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.