Medication again

odds_on

I went to a chemist to get my prescription filled for two weeks supply of medication (30 capsules). It cost me 88+ euros. My complaint is Peripheral Neuropathy - a numbness in my fingers and feet as a result of medication and chemotherapy for cancer of the bone marrow.

I got the same prescription (28 capsules) in England at the end of March for 36+ pounds.

Same manufacturer. Now, someone is making a extremely large profit at my expense.

Definitely, rip off Ireland.

Geuze

See www.pcrs.ie for the factory and wholesale prices.

Click on "List of Remibursable Items".

vicwatson

Geuze wrote: »

See www.pcrs.ie for the factory and wholesale prices.

Click on "List of Remibursable Items".

Are these prices what the Pharmacist pays for them or....?

MagicMarker

Is there any way to get a longer lasting prescription? A two month supply + one ryanair flight every two months would work out considerably cheaper.

mathepac

AFAIK, It's what the HSE pays the pharmacist for dispensing the items listed to people who hold medical cards or long-term illness cards.

The pharmacist in turn pays the distributor a different (lower) price, presumably a similar price to what the HSE pays, thus the HSE "manages" the pharmacist's margin on these products.

If you want to see the difference between the "HSE price" and Sean or Sheila Citizen's price get your hands on a copy of MIMS.

MagicMarker wrote: »

Is there any way to get a longer lasting prescription? A two month supply + one ryanair flight every two months would work out considerably cheaper.

People on long-term illness cards or medical cards get three-monthly prescription from their doctor, Why can't everyone get these? (I have a long-term illness book / card)

ceegee

odds_on wrote: »

I went to a chemist to get my prescription filled for two weeks supply of medication (30 capsules). It cost me 88+ euros. My complaint is Peripheral Neuropathy - a numbness in my fingers and feet as a result of medication and chemotherapy for cancer of the bone marrow.

I got the same prescription (28 capsules) in England at the end of March for 36+ pounds.

Same manufacturer. Now, someone is making a extremely large profit at my expense.

Definitely, rip off Ireland.

The manufacturers charge a lot more here than in the UK, they employ a lot of people here and we're a small market so they have a strong bargaining position.

Wholesale markup isnt imo a big factor (not sure how it compares to UK but is only a small % of overall cost.)

Pharmacy price is worked out as a % markup and so reflects the high initial price (It still is quite high markup, mainly due to compensating for medical card prescriptions)


The only bit of consolation I have is to make sure if you need to get another two weeks supply to do so before the end of the calendar month so that it caps at 132 euro

odds_on

mathepac wrote: »

AFAIK, It's what the HSE pays the pharmacist for dispensing the items listed to people who hold medical cards or long-term illness cards.

The pharmacist in turn pays the distributor a different (lower) price, presumably a similar price to what the HSE pays, thus the HSE "manages" the pharmacist's margin on these products.

If you want to see the difference between the "HSE price" and Sean or Sheila Citizen's price get your hands on a copy of MIMS.

People on long-term illness cards or medical cards get three-monthly prescription from their doctor, Why can't everyone get these? (I have a long-term illness book / card)

Sorry, mathepac, I haven't followed your explanation:
It's what the HSE pays the pharmacist for dispensing the items listed to people who hold medical cards or long-term illness cards.
So tyhe HSE are paying €88 to the pharmacist (which in the UK can be bought by the general public for approx €40 thus the HSE are overpaying for the medication - no wonder the country is in dire straights.

The pharmacist in turn pays the distributor a different (lower) price,
The wholesale price - probably about 20-25 euros based on the UK retail price.

presumably a similar price to what the HSE pays, thus the HSE "manages" the pharmacist's margin on these products.
I don't follow this part but are you saying that it is the HSE that sets the price?

Unfortunately, I do not have a Medical card - as yet - as I have only returned from nearly 15 years abroad. I may have difficulty proving my Habitual residency which has now very strict rules. I was treated for cancer of the bone marrow - approx 25,000 euros worth of treatment. This includes a stem cell transplant (with the help of the Irish Embassy in Argentina, which the HSE did not have to pay for, thus I have saved the country a fair sum! And now someone wants to charge me an exorbitant price for medication. At this price I am going to have to give it a miss as I am retired and only have a very small private pension from the UK - about 40 euros a week, in spite of having worked many years in Ireland in the 60s, 70s and 80s and early 90s.

