Pharmacy question.

UrbanFox

My GP writes a prescription for 30 of a regular/repeat medication.
The pharmacy usually dispenses 28 (4 strips of 7).
Is this proper practice or sharp practice ?

Curiously enough if the script is for antibiotics they will dispense the exact number prescribed !

Noticed something similar for a relative whose meds I was checking for him.
He has a script for Arcoxia - an NSAID that he uses as symptoms require.
His GP wrote a script for 30 Arcoxia.
The pharmacist's label shows 28 dispensed - again usually 4 strips of 7. I saw this previously to be so.
On checking the last box I find that there are 4 strips of 5. The strips are clearly manufactured that way and have not been interfered with. So he was only dispensed 20 i.e. 4 strips x 5 tablets.
He paid for 28 but only got 20 ?

ohnonotgmail

Have you mentioned this to the pharmacist?

UrbanFox

ohnonotgmail wrote: »

Have you mentioned this to the pharmacist?

Not yet. It is the local pharmacy for all in the house. I wanted to check my facts on what people think is proper practice before broaching it as the pharmacist is not entirely approachable !!

ohnonotgmail

UrbanFox wrote: »

Not yet. It is the local pharmacy for all in the house. I wanted to check my facts on what people think is proper practice before broaching it as the pharmacist is not entirely approachable !!

Not acceptable to me. If the script says 30 you should get 30. If they are giving you 28 and charging you for 30 that is even worse. I wouldnt worry about how approachable the pharmacist is. No shortage of pharmacies to go to.

UrbanFox

Yes, I agree with you totally and we are thinking about shifting elsewhere. I just wanted to check if this situation was normal practice and likely to happen again !!!

JOSman

There are only 28 days in a month and 13 months in a year (that's a pharma year).

ohnonotgmail

JOSman wrote: »

There are only 28 days in a month and 13 months in a year (that's a pharma year).

doesnt matter. they should dispense what is on the script.

pilly

My father had uproar with a couple of pharmacists about this before he got the right one. If you're paying the €144 per month charge they should be dispensing the amount of days in each month and not 28. If they only dispense 28 then you've to pay the €144 thirteen times instead of 12.

Insist on the correct amount.

witchgirl26

I've never had that. The packs are often a 28 day pack for certain meds but my pharmacy would always have an open box they'd cut 2 out from & put into the box if the script said 30 days. It also gave a little bit of a grace period for me getting my meds each month. I'd casually mention it to them and gauge the reaction. Maybe they honestly didn't see it as a problem.

Miaireland

Had this problem with my local pharmacist. He claim that it was the way the boxes are packaged.

Former Former

UrbanFox wrote: »

My GP writes a prescription for 30 of a regular/repeat medication.
The pharmacy usually dispenses 28 (4 strips of 7).
Is this proper practice or sharp practice ?

Curiously enough if the script is for antibiotics they will dispense the exact number prescribed !

Noticed something similar for a relative whose meds I was checking for him.
He has a script for Arcoxia - an NSAID that he uses as symptoms require.
His GP wrote a script for 30 Arcoxia.
The pharmacist's label shows 28 dispensed - again usually 4 strips of 7. I saw this previously to be so.
On checking the last box I find that there are 4 strips of 5. The strips are clearly manufactured that way and have not been interfered with. So he was only dispensed 20 i.e. 4 strips x 5 tablets.
He paid for 28 but only got 20 ?

It's not sharp practice - it's just a reflection of the pack sizes that different drugs come in. If you ask for 30, you'll be given 30.

I used to be a pharmacist, long ago, and some people would want the extra two tablets, others would hate it because you have to cut two tablets off the end of one strip, stick it in the box and they were easily lost. Or some people would be on treatments that have to be given in 28s, (e.g. the pill or HRT) so it made no sense to give an extra two for other drugs.

Your pharmacist should have no problem giving you the extra two tablets (unless there's a good reason not to)

For antibiotics; you have to dispense the exact number of antibiotics because that's a defined course of treatment. The pack sizes are usually designed to give you the number you need, e.g. they come in 14- or 21-tablet packs.

Arcoxia comes in similarly sized 20 packs and 28 packs, the pharmacist probably just picked up the wrong box.

ohnonotgmail

Former Former wrote: »

It's not sharp practice - it's just a reflection of the pack sizes that different drugs come in. If you ask for 30, you'll be given 30. I used to be a pharmacist, long ago, and some people would want the extra two tablets, others would hate it because you have to cut two tablets off the end of one strip, stick it in the box and they were easily lost.

Your pharmacist will have no problem giving you the extra two tablets.

You have to dispense the exact number of antibiotics because that's a defined course of treatment. The pack sizes are usually designed to give you the number you need, e.g. they come in 14- or 21-tablet packs.

