to sign, no strikes, no talk of my local pharmacy closing down,no posters about cuts in the windows, no big sections of the shop lined with cosmetics. It was all just so much simpler. I got my tablets, the chemist spoke to me like a patient and not like a trade unionist, or a pushy salesman selling me motillium when I asked for arrets, or the chief executive of some multinational corporation.
Now all I feel is stress when I get my prescription like someone is trying to recruit me to one side or another?
Its all very strange as a customer sometimes and these scandalous news stories don't help

Kurtosis

meditraitor wrote: »

Did you take into account the wholesalers discount given to Pharmacies when you made these calculations?

I do not know of a single drug that is dispensed for less than what the pharmacist actually pays for it...

Im not a pharmacist either so be gentle

I did not take this into account. I was just basing the above on what the actual payment structure is. The cost reimbursed to pharmacies is ~94% of the listed price for that medicine.

Admittedly some pharmacies will get a discount from wholesalers on certain products. As I mentioned above I am not a pharmacist and have only worked a few months in a pharmacy so I don't know enough about what sort of number this would entail. I can say such discounts would depend on the buying power of the pharmacy (i.e. large company vs independent pharmacy, busy pharmacy vs quiet pharmacy). So while some pharmacies may not dispense medicines for less than the cost they paid for them, other pharmacies would get reimbursed less than their cost.

RobFowl

Mary Hairney wrote: »

Well you have a very clear mind and I hope when you become fully fledged you try and bring clarity to all the idiots who thought up these schemes.

You know, a few years ago there was no petitions to sign, no strikes, no talk of my local pharmacy closing down,no posters about cuts in the windows, no big sections of the shop lined with cosmetics. It was all just so much simpler. I got my tablets, the chemist spoke to me like a patient and not like a trade unionist, or a pushy salesman selling me motillium when I asked for arrets, or the chief executive of some multinational corporation.
Now all I feel is stress when I get my prescription like someone is trying to recruit me to one side or another?
Its all very strange as a customer sometimes and these scandalous news stories don't help

I think you have clearly identified the problems here. The HSE, IPU and media are all spinning these disputes to suit their own agenda.
This results in misinformation, confusion and frustration.
Literally we don't know who or what to believe any more.


(I'm impressed with the name by the way very witty and with Fas back on the news radar very topical)

locum-motion

Declaration of Interest: I am a Pharmacist. I am also a Moderator on this forum.

Mary, I think it's great that you're taking an interest, and Yes, it is very confusing to those that aren't involved. I would just like to say that what Penguin88 (a pharmacy student), bleg (a recently qualified pharmacist) and RobFowl (a GP) have said is pretty much on the money.

Vorsprung

Mary Hairney wrote: »

Will I be charged cost +20 %+ fee from now on (minus my 40 %) or will you refuse to do it (presuming you are a pharmacist)?
Surely the IPU, your professional body, inforces standards of ethics on you guys or are they just a quango like all the other Mary Harney appointed health boards ?

How did you have the neck to go on overcharging me without the smallest bit of conscience ? I was shocked when I read all that stuff and it makes me wonder how fit you all are to look after people like me when money and profit seems to consume you guys

I'm a doctor in Oz, not a pharmacist .

liam84

penguin88 wrote: »

No need to apologise, I only wanted to let you know of a few points that were a bit mixed up.

I can give you an example of mark up and margin if you think it would help?
Take the example of something that is say 10 euro. If the mark-up on this is 50% (i.e. one half), then the final price is 15 euro.
The profit is 5 euro, so the margin is 5 euro out of 15 euro is 33% (i.e. one third). I hope this makes sense.

I do not want to get too bogged down in detail.

Firstly, you were right that the DPS payment structure is cost + 20% mark-up +fee. My point was this 20% is not 20% profit, and is actually 16.7% profit, but this is really just semantics. Also the cost reimbursed by the government is actually less than cost price paid by the pharmacist.

Secondly, the "price cuts" introduced by Mary Harney last year to bring the mark-up on the DPS from 50 to 20% were exactly this, it reduced the mark-up that the government would pay to pharmacists for drug dispensed on the DPS scheme. (This is separate from the price cuts to some medicines as of today.) This reduced the amount paid to pharmacists, and so is not to do with the patient (so not a case of price cuts to be passed on). The DPS is a scheme where that the patient will only pay up to a certain amount per month for medicines and the government will pay the rest. Mary Harney decided that the government would not pay as much as before and so decreased the mark-up they would pay.

However unless medicines go over the DPS threshold, then business is between the pharmacy and the patient and the government does not pay anything. For this reason, no one is entitled to be charged/charge a certain price/mark-up for medicines that are not dispensed under the drug schemes. The Dept of Health/HSE cannot dictate what pharmacies should charge as this would amount to price fixing as no competition would be allowed.

I don't follow all of this. At least not in relation to the 40% cuts that were announced yesterday.

If I understand what was announced yesterday was that manufacturers dropped their factory prices by 40% on about 300 drugs which are off patent. These drugs are now cheaper than their generic brothers cos the generic makers haven't cut their costs.

So who does this make a difference to?
If your a GMS person, the State saves money, but the punter doesn't. Or if your a person who gets drugs regularly for certain types of long-term treatments. Under the new cuts of 40%, the State now reimburses pharmacies 40% less of the factory cost of the branded drugs on the list? So the taxpayer benefits from this - right?

Anyone else can apply to be part of the Drugs Payment Scheme. Under this, you have to pay the first 120 euro each month of your meds, and after that the government pays. If the drugs you get are on the list, then these should be reduced by 40%, and the punter should get this benefit into her/his pocket. The IPU said they would pass on the reductions. So if I'm paying 100 euro for my monthly meds at the moment, and they're all on checkthelist.ie site, then I should only have to pay 60 euro now?

Lastly, you said that only if the drugs went over 120 euro, say 160, that the reduced mark-up kicks in. Is the reduced mark-up only paid on the amount over 120 i.e. 40 euro, or on the whole thing - 160?

hope this makes sense.

