I paid €50 in secret dispensing fees on a DPS €124 prescription. Calculate your fees!

paddy19

I paid almost €50 in secret Pharmacy dispensing fees, on a DPS €124 private prescription.

Calculate your fees!

My DPS HSE receipt showed a total price, no individual prices for the five items, no dispensing fees.

My friendly pharmacist got very defensive when I asked about his dispensing fees for my DPS prescription.
They vary he told me. Later, his locum point blank refused to tell what the dispensing fees were, he claimed it was not available on the computer.

So it being Covid time and not much on the tele I did some digging.

There is a 5 digit drug code on the white HSE receipt form for each Drug/Brand/Dose/Quantity.

I was surprised to find that the HSE publish a handy searchable list of prescription reimbursable prices, (all 7,458 of them) using the drug code.

https://www.sspcrs.ie/druglist/pub You can even download the lot into excel if fancy sorting it.

You can work out the dispensing fees by getting the individual drug prices from the web using the drug codes and adding them up.

Drug Code X5XXX. €11.63
Drug Code X5XXX. € 6.34
Drug Code XX9XX. €10.68
Drug Code XXX5X. €14.04
Drug Code 3XXXX. €31.64

Total € 74.33

Total Charged €124


Calculated Total dispensing fees: €49.67.
(Individual prices and codes changed to maintain privacy, totals are actual.)

The HSE form is aptly titled GMS 007, a good number for a form that contains secrets!

If other boardies could get or calculate the secret fees be interesting to see if there is any competition between different Pharmacists.

sundodger5

Is the reimbursement price not a totally different thing to a dispensing charge?

Bikerman2019

You talk about the GMS scheme. Is that not where you have a medical card and are getting your drugs for free. The dispensing fees are what the chemist gets for their services and payment for their staff? They don't get anything for the drugs as they just pass them on to you?



Accordingly, the fees you quote may not be relevant for a private customer and may not be appropriate in this case.

stezie

And the drug reimbursement scheme doesn't factor in this dispensing fee.. You can't get drugs without paying this fee .

Since noticing this I get my scripts in the North.

The cost of the drug should include any charges relating to acquiring the drugs, including dispensing..

What ever is next, a checkout fee at the supermarket?

L1011

GMS fees have nothing to do with private pricing so you may as well ignore that listing - it tells you absolutely nothing.

Your DPS receipt should show the cost per item but it doesn't not break that down in any way.

There is quite significant competition between pharmacies, in certain areas at least, for private prescription pricing. Phone around and ask; just maybe not on the first entirely normal working day after Christmas when its busy and you'll have a higher % of locum staff.

Bikerman2019

This is the point I was getting at. If they sell drugs to a private prescription, they get whatever their margin is and maybe a dispensing fee. If it is free drugs, paid for by the HSE, then they get a dispensing fee for their services. I do not believe your point is relevant and is misplaced.

duffman13

paddy19 wrote: »

I paid almost €50 in secret Pharmacy dispensing fees, on a €124 private prescription.

Calculate your fees!

My HSE receipt showed a total price, no individual prices for the five items, no dispensing fees.

My friendly pharmacist got very defensive when I asked about his dispensing fees for my private prescription. They vary he told me. Later, his locum point blank refused to tell what the dispensing fees were, he claimed it was not available on the computer.

So it being Covid time and not much on the tele I did some digging.

There is a 5 digit drug code on the white HSE receipt form for each drug/pack/dose.

I was surprised to find that the HSE publish a handy searchable list of prescription reimbursable prices, (all 7,458 of them) using the drug code.

https://www.sspcrs.ie/druglist/pub

You can work out the dispensing fees by getting the individual drug prices from the web using the drug codes and adding them up.

Drug Code X5XXX. €11.63
Drug Code X5XXX. € 6.34
Drug Code XX9XX. €10.68
Drug Code XXX5X. €14.04
Drug Code 3XXXX. €31.64

Total € 74.33

Total Charged €124


Calculated Total fees: €49.67.
(Individual prices and codes changed to maintain privacy, totals are actual.)

The HSE form is aptly titled GMS 007, a good number for a form that contains secrets!

If other boardies could get or calculate the secret fees be interesting to see if there is any competition between different Pharmacists.

That's a reimbursement amount pharmacies get for dispensing meds on schemes from the government. Applying them to a private prescription without comparing brands is somewhat pointless. Even on a government scheme like DPS, the pharmacy is paid the reimbursement amount plus €5 per item.