Arcoxia comes in similarly sized 20 packs and 28 packs, the pharmacist probably just picked up the wrong box.

if the script says 30 then they have asked for 30.

Former Former

ohnonotgmail wrote: »

if the script says 30 then they have asked for 30.

Sorry, I meant "ask" in a "talk to the human being standing across the counter from you" kind of way.

Technically too, since each strip of tablets usually only has the batch number and expiry printed on one end, the pharmacist isn't supposed to cut them at all, but now we're getting into some grade-A specifics.

FreshCoffee

I pick up medicine for an elderly relative. Monthly prescription always has 30 tablets (blood pressure). Box is always 28 & pharmacist ALWAYS adds 2 tablets cut from another strip to conform to what is prescribed. Frankly I wouldn't find anything else acceptable. Someone above says as a pharmacist "some people want the extra 2 tablets". It's clearly not 'extra' tablets. 'extra' tablets would be issuing more than what is prescribed. A fundamental aspect of pharmacist training is based on the need to be very exact and precise on dispensing. I wouldn't go near a pharmacist who cannot meet that standard. If they are sloppy in one area you can be sure they are sloppy in other areas too.

quadrifoglio verde

pilly wrote: »

My father had uproar with a couple of pharmacists about this before he got the right one. If you're paying the €144 per month charge they should be dispensing the amount of days in each month and not 28. If they only dispense 28 then you've to pay the €144 thirteen times instead of 12.

Insist on the correct amount.

You should only pay 12X144 lots under the DPS.
The PCRS who reimburses the pharmacy takes account that some months have 30, others have 31 and one has 28.
As a result, they will allow two months supply of medication (they have to go through at the start and end of the same month) go through for reimbursement in the same month once a year.

As for dispensing in 28 day packs, as a rule you dispense in the original pack size. Most come in 28 day packs. Some come in 30. Adding to the pack size can just lead to an increase risk of error. Personally I'd prefer if the manufacturers would supply everything in 30 day packs

L1011

pilly wrote: »

My father had uproar with a couple of pharmacists about this before he got the right one. If you're paying the €144 per month charge they should be dispensing the amount of days in each month and not 28. If they only dispense 28 then you've to pay the €144 thirteen times instead of 12.

Insist on the correct amount.

The month you end up getting two will have a single 144 cap. If you're going over that you get the second set free. This is set by the state and enforced in dispensing software.

If they managed, somehow, to charge you and give you a receipt for 144 they wouldn't be reimbursed by the state for the rest as the claim would be processable.

AndrewJRenko

My pharmacist issues 28 and charges for 28, but will issue a 13th month in the year if asked, which puts off going back to the doc until absolutely necessary.

pilly

L1011 wrote: »

The month you end up getting two will have a single 144 cap. If you're going over that you get the second set free. This is set by the state and enforced in dispensing software.

If they managed, somehow, to charge you and give you a receipt for 144 they wouldn't be reimbursed by the state for the rest as the claim would be processable.

I'm glad by the sounds of this thread that some pharmacists seem to understand this but I'm telling you for a fact that they were attempting to charge him 13 times. That's what started off a whole rigmarole of changing pharmacists. No way would they give him 2 prescriptions in one month without him paying the 144 again, totally insisted on it. And he never got that 144 back either.

ohnonotgmail

pilly wrote: »

I'm glad by the sounds of this thread that some pharmacists seem to understand this but I'm telling you for a fact that they were attempting to charge him 13 times. That's what started off a whole rigmarole of changing pharmacists. No way would they give him 2 prescriptions in one month without him paying the 144 again, totally insisted on it. And he never got that 144 back either.

the cap is 144 per calendar month.

Former Former

FreshCoffee wrote: »

I pick up medicine for an elderly relative. Monthly prescription always has 30 tablets (blood pressure). Box is always 28 & pharmacist ALWAYS adds 2 tablets cut from another strip to conform to what is prescribed. Frankly I wouldn't find anything else acceptable. Someone above says as a pharmacist "some people want the extra 2 tablets". It's clearly not 'extra' tablets. 'extra' tablets would be issuing more than what is prescribed. A fundamental aspect of pharmacist training is based on the need to be very exact and precise on dispensing. I wouldn't go near a pharmacist who cannot meet that standard. If they are sloppy in one area you can be sure they are sloppy in other areas too.

By "extra", I meant "the two tablets, in addition to the 28 that are in the original pack". I wasn't impugning anyone's constitutional right to a round number of tablets.

It's not sloppiness on the part of the pharmacist. In fact, as I explained above, it's the more correct way of doing it for many drugs.

These things can usually be solved with a simple request to the pharmacist.

pilly

ohnonotgmail wrote: »

the cap is 144 per calendar month.