See www.pcrs.ie for the factory and wholesale prices.

Click on "List of Remibursable Items".

32257 Lyrica Caps. 75 mg. 56 (A) €88.23

I've highlighted the red - as a box of Lyrica containes 56 capsules, so, it looks to me that the €88.23 is for 56 capsules and not 30 that I received but paid the €88.23.

I went back to the pharmacy a few days ago to get them to check the price, showing them the prescription and the said that €88.23 was the correct price but didn't actually say for what quantity.
I'll have to check again

odds_on

ceegee wrote: »

The manufacturers charge a lot more here than in the UK, they employ a lot of people here and we're a small market so they have a strong bargaining position.

Wholesale markup isnt imo a big factor (not sure how it compares to UK but is only a small % of overall cost.)

Pharmacy price is worked out as a % markup and so reflects the high initial price (It still is quite high markup, mainly due to compensating for medical card prescriptions)


The only bit of consolation I have is to make sure if you need to get another two weeks supply to do so before the end of the calendar month so that it caps at 132 euro

Thanks ceegee, you posted while I was compiling my last post.

Surely manufacturers manufacture a quantity of any particular drug and supply Europe or world-wide or whatever. Therefore the cost of production remains the same for any country supplied apart from transport charges. Therefore the manufacturers are making more the Irish market because they supply us with a smaller quantity than, say, the UK.
I got the same drug in Argentina (though a different manufacturer) at approximately the same as the UK price.

To have a difference of around 100% more in Ireland than the UK is, in my mind daylight robbery by someone.

The box the capsules came in is actually in Spanish with a large sticker on one side of the box in English and marked IRELAND /UNITED KINGDOM [POM]. It also says Marketing Authorization Holder: Pfizer Ltd, Sandwich, Kent, UK and manufactured by Pfiser Manufacturing Deutschland GmbH ... Germany and repackaged by a company in Ireland.

Someone I was talking to said that when she needs drugs, she gets a prescription from the doctor and takes it over the border to get it filled because it is much cheaper to do so - OK if you live near the border!

keithclancy

Just checked the price here in the Netherlands:

http://www.medicijnkosten.nl/

CAPSULE 75MG
De kosten zijn berekend aan de hand van 28 stuks, inclusief BTW en exclusief aflevertarief.
(The costs are calculated on the basis of 28 pieces, including VAT and plus delivery rate)

LYRICA CAPSULE 75MG
Total Cost
€ 25,81

50 Tablets comes to € 46,10

You could get a Ryanair Flight from Dublin to Eindhoven on the cheap ?

Xterminator

the importation and wholesale distribution of drugs in ireland is controlled and licened by the IMB. They effectively prevent cross importing, from cheaper sources by wholesalers or pharmacy chains.

the wholesaler markup is as low as 2% on some medicines as recent price changes in the sector have squeezed their margins hard.

the pharmacies have agreed markups for scripts handed in by medical card holders, as the government set these prices.

however they can charge whatever they like to private patients scripts.

as an example i purchased a bottle of betnesol eye drops from a pharmacy last year.

Wholesale price is approx 2.50 ex vat. ( i have access to these prices).

I paid 12 euros in the pharmacy. they stuck a sticker on the bottle, that was their contributions, and they got a 400% + mark-up for that action.

PS there are a handful of pharmacies which voluntarily change their private script patients the same price as their medical card patients.

X

mathepac

Xterminator wrote: »

the importation and wholesale distribution of drugs in ireland is controlled and licened by the IMB. They effectively prevent cross importing, from cheaper sources by wholesalers or pharmacy chains....

Please complete the following question.

The Irish Medicines Board, IMB, is funded and run by :

1. The Department for Health & Children on behalf of the citizens
   
2. A Panel of Irish Consumers
   
3. Medical Professional & Qualified Pharmacists
   
4. Drug Manufacturers
   
5. The Irish Pharmaceutical Industry.

If you answered 4 or 5 you are correct.

wmpdd3

I though it was part of the HSE, interesting.

bureau2009

Xterminator wrote: »

PS there are a handful of pharmacies which voluntarily change their private script patients the same price as their medical card patients.