Ask for a price for products and then go to another pharmacy and ask for a price.

Also DPS limit is now €114 so get a card

stezie

duffman13 wrote: »

That's a reimbursement amount pharmacies get for dispensing meds on schemes from the government. Applying them to a private prescription without comparing brands is somewhat pointless. Even on a government scheme like DPS, the pharmacy is paid the reimbursement amount plus €5 per item.

Ask for a price for products and then go to another pharmacy and ask for a price.

Also DPS limit is now €114 so get a card

A DPS Card wont help in the OP's example.. As the DPS limit is now €114, they will only recognise the € 74.33. They wont calculate a refund including the dispensing fee. I queried this a few years back. Sent a written letter asking clarification on why the full cost of acquiring the drugs was not factored in to the reimbursement..

You would need to spend more than €114 on the drugs alone to get anything back.. So in this case, if the drugs cost €115 and the dispensing fee was still €50, you would only get a refund of €1 on your €165 spend in the pharmacy( plus what ever the GP needs to consult and the script).. Some system..

L1011

stezie wrote: »

A DPS Card wont help in the OP's example.. As the DPS limit is now €114, they will only recognise the € 74.33. They wont calculate a refund including the dispensing fee. I queried this a few years back. Sent a written letter asking clarification on why the full cost of acquiring the drugs was not factored in to the reimbursement..

You would need to spend more than €114 on the drugs alone to get anything back.. So in this case, if the drugs cost €115 and the dispensing fee was still €50, you would only get a refund of €1 on your €165 spend in the pharmacy( plus what ever the GP needs to consult and the script).. Some system..

That's not how DPS works. At all.

DPS covers the cost of the medication and a margin. Some pharmacies charge higher margins to non-DPS customers, leading to an odd situation where you're paying (just under) €114 for a months drugs privately, then get an additional drug added and are still paying about €114 with no state involvement as you're now paying the DPS price - this is a slightly convoluted thing to explain, my first attempt there definitely didn't make sense.


Were you making a retrospective claim on the DR, not DPS scheme by any chance? This pays what the state would have paid, even if you paid more.

The Hound Gone Wild

These's are reimbursement fees paid by the government to pharmacies for medication dispensed through the various medical schemes.

They are not cost price references and they do not include VAT (applicable on non-oral drugs/medical devices). As a general rule of thumb a dispensing fee is somewhere in the region of €4-6 per item. The margin on prescription drugs is tiny so dispensing fees pay overheads for the Pharmacy.

stezie

L1011 wrote: »

That's not how DPS works. At all.

DPS covers the cost of the medication and a margin. Some pharmacies charge higher margins to non-DPS customers, leading to an odd situation where you're paying (just under) €114 for a months drugs privately, then get an additional drug added and are still paying about €114 with no state involvement as you're now paying the DPS price - this is a slightly convoluted thing to explain, my first attempt there definitely didn't make sense.


Were you making a retrospective claim on the DR, not DPS scheme by any chance? This pays what the state would have paid, even if you paid more.

I went to GP, got a prescription, went to a pharmacy, payed for the drugs, submitted the receipts to the DPS and they write a cheque. Minus the €124( this was 4 or so years ago) the cheque was €17 short to what I was expecting. I queried this shortfall. I was €141 out of pocket on drugs that month...

I was told that the DPS do not pay for the pharmacy overheads, including dispensing fees. The price the pharmacy charges you is not necessarily the same figure that the DPS has on their register for refund. This was at a large pharmacy chain... not mentioning name, as I don't know if its allowed. I was advised to query this €17 with the pharmacy.

The DPS only calculate the refund on the list price on : https://www.sspcrs.ie/druglist/pub

L1011

stezie wrote: »

I went to GP, got a prescription, went to a pharmacy, payed for the drugs, submitted the receipts to the DPS and they write a cheque. Minus the €124( this was 4 or so years ago) the cheque was €17 short to what I was expecting. I queried this shortfall. I was €141 out of pocket on drugs that month...

I was told that the DPS do not pay for the pharmacy overheads, including dispensing fees. The price the pharmacy charges you is not necessarily the same figure that the DPS has on their register for refund. This was at a large pharmacy chain... not mentioning name, as I don't know if its allowed. I was advised to query this €17 with the pharmacy.

The DPS only calculate the refund on the list price on : https://www.sspcrs.ie/druglist/pub

That's the DR scheme, then, repayment. You were repaid what the state would have paid on the DPS and then given a really, really bad explanation as to why.

