Is there a medication dispensing charge?

[Sue Ellen]

Does anyone know if pure pharmacy charge a script dispensing fee?

Think the only way you would know that is either by asking them or buying the item on a 1 month basis and see if that works out dearer than the multiple issue.

They were refusing to dispense multiple months together for me and I was wondering fi it was due to this (may not be)

That could be the Manager's way of doing things or as so many items are scarce at the moment they may not be in a position to issue it for a few months. I stopped using Tesco Pharmacy because their Manager over the pharmacists would not allow them to issue multiples any longer. That was in and around the start of Covid where lots of stuff was going scarce.

 

[Pmc365]

Are Pharmacists still encouraging patients on multiple medications to have them in a pill box as they can charge extra dispensing fees?

I always obtain six months of medication in order to reduce dispensing fees which I understand would be higher if I obtained the medication every month.

 

[odyssey06]

Are Pharmacists still encouraging patients on multiple medications to have them in a pill box as they can charge extra dispensing fees?

I always obtain six months of medication in order to reduce dispensing fees which I understand would be higher if I obtained the medication every month.

I hadn't experienced it when I was using Pure Pharmacy.
Am now with Lloyds on DPS scheme and not something I see them pushing in my branch. I remember reading media articles about it, maybe they have toned it down since then.

 

[Pmc365]

Personally I wouldn't trust community Pharmacist or their technicians to correctly place multiple daily medications in a pill box, particularly if the medication was quite potent. The same goes for Nurses in hospital drug rounds, if I was well enough and the medication was particularly potent I would ask her to bring the bottle to the bedside.
I was in an Irish public hospital a few years ago the nurse rushed in and told the patient she gave an incorrect iv infusion. I admired her honesty in admitting the mistake. The elderly patient wisely didn't tell his family when they visited as he knew they were the type to kick up a fuss.
When I was in hospital the nurse admitted they( the doctor) miscalculated the dose of an iv infusion it can easily happen. Thankfully it wasn't a particularly potent medication but imagine if it was a Chemotherapy drug. I think these are prepared by hospital pharmacists. A dosage error could result in the patients death.

 

[masterboy123]

Personally I wouldn't trust community Pharmacist or their technicians to correctly place multiple daily medications in a pill box, particularly if the medication was quite potent. The same goes for Nurses in hospital drug rounds, if I was well enough and the medication was particularly potent I would ask her to bring the bottle to the bedside.
I was in an Irish public hospital a few years ago the nurse rushed in and told the patient she gave an incorrect iv infusion. I admired her honesty in admitting the mistake. The elderly patient wisely didn't tell his family when they visited as he knew they were the type to kick up a fuss.
When I was in hospital the nurse admitted they( the doctor) miscalculated the dose of an iv infusion it can easily happen. Thankfully it wasn't a particularly potent medication but imagine if it was a Chemotherapy drug. I think these are prepared by hospital pharmacists. A dosage error could result in the patients death.

We are ethically, legally and morally obliged to inform the patients of any mistakes. That said, I am a doctor and I have never prescribed an incorrect dose of a medication in my career. However, I recall a handful number of cases where there was an error in the dispensing/administering. The healthcare professionals often carry out medication reconciliation audits to improve any deficits and hospital pharmacists are good to pick up any errors during the prescribing process
I suppose it was an exceptional day during your hospital visit and very sorry to hear your experience.

 

[arbitron]

That said, I am a doctor and I have never prescribed an incorrect dose of a medication in my career. However, I recall a handful number of cases where there was an error in the dispensing/administering.

That is not possible unless you retired immediately after graduating from medical school.

I am also a doctor and have been on drugs and therapeutics committees and patient safety committees for years. We review these types of mistakes on a weekly basis. I have also been line manager for dozens of doctors which included reviewing any clinical errors.

Every single prescriber makes mistakes on a regular basis, even the best clinicians.

 

[Pmc365]

Yes I thought that was quite a strange thing to say, that in his medical career he never made any prescription errors. It's very easy to happen.
When I was in hospital I noticed a lady going around looking at several patients drug prescription charts at the end of the beds. I enquired who she was and was informed she was the Pharmacist.

 

[masterboy123]

That is not possible unless you retired immediately after graduating from medical school.

I am also a doctor and have been on drugs and therapeutics committees and patient safety committees for years. We review these types of mistakes on a weekly basis. I have also been line manager for dozens of doctors which included reviewing any clinical errors.

Every single prescriber makes mistakes on a regular basis, even the best clinicians.

There is no association between an excellent clinician and the best prescriber. That said, I may not be the best clinician, but I am proud of my prescribing practices with no known prescribing error so far in my 10+ years of experience and on going.

I know pharmacists and GPs are contacting our hospital to clarify prescriptions, but I haven't received any call or contact thus far. And I am sure there are plenty other doctors on the same boat as me.

 

[sickfees.ie]

Think the only way you would know that is either by asking them or buying the item on a 1 month basis and see if that works out dearer than the multiple issue.



That could be the Manager's way of doing things or as so many items are scarce at the moment they may not be in a position to issue it for a few months. I stopped using Tesco Pharmacy because their Manager over the pharmacists would not allow them to issue multiples any longer. That was in and around the start of Covid where lots of stuff was going scarce.

I asked Pure if they would supply 30, 90 and 180 of my blood pressure tablets at a reduced price. She said that it would simply be a multiple of the monthly price. The same approach is adopted by Boots. The local independents were best at ~€155, Boots was worst at €274, Pure wasn't far behind at €237. Most pharmacies will now supply online and will reply to a request for quote via email. You can't use healthmail email addresses.