RobFowl

liam84 wrote: »

Lastly, you said that only if the drugs went over 120 euro, say 160, that the reduced mark-up kicks in. Is the reduced mark-up only paid on the amount over 120 i.e. 40 euro, or on the whole thing - 160?

When the DPS scheme takes effect the chemist only gets the reduced mark up on the entire amount i.e the entire 160 rather than the 40 (using as an example)

liam84

RobFowl wrote: »

When the DPS scheme takes effect the chemist only gets the reduced mark up on the entire amount i.e the entire 160 rather than the 40 (using as an example)

How do you mean only gets the mark-up on the entire amount? Surely that's a good thing? For the pharmacist I mean.

And if your under the 120, what level of mark-up does the pharmacist get?

Are medicines calculated by purchase, or the total of purchases during a month?

locum-motion

Liam,

Read this thread (it's not very long):

http://www.boards.ie/vbulletin/showthread.php?t=2055794531

If you're still unsure, comeback and let us know.

Thanks,
L-M.

Kurtosis

liam84 wrote: »

I don't follow all of this. At least not in relation to the 40% cuts that were announced yesterday.

My post was not really concerning the 40% reduction in the price of some off patent medicines, it was just purely discussing how the DPS scheme works.

In short, the 40% cut affect everyone. The manufacturer is paid less by the wholesaler, the wholesaler is paid less by the pharmacist and the pharmacist is paid less by the government and the patients.

The DPS scheme works exactly the same as before, the medicines that were reduced are now cheaper so if your medicines come to under €120 a month, you'll pay less.

Lastly, you said that only if the drugs went over 120 euro, say 160, that the reduced mark-up kicks in. Is the reduced mark-up only paid on the amount over 120 i.e. 40 euro, or on the whole thing - 160?

How do you mean only gets the mark-up on the entire amount? Surely that's a good thing? For the pharmacist I mean.

And if your under the 120, what level of mark-up does the pharmacist get?

Are medicines calculated by purchase, or the total of purchases during a month?

With the above quoted text just to clarify, none of this is directly affected by yesterday's price cuts, only in that the cost price any mark up will be calculated off is lower.

The reduced DPS margin applies to the whole transaction amount for your example of €160 - the patient contributes 120, the government the other 40, but the mark up on both portions is the same.

If under 120, the pharmacist is being paid by the customer and so this is a private transaction. As this is not dictated by the terms of the drug schemes, the pharmacist must charge whatever mark up they decide. No formal arrangement of what mark up pharmacists should charge is permissible as this would be in breach of competition law.

The total amount per month is what is taken into account. A DPS patient will not pay more than €120 over the course of a month, this can be in multiple transactions.

liam84

penguin88 wrote: »

My post was not really concerning the 40% reduction in the price of some off patent medicines, it was just purely discussing how the DPS scheme works.

In short, the 40% cut affect everyone. The manufacturer is paid less by the wholesaler, the wholesaler is paid less by the pharmacist and the pharmacist is paid less by the government and the patients.

The DPS scheme works exactly the same as before, the medicines that were reduced are now cheaper so if your medicines come to under €120 a month, you'll pay less.

With the above quoted text just to clarify, none of this is directly affected by yesterday's price cuts, only in that the cost price any mark up will be calculated off is lower.

The reduced DPS margin applies to the whole transaction amount for your example of €160 - the patient contributes 120, the government the other 40, but the mark up on both portions is the same.

If under 120, the pharmacist is being paid by the customer and so this is a private transaction. As this is not dictated by the terms of the drug schemes, the pharmacist must charge whatever mark up they decide. No formal arrangement of what mark up pharmacists should charge is permissible as this would be in breach of competition law.

The total amount per month is what is taken into account. A DPS patient will not pay more than €120 over the course of a month, this can be in multiple transactions.

Ok - now I get it. Thanks. Would you ever think of just printing that on a website for pharamcists that the public could read? Cos it makes the whole completely clear instead of the confusion and mayhem around prices that seems to come up every time.

One last thing - if you're willing to put up with another question or two!!
I went to get some meds this week, and the palaver I got from the pharamcist in explaining to me why he couldn't give me the reduced price cos the list wasn't accurate, and anyway he wasn't sure if one of the meds was on the 40% list, that I'd have to be buying more than 120 euro of drugs before he could give me a lower mark-up cos the State was paying it, and telling me that the generic drug he was giving me was cheaper than the branded one on my prescription. (didn't think he could do this, but since he said it was cheaper to me, I didn't argue and wasn't sure anyway.)

I gave up and just paid. The receipt I got had just one lump sum on it, not the individual price of the meds - is this legal?

Someone said to me that if was a DPS member - anyone can join apparently - then the pharmacist has to give you the lower mark-up even if your meds are lower than 120?

RobFowl

liam84 wrote: »

Someone said to me that if was a DPS member - anyone can join apparently - then the pharmacist has to give you the lower mark-up even if your meds are lower than 120?

Thats simply not true as the DPS only kicks in when you pay above the thresehold (which is 120 at the moment)

PS I'm a GP not a pharmacist and also as a family we always go over the limit and pay the 120

Kurtosis

liam84 wrote: »

Ok - now I get it. Thanks. Would you ever think of just printing that on a website for pharamcists that the public could read? Cos it makes the whole completely clear instead of the confusion and mayhem around prices that seems to come up every time.

Glad it helped!

One last thing - if you're willing to put up with another question or two!!
I went to get some meds this week, and the palaver I got from the pharamcist in explaining to me why he couldn't give me the reduced price cos the list wasn't accurate, and anyway he wasn't sure if one of the meds was on the 40% list, that I'd have to be buying more than 120 euro of drugs before he could give me a lower mark-up cos the State was paying it, and telling me that the generic drug he was giving me was cheaper than the branded one on my prescription. (didn't think he could do this, but since he said it was cheaper to me, I didn't argue and wasn't sure anyway.)

I gave up and just paid. The receipt I got had just one lump sum on it, not the individual price of the meds - is this legal?

As I (may) have said earlier, I'm only a pharmacy student, haven't worked in a pharmacy for about 6 months, so I don't really know a huge amount about the current situation. I know there has been problems with pharmacies who have to run through a small amount of stock which they had left over form before the price cuts, I do not know if this applied in your case. I am also aware that one manufacturer which is on the list may not be included in the cuts.