X

How can we find out about this handful of pharmacies? We'd all love to know who and where they are, because we're all careful consumers here.

ceegee

mathepac wrote: »

Xterminator wrote: »

the importation and wholesale distribution of drugs in ireland is controlled and licened by the IMB. They effectively prevent cross importing, from cheaper sources by wholesalers or pharmacy chains....

Please complete the following question.

The Irish Medicines Board, IMB, is funded and run by :

1. The Department for Health & Children on behalf of the citizens
   
2. A Panel of Irish Consumers
   
3. Medical Professional & Qualified Pharmacists
   
4. Drug Manufacturers
   
5. The Irish Pharmaceutical Industry.

If you answered 4 or 5 you are correct.

In what way do drug manufacturers run the IMB ? Or do you just mean its partly funded by the license fees paid by pharma companies, in addition to exchequer funding? Also your answer seems to imply that pharmacists and other medical professionals arent involved in running the IMB. Care to clarify this?

mathepac

ceegee wrote: »

In what way do drug manufacturers run the IMB ? Or do you just mean its partly funded by the license fees paid by pharma companies, in addition to exchequer funding? Also your answer seems to imply that pharmacists and other medical professionals arent involved in running the IMB. Care to clarify this?

You seem to imply that you are adequately resourced to answer your own questions, so why should I bother? Don't forget all the detail ...

ceegee

mathepac wrote: »

You seem to imply that you are adequately resourced to answer your own questions, so why should I bother? Don't forget all the detail ...

Fine, I'll put it another way, your little pop quiz, and the "correct" answers you give were inaccurate and deliberately trying to mislead those who read them. By declaring that Drug Manufacturers and The Irish Pharmaceutical Industry run and fund the IMB you ignored the fact that

(a) not all funding is received through license fees etc - It is also publicly funded

(b) the minister for health appoints the IMB board and its advisory committees

keithclancy

ceegee wrote: »

Fine, I'll put it another way, your little pop quiz, and the "correct" answers you give were inaccurate and deliberately trying to mislead those who read them. By declaring that Drug Manufacturers and The Irish Pharmaceutical Industry run and fund the IMB you ignored the fact that

(a) not all funding is received through license fees etc - It is also publicly funded

(b) the minister for health appoints the IMB board and its advisory committees

Yeh, but the prices pretty much are dictated by the Pharma companies.

Go to any Doctors surgery and they'll have pens, notepads and all sorts of stuff from them.

Northern Monkey

Just curious, I am on long term medication prescribed by my consultant in Dublin, but I travel to Northern Ireland most weekends (I'm from there). Would I be able to take my prescription from Dublin and get it fulfilled in Northern Ireland? Or would it have to be prescribed by a doctor/consultant in the UK?

MadamX

I've had a private GP prescription filled in the pharmacy in the Quays shopping center in Newry - no problem and much cheaper.

Nonoperational

The price the drug company charges for the drug is different in Ireland and the UK.

But lets forget about all logic. It was me. Every time you buy your Lyrica I go for a champagne and Lobster dinner... :pac::pac::pac:

mathepac

gpf101 wrote: »

The price the drug company charges for the drug is different in Ireland and the UK. ...

Consistently lower by a large margin for all drugs sold in the UK than here in Ireland where they are manufactured.

Is the retail price of drugs heavily subsidised by the Government in the UK?

Is the NHS a better negotiator than the HSE?

If Ireland is a high-expense manufacturing economy (labour & energy costs, insurance, transport, etc) how come we can export products that are sold at a lower retail price abroad, while still maintaining distributor and retailer margins, while also paying licensing and transport costs?

nua domhan

Xterminator wrote: »

the importation and wholesale distribution of drugs in ireland is controlled and licened by the IMB. They effectively prevent cross importing, from cheaper sources by wholesalers or pharmacy chains.

the wholesaler markup is as low as 2% on some medicines as recent price changes in the sector have squeezed their margins hard.


the pharmacies have agreed markups for scripts handed in by medical card holders, as the government set these prices.

however they can charge whatever they like to private patients scripts.

as an example i purchased a bottle of betnesol eye drops from a pharmacy last year.

Wholesale price is approx 2.50 ex vat. ( i have access to these prices).