That's exactly my point, don't know why you're making it again for me.

coylemj

I was also on medication for a while a few years back, chemist gave me 30 every month which included a box with 2 x 14 pill cards plus two pills snipped off another pack, it can easily be done. Tell the chemist you know it can be done and if he doesn't agree, move your business.

quadrifoglio verde

coylemj wrote: »

I was also on medication for a while a few years back, chemist gave me 30 every month which included a box with 2 x 14 pill cards plus two pills snipped off another pack, it can easily be done. Tell the chemist you know it can be done and if he doesn't agree, move your business.

It can be done. On a 10 item script its a monumental pain the arse, especially as it brings in added dispensing risks.
I've lost count how many times I've seen someone pick up two strenghts of the same tablet, or a controlled release version instead of an instant release to add in 2 extra tablets.

daheff

pilly wrote: »

My father had uproar with a couple of pharmacists about this before he got the right one. If you're paying the €144 per month charge they should be dispensing the amount of days in each month and not 28. If they only dispense 28 then you've to pay the €144 thirteen times instead of 12.
Insist on the correct amount.

pilly wrote: »

I'm glad by the sounds of this thread that some pharmacists seem to understand this but I'm telling you for a fact that they were attempting to charge him 13 times. That's what started off a whole rigmarole of changing pharmacists. No way would they give him 2 prescriptions in one month without him paying the 144 again, totally insisted on it. And he never got that 144 back either.

Sounds like you know they are wrong but are willing to accept it. You know you are not tied to a pharmacy for the DPS scheme? If you were to get two perscriptions in the same month you can provide your details to both pharmacies and the second time if they call the first pharmacy most will not charge you (and the ones that do, you can claim back).

But somebody knowingly charging you the 144e twice in a month is taking the piss and should be reported.



for the OP's question, if you are prescribed X amount then thats the amount you should get. Its like asking for a six pack of beer and getting 5.

quadrifoglio verde

daheff wrote: »

Sounds like you know they are wrong but are willing to accept it. You know you are not tied to a pharmacy for the DPS scheme? If you were to get two prescriptions in the same month you can provide your details to both pharmacies and the second time if they call the first pharmacy most will not charge you (and the ones that do, you can claim back).

I have yet to come across any pharmacy that will do this. The PCRS system has no way of telling any other pharmacy if Joe Bloggs has already paid 144 that month. Just like the PCRS system has no way of telling if Joe Bloggs Snr has gone over his GMS levies for the month.

I do agree on the second part however, that if you pay more than 144 a month in a number of pharmacies and have a DPS card, you can claim it back. It also applies for the rental of sleep apnea machines

daheff

quadrifoglio verde wrote: »

I have yet to come across any pharmacy that will do this. The PCRS system has no way of telling any other pharmacy if Joe Bloggs has already paid 144 that month. Just like the PCRS system has no way of telling if Joe Bloggs Snr has gone over his GMS levies for the month.

I do agree on the second part however, that if you pay more than 144 a month in a number of pharmacies and have a DPS card, you can claim it back. It also applies for the rental of sleep apnea machines

they do in my town anyways. might be they have some agreement.

quadrifoglio verde

daheff wrote: »

they do in my town anyways. might be they have some agreement.

Strange. Unless its owned by the same people (more common than you'd think).
There is no way of claiming for DPS until it goes over 144 and they only make up the difference between what youve paid on the 144 and what the drugs cost plus fee is.

Lau2976

daheff wrote: »

they do in my town anyways. might be they have some agreement.

Would that not be a data protection issue? I don't think pharmacies can share your details, especially medical ones, without prior consent.

L1011

Lau2976 wrote: »

Would that not be a data protection issue? I don't think pharmacies can share your details, especially medical ones, without prior consent.

The person would have given consent to do so by asking them to do.

If they are owned by the same person (very common - I know of multiple cases; one pharmacist owning one each end of a village, I guess to keep competitors out; one pharmacist owning three on one street - two opposite each other; etc etc) it'd be treated differently too.

UrbanFox

Thanks everyone. I now have what I wanted, namely to be better informed before I try to sort this out with the pharmacy.

kellso81

I try to dispense in original boxes as much as possible, whether that's a 30 box or a 28 box without any additions or removals. Studies have shown that it's much safer. A pharmacy can be dispensing 100s of boxes of medication everyday, if you're cutting tablets from other boxes and adding them, it doubles the amount of checks you have to do, because you have to check the original box and the box you're cutting from. It also leaves lots of cut up strips of tablets that are much more difficult to check next time you're cutting more off them. It's just a much safer and much more efficient way of doing things, and is the norm in most countries in the developed world for safety reasons. On the issue of charging, if they're dispensing 28 then they get paid for 28 from the HSE whether it's 30 on the prescription or not, so they're not trying to scam a few extra quid either. As other people have said, if you have an issue with this and want 30, just ask your pharmacist, it should be no problem. You might just have to wait a little bit longer for it to be ready