Sorry I can't really shed more light on this for ya.

Someone said to me that if was a DPS member - anyone can join apparently - then the pharmacist has to give you the lower mark-up even if your meds are lower than 120?

As RobFowl rightly said, the DPS scheme only applied once the threshold is reached. It is governed by a contract between the government and the pharmacist which sets the mark-up. Under the threshold isn't controlled by the contract and so the pharmacist must decide the mark-up themselves. If a mark-up was set.agreed for this, that would not be permitted under competition law.

Again sorry I can't help on some of the points, hope this is still useful.

supremenovice

penguin88 wrote: »

However unless medicines go over the DPS threshold, then business is between the pharmacy and the patient and the government does not pay anything. For this reason, no one is entitled to be charged/charge a certain price/mark-up for medicines that are not dispensed under the drug schemes. The Dept of Health/HSE cannot dictate what pharmacies should charge as this would amount to price fixing as no competition would be allowed.!

Im still a bit confused.

Take this hypothetical example for two DPS scripts:
Patient 1.Ponstan + Losec + Zirtek + 50% markup on each item =€170
&
Patient 2.Ponstan + Losec + Zirtek + 25% markup on each item =€120

Patient 1 goes to Johnnys pharmacy, hands in his script, pays the €120 limit and goes home.
Patient 2 goes to Marys pharmacy, hands in his script, pays the €120 limit and goes home.
Because Johnnys pharmacy decided to charge the Patient 1 50% markup (since its a private transaction until he reaches €120) that script gets sent to HSE to claim the outstanding amount.
But should he claim for that? Because Marys pharmacy decided to charge a more reasonable 25%, they dont claim anything.

My point is, if the pharmacist charge what they like under €120, it will mean the HSE have to pay also if it goes over.
Have I gotten this completely wrong?
Theres no venom in my question Im just trying to get to the bottom o it like everyone.

angeldelight

supremenovice wrote: »

Because Johnnys pharmacy decided to charge the Patient 1 50% markup (since its a private transaction until he reaches €120) that script gets sent to HSE to claim the outstanding amount.
But should he claim for that? Because Marys pharmacy decided to charge a more reasonable 25%, they dont claim anything.

My point is, if the pharmacist charge what they like under €120, it will mean the HSE have to pay also if it goes over.
Have I gotten this completely wrong?
Theres no venom in my question Im just trying to get to the bottom o it like everyone.

yes it does start to get complicated when there are people in and around the DPS threshold - however the HSE won't pay more than they have agreed to. It is up to the individual pharmacist how they deal with this - many have equations etc that allows them to see which ones will reach the threshold as set by the HSE and then these are the only ones that get sent. If a pharmacist were to send one which under the HSE's criteria shouldn't be paid they would simply refuse to pay it.

Every month, regardless of the DPS mark up etc there's a number of claims that the HSE refuse to pay or "rejects" which are sent back to the pharmacy who then has to rectify whatever the problem was e.g. GMS number may be incorrect or wrong drug code used. So the HSE would reject the claim.

I can't go into details about the equations etc as different pharmacists come up with their own - I don't have a full time job so I don't generally have to deal with the end of month paperwork so I don't even know any. In essence it wouldn't make any difference to the patient though in terms of which are sent off as over-threshold DPS claims - it would be between the pharmacist and the HSE

supremenovice

Thanks for the prompt response Angel... I wouldnt be able to sleep otherwise lol.
Sounds like a lot of maths involved for pharmacists these days!!

BTW, i know Harney was on Pat Kenny this morning about fees and things, did anyone here it and can give a quick summary of what was said?

Mary Hairney

angeldelight wrote: »

yes it does start to get complicated when there are people in and around the DPS threshold - however the HSE won't pay more than they have agreed to. It is up to the individual pharmacist how they deal with this - many have equations etc that allows them to see which ones will reach the threshold as set by the HSE and then these are the only ones that get sent. If a pharmacist were to send one which under the HSE's criteria shouldn't be paid they would simply refuse to pay it.

Every month, regardless of the DPS mark up etc there's a number of claims that the HSE refuse to pay or "rejects" which are sent back to the pharmacy who then has to rectify whatever the problem was e.g. GMS number may be incorrect or wrong drug code used. So the HSE would reject the claim.

I can't go into details about the equations etc as different pharmacists come up with their own - I don't have a full time job so I don't generally have to deal with the end of month paperwork so I don't even know any. In essence it wouldn't make any difference to the patient though in terms of which are sent off as over-threshold DPS claims - it would be between the pharmacist and the HSE

Would this be a solution:

The patient goes in to their pharmacy with DPS and gets charged cost+50% up to 120 euro. The pharmacist then adjusts the claim to Cost+20%, sends it to the department of health, waits to see if they get fully paid and then reimburses the patient the 30 % profit when they do get paid.
Treat the 30 % like a deposit rather than a profit.
Is that helpful?

Another idea: if the newly adjusted receipt don't come to 120 euros could the pharmacist put down something to bring the claim to 120 euro, submit it and then refund the patient the difference ? We could even ask our doctors to write a prescription for something expensive we don't need to make the claim 120 ???
Any good as a solution ?

liam84

Mary Hairney wrote: »

Would this be a solution:

The patient goes in to their pharmacy with DPS and gets charged cost+50% up to 120 euro. The pharmacist then adjusts the claim to Cost+20%, sends it to the department of health, waits to see if they get fully paid and then reimburses the patient the 30 % profit when they do get paid.
Treat the 30 % like a deposit rather than a profit.
Is that helpful?


Another idea: if the newly adjusted receipt don't come to 120 euros could the pharmacist put down something to bring the claim to 120 euro, submit it and then refund the patient the difference ? We could even ask our doctors to write a prescription for something expensive we don't need to make the claim 120 ???
Any good as a solution ?