 

[ClubMan]

I asked Pure if they would supply 30, 90 and 180 of my blood pressure tablets at a reduced price. She said that it would simply be a multiple of the monthly price. The same approach is adopted by Boots. The local independents were best at ~€155, Boots was worst at €274, Pure wasn't far behind at €237. Most pharmacies will now supply online and will reply to a request for quote via email.

Did you check Chemist Warehouse or are you not within range of one of their stores?

You can't use healthmail email addresses.

What does this mean?

 

[sickfees.ie]

Sadly CW is far far away.
I checked there prices from an old price list posted in June 2022 by Louis,
Chemist Warehouse price list prescriptions

They were lowest for one month, but were about the same as the local independents for 180 Tablets.

Healthmail is a private secure email service for doctors and pharmacists to exchange prescriptions among other things.

 

[Bettyk]

I get one month of my medication for €16ish but 6 months is €65 in a local pharmacy. There is definitely a dispensing fee as they told me a few years ago that if I can afford it, I should get the 6 months as it is a "forever" table so ill definitely be using it then anyway.

 

[Sue Ellen]

I get one month of my medication for €16ish but 6 months is €65 in a local pharmacy. There is definitely a dispensing fee as they told me a few years ago that if I can afford it, I should get the 6 months as it is a "forever" table so ill definitely be using it then anyway.

That's a ferocious difference of approx €5.00 a month just for dispensing? Have never heard that expression 'forever' table and don't quite know what it means?

 

[ClubMan]

That's a ferocious difference of approx €5.00 a month just for dispensing? Have never heard that expression 'forever' table and don't quite know what it means?

Think they meant "forever tablet" as in it's a medicine that they take indefinitely so need every month?

 

[Bettyk]

That's a ferocious difference of approx €5.00 a month just for dispensing? Have never heard that expression 'forever' table and don't quite know what it means?

Apologies, yes forever tablet! So will more than likely be on it for life. But yes im not sure how the dispensing fee is calculated but sounds high!

 

[sickfees.ie]

Apologies, yes forever tablet! So will more than likely be on it for life. But yes im not sure how the dispensing fee is calculated but sounds high!

The best place to check out the dispensing fee is on the HSE reimbursable items web site on:

.sspcrs.ie/druglist/pub

This shows the price the HSE pays the pharmacist for each of the 8,000 items that it has negotiated with the drug companies and includes the distributors markup of 8% for GMS and DPS over €80 per month prescriptions.

You can search this data by category, code, price, drug name, INN or generic name for your medicine.
(You can download the full list by leaving all fields blank, select "search" then select "download").

The safest search is the five digit Drug Code that you get on the white HSE prescription claim form you get as a receipt from the pharmacists .

eg

Drug code 49420

Drug Code	Drug Name	Price	Coding Instruction	Name	Pk Size	Strength	Dental	Reference Priced	INN
49420	Teveten Tabs. 600 mg. 28 (A)	€12.83		TEVETEN	28	600MG			EPROSARTAN

The price quoted here is the price the HSE pays the pharmacist for this specific product.
This is the highest price the pharmacist will pay for the drugs and does not include kickbacks/discounts/training courses that manufacturers/distributors can supply to maximise market share.

In addition the pharmacist will get a dispensing fee for each item. There are 3 different dispensing fees but the max is €5.

So for this example the HSE will pay the pharmacist €12.83 product cost and + €5 dispensing = €17.83.

If you're not on a medical card or over €80 on DPS you are game to been taken advantage of!

My local late night pharmacy quoted me €27.67.

So this is a dispensing fee of €14.84, triple what the same pharmacist will get from the HSE.



Interesting that the Chemist Warehouse have it for €14.99 so there so they are getting a €2.16 dispensing fee.

So for exactly the same product and service you can pay more than 6 times the lowest fee.

The most important point is to remember is this is per item not per prescription.

So if you had 3 items on one prescription you could save 3 x €12.68 =€38.04.

Time to cure these sick dispensing fees.

 

[Sue Ellen]

So this is a dispensing fee of €14.84, triple what the same pharmacist will get from the HSE.

We're in the wrong business lads

 

[Des Pondent]

So for this example the HSE will pay the pharmacist €12.83 product cost and + €5 dispensing = €17.83.

If you're not on a medical card or over €80 on DPS you are game to been taken advantage of!

My local late night pharmacy quoted me €27.67.

Even when over the €80 on DPS, you are disadvantaged if you can't always use the same chemist. You then pay the €27.67 and reclaim it. But you are refunded the approved DPS rate which is only €12.83.

 

[sickfees.ie]

Even when over the €80 on DPS, you are disadvantaged if you can't always use the same chemist. You then pay the €27.67 and reclaim it. But you are refunded the approved DPS rate which is only €12.83.

Yes that is the very strange aspect of the DPS system. The pharmacist can charge whatever they like up to €80 but once it goes over this amount the government will only pay the reimbursable price plus the €5 maximum dispensing fee.

This leads to the weird situation that if you are under the limit one month the pharmacist keeps whatever fee they charge say €60. (4 x€15).
If on month two you get additional two medicines and go over the limit the government will only pay the pharmacist €30 (6x€5) in fees.

So additional work and half the fees.

This shows how ridiculous this system is that allows pharmacist to charge 3X the fee for cash customers for exactly the same medicine.