Pharmacies - Price competition - Why is there none?

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gearoid

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Hi,

I've just read the Irish Pharmaceutical Unions threat of job losses in pharmacies.

To me, a reduction in the price of basic drugs, prescriptions etc. would reduce our inflation, make us more competitive and give us a better standard of living.

Why do we have to put up with this sort of anti-competitive nonsense from the IPU?

I'm sick of picking up medicines in pharmacies with Greek or Italian prices stickers underneath the Irish one for often 20%-40% of the Irish price.

One example. I picked up a cream thats on prescription here in a 30g tube for about 27 euros. In Spain this is 10.40 euros and available over the counter. In Ireland the same cream is branded differently and available OTC for 8 or 9 euros in 7.5g quantities. This equates to four times the price.

It would seem the IPU has fought every competitive practice and the government hasn't put up much fight for the consumer. In the 1980s there was the absurd limit on the number of places in university pharmacy departments and the clamour for special interviews for certain professions so that their children could get in. In the 90s and 00's we had the fight to stop allowing foreign pharmacists to practice. Now we have the fixed prices for drugs which are ludicrous.

Why cant we have open price competition for common medicines?

GIVE ANTI-COMPETITIVE PRACTICES THE BOOT!

Gearoid.
 
I agree completely. The supernormal profits made by pharmacies are obscene.
I know of one pharmacy in Dublin which employs 8 people (none of them work a full week, at most they do 32 hours) and the owner draws €40’000 per month basic salary.
 
Here's a short report made by forfas in 2004

http://www.nca.ie/eng/Research_Zone/Reports/pharmaceuticals_and_consumers.pdf

Confirms Ireland is one of the more expensive countires for medicine, however you also need to take into account that if monthly prescriptions are over €100 you are refunded the cost over this. Also, nearly all over 70's get all their prescription medicine free.

Overall, those of us who only need periodic low price medicine pay more than other countries (don't forget all costs are tax deductible!!) whereas those of us that need high priced drugs are probably better off than other countires.

Margins on medicines is 33% for retailers & 15% for wholesalers.
 
mcaul said:
Confirms Ireland is one of the more expensive countires for medicine, however you also need to take into account that if monthly prescriptions are over €100 you are refunded the cost over this. Also, nearly all over 70's get all their prescription medicine free.

Overall, those of us who only need periodic low price medicine pay more than other countries (don't forget all costs are tax deductible!!) whereas those of us that need high priced drugs are probably better off than other countires.
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This looks like a pharmacists POV. Your points about the refunds over €100, free for over 70's and tax deductibles are all correct - but you forget to mention that these are real costs going from the state into the pharmacists pocket. The patient may not pay, but the pharmacist gets the money either way.
 
If I have a script for something that cost say €10, and its available OTC at say €7, the pharmacist will always tell me and says that it'd be cheaper not to use the Prescription.
 
Smashbox said:
If I have a script for something that cost say €10, and its available OTC at say €7, the pharmacist will always tell me and says that it'd be cheaper not to use the Prescription.
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If you have a script for 75mg uncoated aspirin, which costs about €6 for 1 month's supply, does he tell you to get someone to pick up a bottle in the States for about $2 for six months supply?
 
Pharmacists are running an uncompetitive restrictive monopoly - this is what the disputes in the papers are all about.

Pharmacists think that having a pharmacy degree automatically entitles them to be well paid business operators who own their own shops. I personally dont see the reason the system equates having a pharmacy degree and running a business - they are both very different skill sets.

If it werent for the restrictions, then every supermarket would have a pharmacy counter maned by PAYE pharmacists dispensing medicines at a fraction of the cost of standalone pharmacies. PAYE pharmacists would probably be paid the going rate for a professional with a degree which would be above the average wage, but not as much as the 100,000s or even 1,000,000s that can be made in the current monopoly.
 
Factory gate prices set by Govt in negotiation with manufacturers.

Govt allow a 17.64% wholesale margin to the 3 wholesalers and reimburse the pharmacy 117.64 for every 100 euro drugs.

Wholesalers can't compete on price, so give rebates/discounts out of the 17.64% back to the pharmacy.

Pharmacy then adds 50% retail margin for the DPS scheme.

No retail margin on the medical card.

Also a fee for each dispense, approx. 3.50-5.00.
 
Govt plans:

1) Reduce the factor gate prices - DONE

2) Reduce the reimbursement rate to 8% or 9%, i.e. give the pharmacy 108 for every 100 euro of drugs, meaning a lower wholesale margin.

They tried this last year, pharmacies went to court for breach of contract.

3) Change the retail margin and fee structure - IN THE NEWS TODAY.
 