DPS cards do not work the way you are suggesting, at all. You pay at most €114 a month at point of sale; unless you are getting an exceptionally rare medication that is not DPS nor covered by another scheme. If a pharmacy charges a higher margin to private patients - which you were in this case - that's irrelevant.

Get a DPS card and this issue won't recur. For anyone who does not have a DPS card and has >€114 to buy, request a DPS emergency registration at the pharmacy.

paddy19

duffman13 wrote: »

That's a reimbursement amount pharmacies get for dispensing meds on schemes from the government. Applying them to a private prescription without comparing brands is somewhat pointless. Even on a government scheme like DPS, the pharmacy is paid the reimbursement amount plus €5 per item.

Ask for a price for products and then go to another pharmacy and ask for a price.

Also DPS limit is now €114 so get a card

The Hound Gone Wild.
"As a general rule of thumb a dispensing fee is somewhere in the region of €4-6 per item. "

Bikeman 2019
"You talk about the GMS scheme. Is that not where you have a medical card and are getting your drugs for free. The dispensing fees are what the chemist gets for their services and payment for their staff? They don't get anything for the drugs as they just pass them on to you?

Accordingly, the fees you quote may not be relevant for a private customer and may not be appropriate in this case."

I have a DPS card but my pharmacist is charging hefty dispensing fees way higher than the €5 you are quoting because I am not going over the €114 limit per month.

The reimbursement price is the max price the HSE will allow for €114 monthly limit so it is highly relevant.

The drug code is specific to the Brand/Dose/Quantity.

Why won't the pharmacists show the dispensing fees on the DPS receipt?

L1011

Because they don't have to, basically. Its also not really of much use - if you ask a pharmacy for prices you'll know who is cheaper from that.

You should have got an individual price per drug on the receipt, though.

paddy19

L1011 wrote: »

Because they don't have to, basically.

That's the best answer yet!

The fee really matters because it seems to be only way to reduce costs.

This receipt has HSE watermarked all over it but it seems to be inadequate, misleading, and hides the secret dispensing fees.

It does not require that each item and fee be separately priced.

The total figure quoted, which can include several months supply, does not relate to the relevant monthly limit of €114.

It does not show the dispensing fee which is a max of €5 for the HSE but can be anything the pharmacist likes for me.

Other than that its bleeding brilliant.

So the ever friendly pharmacist charges me €50, double/treble the fees he charges the government (€25/€17.50) for exactly the same work.

duffman13

paddy19 wrote: »

That's the best answer yet!

The fee really matters because it seems to be only way to reduce costs.

This receipt has HSE watermarked all over it but it seems to be inadequate, misleading, and hides the secret dispensing fees.

It does not require that each item and fee be separately priced.

The total figure quoted, which can include several months supply, does not relate to the relevant monthly limit of €114.

It does not show the dispensing fee which is a max of €5 for the HSE but can be anything the pharmacist likes for me.

Other than that its bleeding brilliant.

So the ever friendly pharmacist charges me €50, double/treble the fees he charges the government (€25/€17.50) for exactly the same work.

I cant remember exactly as I'm a little removed from it now but I think there is a PSI directive that you shouldn't advertise prices. Some pharmacies (Pure etc) have been challenged on it but just kept doing it

For DPS the pharmacist will get paid €5 per item full stop.

For privates, ive seen fees of anything from cost plus €5 up to cost plus €9.50. Some old school places still charge a mark up in which case they will be really cheap for some things like cheaper meds but way more expensive for expensive items.

Shop around, chains will be most consistent for pricing but are *usually* the more expensive. I have an inhaler that I buy monthly for 42 euro. Cost price is 37 so I'm happy to pay the mark up. I've been quoted up to 67 euro for the same medication in other pharmacies. Its 100% worth shoppng around

Edit: Just to be clear, the government getting a cheaper rate is not surprising, they pay for 70% of all business that goes through the pharmacy so they can dictate the pricing structure. Shop around for yourself personally though

paddy19

I hear what your saying, but if you can afford to buy up to 9 months supply, dispensing fees of €13 which I paid become significant.

Not to be pinkie, but the HSE DPS fees are,
€5 for first 1,667 items,
€4.50 for the next 833
€3.50 for the rest.

per the 2013 act unless it's changed somewhere I can't see.

L1011

The receipt paper being HSE provided does not mean the format of the receipt is official. Most pharmacies have only one method of giving an itemised/semi-itemised receipt for a prescription and that is the dot matrix printer attached to the box of HSE branded paper. I suspect they're not meant to use it for purely private scripts, but they do.