First one sounds like a plan. An illegal one. It would also mean relying on the pharmacist to come clean on their profit margin/mark-up which they're unlikely to do. and to provide itemised bills on each of the meds as opposed to lumping them all into one total so the customer can't see what they've been charged for each med (sneaky)

Second one involves doing something illegal as well. If I buy some meds in the first week of the month that costs 90 incl private mark-up; then I get a scond lot for my family and it comes to say 65, this would take me over the limit. The total month should be marked up only at 20% as per State agreement. If the pharamcist has charged me 50% on the first transaction, then should he/she refund me the difference, since I would have paid it. Presume this has to happen on a regular basis where a family might buy drugs/meds over a month, and they might only hit the 120 mark towards the end, but they've been paying higher mark-ups up to that point.

Mary Hairney

liam84 wrote: »

First one sounds like a plan. An illegal one. It would also mean relying on the pharmacist to come clean on their profit margin/mark-up which they're unlikely to do. and to provide itemised bills on each of the meds as opposed to lumping them all into one total so the customer can't see what they've been charged for each med (sneaky)

Second one involves doing something illegal as well. If I buy some meds in the first week of the month that costs 90 incl private mark-up; then I get a scond lot for my family and it comes to say 65, this would take me over the limit. The total month should be marked up only at 20% as per State agreement. If the pharamcist has charged me 50% on the first transaction, then should he/she refund me the difference, since I would have paid it. Presume this has to happen on a regular basis where a family might buy drugs/meds over a month, and they might only hit the 120 mark towards the end, but they've been paying higher mark-ups up to that point.

Bloody hell. Here we are speculating about how these guys operate and no doubt we have hundreds of civil servants who should be investigating this kind of thing sitting around doing nothing.
We're like the Famous Five amateurly figuring it all out while the professionals couldn't give a damn!
I wonder in the UK would you be allowed to have 2 pricing systems for the one transaction.

But. I give up. Its too hard to figure out

Kurtosis

liam84 wrote: »

If I buy some meds in the first week of the month that costs 90 incl private mark-up; then I get a scond lot for my family and it comes to say 65, this would take me over the limit. The total month should be marked up only at 20% as per State agreement. If the pharamcist has charged me 50% on the first transaction, then should he/she refund me the difference, since I would have paid it. Presume this has to happen on a regular basis where a family might buy drugs/meds over a month, and they might only hit the 120 mark towards the end, but they've been paying higher mark-ups up to that point.

Just to pick out one point above, this kind of sums up what ye are discussing, yes? I'm not sure if I'm missing something but I don't know what the problem is that you're trying to solve.

Taking your example above, where the private mark up the pharmacy is charging is 50%. When you come in to buy the 2nd lot of medicines, this brings you over the €120 threshold. So you paid €90 initially, then when you come in the second time it's simply a case that instead of paying €65 for the medicine, you will pay €30, since no DPS patient (household) has to pay over this per month. So there's no need for any refunds or anything, you've paid your €120 and it does not really matter how you got there.

When the pharmacist claims for the DPS that month, instead of their private mark up they get 20% mark up on the amount. So to work it out:

(€155 / 1.5) x 1.2 = €124

So having being paid the €120 from you, the patient, the pharmacist will be paid €4 from the government for the above example.

Don't know if that helps! If you have any other qs just shoot.

locum-motion

liam84 wrote: »

First one sounds like a plan. An illegal one. It would also mean relying on the pharmacist to come clean on their profit margin/mark-up which they're unlikely to do. and to provide itemised bills on each of the meds as opposed to lumping them all into one total so the customer can't see what they've been charged for each med (sneaky)

Second one involves doing something illegal as well. If I buy some meds in the first week of the month that costs 90 incl private mark-up; then I get a scond lot for my family and it comes to say 65, this would take me over the limit. The total month should be marked up only at 20% as per State agreement. If the pharamcist has charged me 50% on the first transaction, then should he/she refund me the difference, since I would have paid it. Presume this has to happen on a regular basis where a family might buy drugs/meds over a month, and they might only hit the 120 mark towards the end, but they've been paying higher mark-ups up to that point.

Several pharmacists have posted on threads here explaining how it works. I think that counts as coming clean. Don't you?

locum-motion

I think it's supremely ironic that the OP started this thread with a title suggesting that all pharmacists are being dishonest with their customers, then started suggesting that those same pharmacists should commit fraud (Post #28) against the government, before finally deciding that what she actually wanted to do was investigate (Post #30) on behalf of the government.

liam84

penguin88 wrote: »

Just to pick out one point above, this kind of sums up what ye are discussing, yes? I'm not sure if I'm missing something but I don't know what the problem is that you're trying to solve.

Taking your example above, where the private mark up the pharmacy is charging is 50%. When you come in to buy the 2nd lot of medicines, this brings you over the €120 threshold. So you paid €90 initially, then when you come in the second time it's simply a case that instead of paying €65 for the medicine, you will pay €30, since no DPS patient (household) has to pay over this per month. So there's no need for any refunds or anything, you've paid your €120 and it does not really matter how you got there.

When the pharmacist claims for the DPS that month, instead of their private mark up they get 20% mark up on the amount. So to work it out:

(€155 / 1.5) x 1.2 = €124

So having being paid the €120 from you, the patient, the pharmacist will be paid €4 from the government for the above example.

Don't know if that helps! If you have any other qs just shoot.

It does help. You're saying the customer is blind to what mark-up they've been charged if they exceed the DPS threshold - they still have to pay out €120. The State (acting for us the taxpayers) picks up the rest at a reduced mark-up. The customer is also blind to the scalable dispensing fee €3.50 - €5 since it's based on volumes - and this is only calculated at point of reimbursement, not at point of sale to the customer.

It's only when it's under €120 that the customer has any say in what they pay or whether they pay a particular pharmacy.

It all depends on how motivated you are as a customer to seek out value for money.

To assist this, pharmacies should be required to provide itemised receipts for the drugs they dispense instead of just gross totals. And an itemised price list of drugs should be made available in stores so that customers can compare. And someone should put together a website that lists all the prices of these drugs for even greater transparency.