I paid 12 euros in the pharmacy. they stuck a sticker on the bottle, that was their contributions, and they got a 400% + mark-up for that action.

Their "contributions" is to make sure you get the right medication. GP prescribing error rates are between 6-10% in some cases (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)62104-8/fulltext)

When you factor in the pharmacist checking your medication against medications you've had in the past, the dose is right, the formulation is right, the length of treatment and condition it's treating is right, then that error rate drops to below 0.01%

In this study 2.2% of the prescribing errors would have been fatal to the children (http://adc.bmj.com/content/early/2012/02/21/archdischild-2011-301239.abstract). I myself have been involved in stopping medications reaching the patient which would have at the very least, been harmful and in a few cases may have caused hospitalisation. (Really earning that 2% mark-up hey). Factor in those costs to the HSE :P


I accept that Betnesol may not have been the most dangerous of medications, but the pharmacist would have picked up while dispensing it if you were on any other drops for Glaucoma or high intra-occular pressure - which when used together could damage your sight - I assume you weren't.

Just because all you see is a label on a box or a bottle doesn't mean nothing is happening - alot of what's done is mental checking again and again. You think we spent 5 years training to learn how to stick labels on? I assume you've never went into a pharmacy for FREE advice instead of paying the €50 euro to be told your GP you only need OTC meds and bed-rest? Or you've never popped in for some FREE advice about side-effects of your medications, or FREE blood pressure check or FREE collection and delivery of your medicines?

Finally, where exactly are you getting your price for betnesol at 2.50?? Was this price recent or a while back. A large chain or a small independant. If the pharmacy are charing you €12 their cost price was more than likely around €8-9

Xterminator wrote: »

PS there are a handful of pharmacies which voluntarily change their private script patients the same price as their medical card patients.

They may change prices cheaper once or twice to increase good will, but believe me, no business would stay open for long if they were relying on the mark up from medical card scripts.

nua domhan

keithclancy wrote: »

Yeh, but the prices pretty much are dictated by the Pharma companies.

Go to any Doctors surgery and they'll have pens, notepads and all sorts of stuff from them.

There's also always stories floating around about GP's receiving incentives (bonuses, cars, holidays etc) for prescribing one drug companies product over another. You can always tell when a rep's been round to the surgery when all of a sudden you're getting scripts for the same thing.

All rumours though - there's absolutely no way GP's would prescribe something as a bonus for themselves, it's probably just a co-incidence.

mathepac

nua domhan wrote: »

...
All rumours though - there's absolutely no way GP's would prescribe something as a bonus for themselves, it's probably just a co-incidence.

I know for a fact that the educational days for new drug releases are held in local community centres and parish halls. The idea of flying doctors to golf weekends in resorts in Spain & Portugal is just too ridiculous for words. And as for taking an entire mental-health team out for lunch or dinner, I mean to say what would that achieve?

nua domhan

mathepac wrote: »

I know for a fact that the educational days for new drug releases are held in local community centres and parish halls. The idea of flying doctors to golf weekends in resorts in Spain & Portugal is just too ridiculous for words. And as for taking an entire mental-health team out for lunch or dinner, I mean to say what would that achieve?

yes, totally ridiculous, never happens.

http://m.guardian.co.uk/world/2007/oct/31/international.mainsection1?cat=world&type=article

Ever.....

http://abcnews.go.com/m/story?id=131602

Xterminator

nua domhan wrote: »

Finally, where exactly are you getting your price for betnesol at 2.50?? Was this price recent or a while back. A large chain or a small independant. If the pharmacy are charing you €12 their cost price was more than likely around €8-9
They may change prices cheaper once or twice to increase good will, but believe me, no business would stay open for long if they were relying on the mark up from medical card scripts.

2.50 was the unit price ex vat, in one of the major wholesalers. TBH i accept there is a value add to the service a pharmacist provides. but surely there should be a set (and transparent) fee for filling a script?

Pharmacists are not transparent as to their pricing policies. Pharmacists dont publish a list of prices as a rule.

Nor do i accept that its costs a pharmacy any more to fill a private script than a medical card one.

The pharmacists currently have the customer over a barrell.

Basically they can change whatever they like, and i dont accept it. like 1000's of others i now purchase my OTC goods in batches from chemistdirect.