The answer for you is the same as given at the very start - phone around for pricing and change pharmacies.

And again, the amounts the state pays are completely irrelevant.

bfa1509

I often hit the 124 threshold for DPS but I'm not sure what the lesson in this thread is. Lets say the cost of my drugs is 115euro, are chemists adding a "dispensing fee" so that it triggers the DPS - it doesn't disproportionately hit me in the pocket but the pharmacy are getting a nice bonus from the government? Or am I mistaken?

Not sure how I'd "shop around" as I don't hit the 124 that often, maybe once or twice a year.

L1011

bfa1509 wrote: »

I often hit the 124 threshold for DPS but I'm not sure what the lesson in this thread is. Lets say the cost of my drugs is 115euro, are chemists adding a "dispensing fee" so that it triggers the DPS - it doesn't disproportionately hit me in the pocket but the pharmacy are getting a nice bonus from the government? Or am I mistaken?

The DPS price is fixed between the state and pharmacies. They can't modify it.

bfa1509 wrote: »

Not sure how I'd "shop around" as I don't hit the 124 that often, maybe once or twice a year.

If you have regular meds that cost ~70 or whatever in one pharmacy they may be ~50 in another. If you're hitting 114 (as it now is) a month there is no point shopping around (either for yourself or the state)

paddy19

L1011 wrote: »

The receipt paper being HSE provided does not mean the format of the receipt is official. Most pharmacies have only one method of giving an itemised/semi-itemised receipt for a prescription and that is the dot matrix printer attached to the box of HSE branded paper. I suspect they're not meant to use it for purely private scripts, but they do.

The answer for you is the same as given at the very start - phone around for pricing and change pharmacies.

And again, the amounts the state pays are completely irrelevant.

Apologies when I said private I should have said DPS.

It's an official DPS receipt, stamped and all.

The reasons itemising the fees is important if you can now
get up to 9 months supply because of Covid for one dispensing fee.

Two pharmacists could quote you an all in price of €50 for one months supply.
One a dispensing fee of €5, the other a fee of €15.

I think the state price is relevant is that obviously pharmacists can supply the exact
same service at half the price to their biggest customer.
Normally higher volume is cheaper because it reduces some of your fixed costs.

It undermines the case that it is due to costs and is in reality just extra profits.

L1011

paddy19 wrote: »

Apologies when I said private I should have said DPS.

It's an official DPS receipt, stamped and all.

The reasons itemising the fees is important if you can now get up to 9 months supply because of Covid for one dispensing fee. Two pharmacists could quote you an all in price of €50 for one months supply. One a dispensing fee of €5, the other a fee of €15.

They could only do this if their cost prices varied hugely, and again that's really not something a consumer needs to know nor does it impact a consumer at all

The only thing that impacts a consumer is the actual price they pay; and in your unlikely example there its the same price for both.

You are never going to be told a businesses operating margins, no matter what business it is.

duffman13

paddy19 wrote: »

Apologies when I said private I should have said DPS.

It's an official DPS receipt, stamped and all.

The reasons itemising the fees is important if you can now
get up to 9 months supply because of Covid for one dispensing fee.

Two pharmacists could quote you an all in price of €50 for one months supply.
One a dispensing fee of €5, the other a fee of €15.

Where are you getting this from? As in €114 for 9 months supply? That would contravene the agreement between the PCRS and pharmacies.

Just to help clarify, are you hitting the DPS threshold every month, im not being rude BTW just trying to help as I'm getting a little confused.

paddy19

L1011 wrote: »

They could only do this if their cost prices varied hugely, and again that's really not something a consumer needs to know nor does it impact a consumer at all

The only thing that impacts a consumer is the actual price they pay; and in your unlikely example there its the same price for both.

You are never going to be told a businesses operating margins, no matter what business it is.

Its a very likely example, there are definitely Pharmacists claiming a no dispensing fee model using a subscription based service.

Pharmacists margins are visible, 20% on wholesale prices for DPS plus dispensing fees. Obviously this does not include, special deals with wholesalers.

My beef is that the fees should be visible. Virtually everyone else gives receipts that show the split between costs and labour.

paddy19

duffman13 wrote: »

Where are you getting this from? As in €114 for 9 months supply? That would contravene the agreement between the PCRS and pharmacies.

Just to help clarify, are you hitting the DPS threshold every month, im not being rude BTW just trying to help as I'm getting a little confused.