Effectively this is a commoditised market. Same drugs available in the same locations, with the same type of qualified person dispensing them. The only difference to the customer is the quality of the pharmacist (difficult to distinguish/assess and one assumes they should all be of similar professional quality) and the price of the prescription products. What other value difference is there between them except for guff about how they take better care of you? I'm leaving out the assorted hairbrushes, nail clippers, plastic bags, emergency kits, cosmetics, etc that they sell front of house.

angeldelight

liam84 wrote: »

To assist this, pharmacies should be required to provide itemised receipts for the drugs they dispense instead of just gross totals. And an itemised price list of drugs should be made available in stores so that customers can compare. And someone should put together a website that lists all the prices of these drugs for even greater transparency.

In general if it is not going to reach the €120 limit most receipts will have the individual amounts. Eg I'm sitting here looking at a receipt I got myself a while ago with 3 items on it and each one has the price beside it.

An itemised price list of drugs really wouldn't work - the prices change a little every month, there's thousands of them, for each drug there can be 3/4 suppliers, if a patient gets more than one month at a time they only pay one dispensing fee... there's way too many variables. However if you were to ask your pharmacist what price your medicines were in that pharmacy I'm sure they'd let you know. You could then choose to check other places if you wished. It does take a bit of work on the customers part but it is doable.

liam84

locum-motion wrote: »

Several pharmacists have posted on threads here explaining how it works. I think that counts as coming clean. Don't you?

Well no it doesn't. We're told that pharmacists don't act in concert, so we presume they don't collude on the mark-ups they charge private customers. Therefore, the information should be made visible in the store and at the till.

One or two pharmacists explaining how they charge does not reflect how the whole market acts or charges, nor should it - if it is truly competitive. In fact, I'd assume any pharamcist worth their salt would keep secret what they charge their private customers in order to remain competitive in the public eye.

On the other hand, pharmacists are working with commodities providing a commoditised service. (I realise you have to have some kind of third level degree over the door before you can dispense medicines - even if it only means filling bottles of pills correctly from a prescription.)

So how do you choose which pharamcy to use? The personality of the person behind the counter? Whether they say "Are ya ok?" or "Can I help you?" when you walk in the door? The kind of cosmetics they sell? Or the price they charge for filling your prescription and/or any word of advice about their use as they are professionally required to do?

If you're a regular meds buyer, then price is going to be the main factor. So the more information I have to see which delivers the best value, the better.

liam84

angeldelight wrote: »

In general if it is not going to reach the €120 limit most receipts will have the individual amounts. Eg I'm sitting here looking at a receipt I got myself a while ago with 3 items on it and each one has the price beside it.

An itemised price list of drugs really wouldn't work - the prices change a little every month, there's thousands of them, for each drug there can be 3/4 suppliers, if a patient gets more than one month at a time they only pay one dispensing fee... there's way too many variables. However if you were to ask your pharmacist what price your medicines were in that pharmacy I'm sure they'd let you know. You could then choose to check other places if you wished. It does take a bit of work on the customers part but it is doable.

You say in general, but only have your own receipt as evidence that it happens. I have receipts from the last three years from four different pharamcies that says they don't. Now maybe I've picked on unusual pharamcies, and the general practice is that prices are itemised sufficiently.

If what you say about the prices changing every month is accurate then a price list would be difficult but not impossible. I presume there must be a Top 20 or 30 drugs prescribed all the time. Those are the ones to publicise within your store and grab customers attention.

locum-motion

liam84 wrote: »

... Therefore, the information should be made visible in the store and at the till...

When you buy half a dozen eggs in Tesco, Dunnes or the corner shop, do you insist on knowing how much they bought the eggs for? No, you don't.

If you asked them, do you think they'd tell you? You can be bloody sure they wouldn't. They'd tell you to fcuk off, and they'd be dead right.

Did the Irish Farmers' Association set up a website last monday listing the price that the farmers sell the eggs to the distributors at? No they didn't.

Did the IFA tell the public that they should insist on paying no more than a particular amount for their eggs? No, they didn't, because
a) the price at which Tesco, Dunnes and your corner shop sell the eggs at is none of the farmer's business.
b) that would probably be illegal under the Competition Act.

If the above did happen, would the Minister for Agriculture come out in public and agree with the farmers? No way. Most Ministers have the cop on to recognise that that would be a bad thing.

Now, in all the above scenarios;
substitute IPHA (the organisation that represents Big Pharma) for the IFA,
substitute pharmacists for Tesco, Dunnes and the corner shop, and
substitute a certain fat cow independent TD/Minister for the Minister for Agriculture.

That is exactly what has happened in the last few days.


EDIT: PS; I thought you made some good points in the remainder of your post.

locum-motion

liam84 wrote: »

You say in general, but only have your own receipt as evidence that it happens. I have receipts from the last three years from four different pharamcies that says they don't. Now maybe I've picked on unusual pharamcies, and the general practice is that prices are itemised sufficiently.

If what you say about the prices changing every month is accurate then a price list would be difficult but not impossible. I presume there must be a Top 20 or 30 drugs prescribed all the time. Those are the ones to publicise within your store and grab customers attention.

My esteemed colleague has only recently joined the profession, so she won't be aware of the history here.

At the time the DPS was set up, a thing called the 'Unified Claim Form' was invented. It's the blue and white receipt that you get with your medicines. It's called the Unified form coz the same piece of paper can have different data printed on it according to which of the various Community Drugs Schemes the patient is on.

Look near the top right corner.
Liam, I bet your paper with no individual prices on it has the letters DP or DPS in a box there.
Angel, I bet yours - that has the prices on - has DR printed there.
(Angel, at work tomorrow, have a look at each receipt before you bag it and you'll see the truth of this)

DR is printed on 'Private' prescription receipts. It stands for Drug Refund.
DP is printed on DPS receipts. The data thereon is the data that the Dept of Health wanted printed on it when the scheme was set up.
There's no mystery or conspiracy there, I'm afraid.