Not quite. Factory gate prices agreed between IPHA and Government at higher levels than Spain or Greece due to some derogation they get because of lack of intellectual property rights. Wholesalers sell to pharmacies at 17.66% mark-up. Pharmacies negotiate a discount with wholesalers for early payment, electronic ordering. Margin on DPS 33.33% (mark-up 50%) , GMS 0% + dispensing fee. While there is an argument for some rebalancing and reductions the current cuts going to come in will be catastrophic and will result in many, many pharmacies failing and falling service levels. A pharmacist.
 
Good question it's something that i have never even thought about. I suppose if your ill and need medicine you just go to the nearest place.

My daughter had to go to the doctor last week, doctor was 60 euro and the medicine was 33 euro. The last thing on my mind was where am i going to get these for the cheapest price. Thats why they dont need to be competative, they dont need to be, people have and will always pay. It wouldn't of mattered if the pharmacy wanted to charge me 200 euro i still would of paid it.

Is it legal to bring back medicines from foreign countries? When ever i go away i always bring back what ever i can to fill the cupboards, such as asprin, cough medine, creams for burns ect ect. Is there a certain limit your allowed to bring back.
What about ordering them online? I dont mean from just anywhere but from a pharmacy, are you allowed to do that. Of course if you could wait for it to arrive.

It's very likely that by daughter will need another prescription to fully clear up her infection, too late to do it now but if you knew you needed it in the next week or so is there anything stopping you from ordering it elsewhere and having it posted out to you?
 
Complainer said:
If you have a script for 75mg uncoated aspirin, which costs about €6 for 1 month's supply, does he tell you to get someone to pick up a bottle in the States for about $2 for six months supply?
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No, because I dont get to travel to America every week
 
Complainer said:
If you have a script for 75mg uncoated aspirin, which costs about €6 for 1 month's supply, does he tell you to get someone to pick up a bottle in the States for about $2 for six months supply?
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Hi complainer. As a pharmacist, I used to sell aspirin 75mg over the counter without a prescription, which is cheaper (currently!) than dispensing it. However, the Irish Medicines Board (not to be messed with!) changed the regulations to make this illegal, and it can now only be bought with a prescription. The reason for this is that anyone who takes this medicine is on it to reduce their platelet count, i.e. thin their blood in order to reduce the possibility of clots occurring which could lead to strokes, heart attacks, deep vein thromboses etcetera. The 75mg dose isn't strong enough for pain relief, and is also coated to reduce potential stomach upset. Therefore, the logic is - anyone who is on this seemingly simple and old-fashioned medication should be on it for a very good reason and not just because they feel like it. Therefore, the IMB feel it should only be dispensed on prescription in to encourage patients who use it to get a check-up from their GP or cardiologist or whoever (in real life - not online!) every 6 months.

If, however somebody comes into my shop and is vocal and irritating enough about the price of the aspirin - I'll sell it to them for a quiet life. They are adults after all - and I'll explain the logic of not selling it without prescription - but they probably won't listen.
 
gearoid said:
Hi,

I've just read the Irish Pharmaceutical Unions threat of job losses in pharmacies.
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You probably read about the brutal cuts being imposed too then:The following are the precise measures the Minister has decided:

  • (a) re-balance the amounts paid in respect of, on the one hand, the GMS and, on the other hand, the Drugs Payments Scheme, Long Term Illness Scheme and other community drugs schemes, by:
    • (i) introducing a new higher dispensing fee structure for the schemes based on a sliding scale as follows: €5 for first 20,000 items, €4.50 for next 10,000 items and €3.50 for the remaining items; and
    • (ii) reducing from 50% to 20% the retail mark-up payable under the community drugs schemes (no mark-up is payable under the GMS); In these two measures, the Minister is responding to concerns expressed by pharmacists that medical card dispensing is cross-subsidised by the retail mark-ups on the other schemes. This should benefit pharmacies with relatively more medical card patients, for example, those serving poorer areas.

  • (b) end a special payment to pharmacists in relation to the automatic entitlement of persons over 70 to a medical card, as that entitlement has been ended; and

  • (c) reduce the ‘wholesale mark-up’ reimbursement price paid for delivery of drugs to community pharmacies, from 17.66% to 10%. This mark-up was intended to pay for wholesale distribution costs but it is almost double the European average for this type of service. Approximately half of this mark-up is being passed back by wholesalers to pharmacists by way of discounts.
The measures will be given effect through Regulations to be issued by the Minister in due course. It is intended to implement them with effect from 1 July.

5,000 jobs isn't a threat, its an unavoidable conclusion.
 
csirl said:
If it werent for the restrictions, then every supermarket would have a pharmacy counter maned by PAYE pharmacists dispensing medicines at a fraction of the cost of standalone pharmacies. PAYE pharmacists would probably be paid the going rate for a professional with a degree which would be above the average wage, but not as much as the 100,000s or even 1,000,000s that can be made in the current monopoly.
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What restrictions?
 
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