Special Covid regulations allows pharmacists to dispense 9 months supply even when prescription is for 6 months.

"- Maximum validity of prescriptions: This has increased temporarily from 6 months to 9 months from the date specified on the prescription (some restrictions continue to apply around the dispensing of Controlled Drugs); only where in the pharmacist’s professional judgement, after consultation with the patient, and if needs be the prescriber, continued treatment is required and it is safe and appropriate to do so. "

https://www.thepsi.ie/tns/news/Coronavirus/InformationforPharmacistsCOVID.aspx

No, I'm always under the €114 limit every month that's why I'm getting creamed by the €13 dispensing fees.

If I was over the €114 the €5 dispensing fee and drug prices would be fixed and the Pharmacists could not rip me off.

L1011

paddy19 wrote: »

Virtually everyone else gives receipts that show the split between costs and labour.

What other retailer shows its margins on the receipt?

paddy19 wrote: »

Special Covid regulations allows pharmacists to dispense 9 months supply even when prescription is for 6 months.

But that has no impact on the monthly DPS limit, or that DPS only applies on a month by month basis (excepting for a 13th 'month' in case of 28 day prescriptions)

You are bringing in piles of irrelevant things here.

If you are not happy with your pharmacists fees - CHANGE PHARMACIES.

paddy19

L1011 wrote: »

What other retailer shows its margins on the receipt?

But that has no impact on the monthly DPS limit, or that DPS only applies on a month by month basis (excepting for a 13th 'month' in case of 28 day prescriptions)

You are bringing in piles of irrelevant things here.

If you are not happy with your pharmacists fees - CHANGE PHARMACIES.

I'm not asking about his margins, I'm asking him to show his labour charge like anyone else, your local mechanic, plumer, lawyer, electrician, splits his bill into labour and parts. His margin is his profits, as you say none of my business.

The dispensing fee is relevant because you can now minimise it's impact by buying up to 9 months supply in one go. If the fee is €13 then it costs €117 for nine months supply if you buy every month.

Buy 9 months in one and save €104

Dav010

Only places I have seen labour itemised is on the invoice for my car service and a tender for construction. I have never seen it in retail.

duffman13

paddy19 wrote: »

Special Covid regulations allows pharmacists to dispense 9 months supply even when prescription is for 6 months.

"- Maximum validity of prescriptions: This has increased temporarily from 6 months to 9 months from the date specified on the prescription (some restrictions continue to apply around the dispensing of Controlled Drugs); only where in the pharmacist’s professional judgement, after consultation with the patient, and if needs be the prescriber, continued treatment is required and it is safe and appropriate to do so. "

https://www.thepsi.ie/tns/news/Coronavirus/InformationforPharmacistsCOVID.aspx

No, I'm always under the €114 limit every month that's why I'm getting creamed by the €13 dispensing fees.

If I was over the €114 the €5 dispensing fee and drug prices would be fixed and the Pharmacists could not rip me off.

Sorry I knew that about the extended validity of prescriptions I thought you were saying something else.

Change pharmacy would be my suggestion or go send your prescription to pure to get a price, present it to your pharmacy and see if they'll match. Honestly, most pharmacies charge cost plus 7 or 8 euro which is not bad, pure would be a euro or two cheaper in my experience. Independents are your best bet for negotiating a price, changes are reluctant to budge

https://purepharmacy.ie/pages/prescription-price-checker

paddy19

Dav010 wrote: »

Only places I have seen labour itemised is on the invoice for my car service and a tender for construction. I have never seen it in retail.

Retail does not normally charge a fee for each item you purchase.

Lets not give them any ideas!

Pharmacists claim they are not retail for prescriptions they are providing a professional service, like any of the so called professions.

L1011

paddy19 wrote: »

I'm not asking about his margins, I'm asking him to show his labour charge like anyone else, your local mechanic, plumer, lawyer, electrician, splits his bill into labour and parts. His margin is his profits, as you say none of my business.

Its a retailer. You're asking for their margin. There is no concept of labour in a retail environment.

Your mechanic, plumber, electrician is very likely making a margin on parts too; which you'll also never know.

paddy19 wrote: »

The dispensing fee is relevant because you can now minimise it's impact by buying up to 9 months supply in one go. If the fee is €13 then it costs €117 for nine months supply if you buy every month.

Buy 9 months in one and save €104

You will find out the price from any individual pharmacy when you phone them. You do not need to know - and never will know - their actual margins.


This thread is going around in circles. Just change pharmacy.