I should point out that I mean absolutely no disparagement of Angeldelight above. Her RW identity is known to me. Although she's only recently qualified, she is already very well regarded by those colleagues who know her.

angeldelight

Sorry yes you're right, mine is drug refund. Ignore that post of mine so! However the pharmacist will give you a break down of the price if you bring your prescription in

liam84

locum-motion wrote: »

When you buy half a dozen eggs in Tesco, Dunnes or the corner shop, do you insist on knowing how much they bought the eggs for? No, you don't.

If you asked them, do you think they'd tell you? You can be bloody sure they wouldn't. They'd tell you to fcuk off, and they'd be dead right.

Did the Irish Farmers' Association set up a website last monday listing the price that the farmers sell the eggs to the distributors at? No they didn't.

Did the IFA tell the public that they should insist on paying no more than a particular amount for their eggs? No, they didn't, because
a) the price at which Tesco, Dunnes and your corner shop sell the eggs at is none of the farmer's business.
b) that would probably be illegal under the Competition Act.

If the above did happen, would the Minister for Agriculture come out in public and agree with the farmers? No way. Most Ministers have the cop on to recognise that that would be a bad thing.

Now, in all the above scenarios;
substitute IPHA (the organisation that represents Big Pharma) for the IFA,
substitute pharmacists for Tesco, Dunnes and the corner shop, and
substitute a certain fat cow independent TD/Minister for the Minister for Agriculture.

That is exactly what has happened in the last few days.


EDIT: PS; I thought you made some good points in the remainder of your post.

Locum-motion - thanks for the responses. Clearly, the aggrieved tone of your response indicates that you're a pharmacist (and I think you said as much in an earlier post) - so you'll excuse my initial response of 'well you would say that, wouldn't you?'

You say that I make some good points in the remainder of my post - my key point was that price is the deciding factor in what is essentially a commoditised service. Therefore price and visibility for the customer about same is essential.

Your response to this is to ask rhetorical questions about buying eggs.

Eggs? Eggs!! You have to be joking.

I'm not buying or choosing from a variety of protein products when buying eggs - I'm buying the same product, albeit with some questionable assertions about their size and origin. But that's it. It's not the same as buying a complex drug that impacts directly on my health. There has to be over 5,000 different drugs available for treatment of different illnesses in Ireland (maybe a lot more?) - most of which are prescribed to you by another professional working in a surgery. And as a pharmacist you compare that to buying eggs? That says far more about how you perceive the value of your products and the service you provide than anyone else.

Unless pharmacists change the type of dispensing service in their shops, and how they behave as trained professionals, they will continue to be judged on price, and price alone.

Some pharmacists may feel that their winning personality and charm - the customer experience - might win them a few customers, and no doubt that helps - I've met a few. But it seems to me that in a profession that has allowed itself to be put into a place where the only real difference is about how much they charge - no doubt the Govt and IPHA have contributed to this recently but ultimately they ain't to blame - then they need to take action and do something about how their profession is perceived.

As far as the public is concerned, pharmacies - and owner-pharmacists by assumption - have been profiteering big-time over the last decade. No doubt there have been smaller pharmacies who haven't enjoyed all the benefits but if large salaries and extraordinary prices for pharamcies are any indicator, then chemists have been making it large for the last while.

Suddenly that's changing as the Government belatedly copped on and started changing things, knowing they were being fleeced (and the taxpayer). New rules got established. Manufacturers got partly kicked into line, new policies emerged, etc, etc. But what changed for the customer? Practically nothing. Because either they weren't paying for their drugs in the first place and so couldn't be bothered about what they paid, or else they had to shrug at either the Govt changing their limit on DPS - 80 odd to 120 in my case - and nothing else of import. Pharmacists hunkered down and tried to protect a shrinking area of profit for themselves - that's now down to the private customer.

Suddenly there seems to be a change that will have a positive impact on the paying customer (and the indirect paying customer who are paying through their taxes if they thought about it) and the pharmacists are up in arms at having the cosy relationship with their private paying customer disturbed.

As a paying patient, who does have DPS in the corner of his Unified Form - I'm suddenly interested in seeing what's what.

So what if a unified form was issued by the Govt? Does that stop pharmacies presenting itemised receipts to their customers? I never mentioned mystery or conspiracies, just give me information. You can whinge about how the Govt has behaved or anyone else, but the reality is that if it wasn't this IPHA thing, it would have been something else that would have inevitably caused greater transparency in a market largely governed by price.

Recession has a great habit of making people stop and think about what they're handing over - that's the free market. I've no problem with pharmacists making a profit - they're entitled in running a business. But they knew the rules when they got into it about it being a state-involved service and receiving monies from it.

There's obvious patterns of settled or defensive behaviour amongst a group of professionals that has allowed itself to become commoditised in its actions and responses to events beyond its control. If ever there was a sign that a supposedly competitive industry or sector was behaving like a commoditised herd of cows plaintitively mooing, but shuffling resignedly in the one direction, pharmacy is it.

Nobody is preventing them from acting differently in how they treat patients, as long as they work within legal requirements. I bet every recent change has been greeted with groans of dismay, muttered curses and paranoiac accusations of people out to get the profession.

the title of this thread is interesting and what grabbed my attention in the first place. "An honest relationship with you the customer". what's an honest relationship? Possibly it's one that involves things like trust, reassurance, dignity, respect, fairness, value and equity. Do all of those involve money? Not in my book.

If I walked into my pharmacy and I knew that the man/woman behind the counter had more than how many 'eggs' they were going to sell me on their mind, I might sit up and take notice. Maybe they'd be aware of the illness I had. Maybe they'd know about the effects other drugs might have on me. Maybe they'd be willing to take the time to talk about that and what impact it was having on my life. Maybe they'd be willing to get involved in what they are actually dispensing drugs for, and provide some value around the product they were otherwise mindlessly shovelling into a pill bottle on my behalf. Maybe they might come up with some added-value service that I'd be willing to pay for because my GP is too busy or hasn't enough time to take time out to discuss things. Maybe they've forgotten things they were taught when they were learning months, years or decades ago, that actually might make a difference in a patient's day or life. Maybe my pharmacy might become a place that I might welcome visiting for my healthcare, as opposed to somewhere to stop off to 'colllect my scrip'.

Eggs?

Should I be surprised that some chickens are coming home to roost.

Alicat

As someone who works in pharmacy (not a pharmacist), I've found the last few days particularly difficult dealing with customers demanding to know the prices of their drugs. I say "demanding" because the attitude of a lot of these customers has been absolutely disgraceful. I've had people shouting down the phone at me, cursing at me and hanging up.

It's the start of the month, the busiest time of the month for any pharmacy, I haven't had time to study the list and know immediately offhand what prices have been reduced. The disk with the updated prices arrived today but it has been so busy we didn't even have time to install it until the shop closed this evening. So don't shout at me! If you could calmly tell me your query, I'll go find out and call you back later or you can call me. One absolute cow said to me today "Can you not just look at the bloody list in front of you for God's sake??"

No I can't you silly, rude, ignorant woman, the shop is packed, I have a dozen HUGE prescriptions waiting on the bench and here you are in my face about the price of your bloody Zirtek! Chill! I am responsible for none of this, I work here yes but I am trying to get my head around it too so back the f*ck off for two minutes

The worst businesses to work in are those which involve either people's health or their money. Somehow it seems to give them all an excuse to be an absolute @sshole to anyone and everyone. The media are getting everyone in a tizzy and giving incorrect or incomplete information and telling everyone to storm their local pharmacy and give them hell.

I had a bad day today, sorry if it comes out as a big rant.

Alicat

liam84 wrote: »

Your response to this is to ask rhetorical questions about buying eggs.

Eggs? Eggs!! You have to be joking.

I'm not buying or choosing from a variety of protein products when buying eggs - I'm buying the same product, albeit with some questionable assertions about their size and origin. But that's it. It's not the same as buying a complex drug that impacts directly on my health. There has to be over 5,000 different drugs available for treatment of different illnesses in Ireland (maybe a lot more?) - most of which are prescribed to you by another professional working in a surgery. And as a pharmacist you compare that to buying eggs? That says far more about how you perceive the value of your products and the service you provide than anyone else.

Talk about over-reacting! Sorry, but the discussion was about prices/discounts/mark ups/profits, a discussion about the business end of the pharmacy world. He responded with an analogy relating to the business end of it. What's the problem? I'm sure he could go into a huge post about the service he provides but that's not what was being discussed.

the title of this thread is interesting and what grabbed my attention in the first place. "An honest relationship with you the customer". what's an honest relationship? Possibly it's one that involves things like trust, reassurance, dignity, respect, fairness, value and equity. Do all of those involve money? Not in my book.

I laughed at this. Do you know how hard it is to gain these traits/qualities FROM customers?

Respect? Dignity? Fairness? Is this yelling at ME in front of all the other customers when the government puts the DPS threshold up? Giving out to me about the price of a drug? Calling me an ignorant bast*rd because your prescription isn't due yet? Is this throwing the money on the counter at me? Not looking me in the eye like a person?

It's my job to treat the customers with respect, dignity and fairness but let me tell you a lot of customers are absolute misers when it comes to returning the favour.

If I walked into my pharmacy and I knew that the man/woman behind the counter had more than how many 'eggs' they were going to sell me on their mind, I might sit up and take notice. Maybe they'd be aware of the illness I had. Maybe they'd know about the effects other drugs might have on me. Maybe they'd be willing to take the time to talk about that and what impact it was having on my life. Maybe they'd be willing to get involved in what they are actually dispensing drugs for, and provide some value around the product they were otherwise mindlessly shovelling into a pill bottle on my behalf. Maybe they might come up with some added-value service that I'd be willing to pay for because my GP is too busy or hasn't enough time to take time out to discuss things. Maybe they've forgotten things they were taught when they were learning months, years or decades ago, that actually might make a difference in a patient's day or life. Maybe my pharmacy might become a place that I might welcome visiting for my healthcare, as opposed to somewhere to stop off to 'colllect my scrip'.

Well maybe you're in the wrong pharmacy! Don't tar them all with the same brush. My boss spoke to a woman in the shop for about half an hour about problems with her son. She came back in a few days later looking for more advice but the boss was off so we took her number and passed it on to him. He rang her on his day off and talked to her for another half an hour on the phone because he cares and is good at his job.

liam84

Alicat wrote: »

Talk about over-reacting! Sorry, but the discussion was about prices/discounts/mark ups/profits, a discussion about the business end of the pharmacy world. He responded with an analogy relating to the business end of it. What's the problem? I'm sure he could go into a huge post about the service he provides but that's not what was being discussed.

Alicat - it's not over-reaction. Look at the specific response regarding eggs - it was a post on its own. Asking people rhetorical questions about whether I or anyone else would ask these price questions of egg producers.

Surely you recognise that this is a laughable response from a trained professional. I don't view pharmacy as the equivalent of an egg producer so why make the comparison?

What analogy do you think he was making relating to the business end of it - as you put it?

Kurtosis

liam84 wrote: »

Alicat - it's not over-reaction. Look at the specific response regarding eggs - it was a post on its own. Asking people rhetorical questions about whether I or anyone else would ask these price questions of egg producers.

Surely you recognise that this is a laughable response from a trained professional. I don't view pharmacy as the equivalent of an egg producer so why make the comparison?

What analogy do you think he was making relating to the business end of it - as you put it?

Just curious about the above liam. I assumed the poster was drawing the analogy to try and see would you feel the same way about other retail environments as you do about a pharmacy with regards to cost, mark-up etc. (Again this is just my assumption, I do not want to put words in locum's mouth if (s)he intended something different.)

Fair enough eggs might be a bit of a wacky example (but a very valid example nonetheless), but would you ask for a cost and profit breakdown for any other services you avail of or goods you buy?

liam84

Alicat wrote: »

As someone who works in pharmacy (not a pharmacist), I've found the last few days particularly difficult dealing with customers demanding to know the prices of their drugs.....
I haven't had time to study the list and know immediately offhand what prices have been reduced. The disk with the updated prices arrived today but it has been so busy we didn't even have time to install it until the shop closed this evening.

I had a bad day today, sorry if it comes out as a big rant.

Alicat - what you describe is not fair behaviour by customers towards you so the rant is allowable.

If it's of help, I found the list here - www.checkthelist.ie - and was able to print it off - 6/7 pages at most. You could print this off and use it as a quick check for phone queries - it shows pretty quickly whether an item is on the list or not, and how much is has dropped by for DPS patients. Obviously you'll know how much extra your pharmacy charges people who aren't covered by DPS. It's fairly straightforward.

Alicat

liam84 wrote: »

Alicat - it's not over-reaction. Look at the specific response regarding eggs - it was a post on its own. Asking people rhetorical questions about whether I or anyone else would ask these price questions of egg producers.

Surely you recognise that this is a laughable response from a trained professional. I don't view pharmacy as the equivalent of an egg producer so why make the comparison?

What analogy do you think he was making relating to the business end of it - as you put it?

Ok I think you've been blinded by the eggs. It was not a laughable response. Locum-motion has provided a lot of answers/discussions regarding pharmacy and it's dealings on this forum over the past while. Some people reading these threads may not have any idea about how pharmacy works, whether it's about prescriptions or prices or the legal aspect of it. He provided an analogy that is EXTREMELY easy to understand, from anyone's point of view.

Were you looking for something more complex?

The analogy clearly relates how ridiculous the government's attempted stranglehold on Pharmacy is when you consider applying it to any other business. Such as egg farming! I'm not against prices being tightened in pharmacy and cut backs made where necessary but they are taking the p!ss.

Alicat

liam84 wrote: »

Alicat - what you describe is not fair behaviour by customers towards you so the rant is allowable.

If it's of help, I found the list here - www.checkthelist.ie - and was able to print it off - 6/7 pages at most. You could print this off and use it as a quick check for phone queries - it shows pretty quickly whether an item is on the list or not, and how much is has dropped by for DPS patients. Obviously you'll know how much extra your pharmacy charges people who aren't covered by DPS. It's fairly straightforward.

I have the list, I think it was the IPHA that sent it out but it's actually in TINY print and not even alphabetical for some reason. And I mean tiny, and my eyesight simply couldn't pick out the one tiny listing for Zirtek. If the customer had just given me a moment to look slowly through it I would have found it but that's not the point. It's the absolute disregard and disrespect from customers such as this who shouted at me when I couldn't find the listing within 30 seconds or whatever. THAT's what really gets my goat. Do I have 'SLAVE' printed across my forehead? No? Good, well treat me with some respect and WAIT while I try to sort your query.

(obviously not directed at you but at customers such as that in general!)

Edit: And actually may I point out that lots of these queries seem to be coming from people who are NOT regular customers but people merely calling around the find prices for the smallest of things.

liam84

Alicat wrote: »

Ok I think you've been blinded by the eggs. It was not a laughable response. Locum-motion has provided a lot of answers/discussions regarding pharmacy and it's dealings on this forum over the past while. Some people reading these threads may not have any idea about how pharmacy works, whether it's about prescriptions or prices or the legal aspect of it. He provided an analogy that is EXTREMELY easy to understand, from anyone's point of view.

Were you looking for something more complex?

The analogy clearly relates how ridiculous the government's attempted stranglehold on Pharmacy is when you consider applying it to any other business. Such as egg farming! I'm not against prices being tightened in pharmacy and cut backs made where necessary but they are taking the p!ss.

You seem to be missing the point. You ask was I looking for something more complex? Well no I wasn't necessarily - I was looking for something more comparable.

Comparing the pricing structure of an egg producer - a single product in a number of sizes that are a basic commodity with an established price range, with a retail outlet selling (I assume) thousands of different medicines, of different quantities, for different illnesses, with different price structures, discounting, bonuses, along with all the other front of shop items does not make sense to me. Maybe it does to you.

If anything, it seems that the Govt is intent on making the complex price structure around drugs - and this extends well beyond the pharmacy - a little simpler for everyone. With the various schemes in place, though, they've a lot of work to do yet. (If pharmacy is a commodity business, maybe it needs to become more streamlined like an egg producer where there is much greater clarity and transparency around production and margins, and as a result much less oversight required as a result.)

EDIT: Oh - the print off list from the actual IPHA website is done alphabetically - well the one I did is, and I was able to increase the size in Excel before printing it off - just took a minute to adjust before I did it and it was easy enough to read.

bleg

liam84 wrote: »

If anything, it seems that the Govt is intent on making the complex price structure around drugs - and this extends well beyond the pharmacy - a little simpler for everyone.

HA!!!! What an absolute joke!

Making the complex price structure simpler. That's why some branded medicines now cost more than their generic equivalents.

The ineptitude of the government and the DoHC in this instance is staggering.

The pharmaceutical companies are laughing all the way to the bank. their products will get a renewed increased market share, they get a boost in public opinion and get their trademarks increased exposure.

In fact I'd put my house on IPHA going to the negotiations willing to put more on the table but pulled back during the negotiations when they realised they could get away with this token gesture.

liam84

bleg wrote: »

HA!!!! What an absolute joke!

Making the complex price structure simpler. That's why some branded medicines now cost more than their generic equivalents.

The ineptitude of the government and the DoHC in this instance is staggering.

The pharmaceutical companies are laughing all the way to the bank. their products will get a renewed increased market share, they get a boost in public opinion and get their trademarks increased exposure.

In fact I'd put my house on IPHA going to the negotiations willing to put more on the table but pulled back during the negotiations when they realised they could get away with this token gesture.

Well is it not the case that the 600 odd medicines on the HSE list are now cheaper than their generic equivalents cos the generic manufacturers refused to lower them until the autumn when their contract runs out?

Why are the DOHC staggeringly inept on this issue? should they have got a greater reduction or should more drugs have been reduced?

Why would IPHA get increased market share? It's down to the pharmacists as to what they promote to their customers in a lot of cases. Since they've gone doolally over these price cuts, presumably they can retaliate with offering alternatives to customers like my pharmacy does at the moment. As long as it's cheaper than the actual prescribed drug, why would the customer complain? I'm sure the generic makers offer discount deals (e.g. buy 2 get 3 free) which they can then flog to their unknowing customers.