# Pharmacies Closed Aug 1, 2009?



## annet (1 Aug 2009)

Was up shopping this morning - and two chemists were closed.  The sign of one shutter was "contract withdrawn from the HSE" the other "Pharmacy Closed Today August 1, 2009" - no reason given.  Maybe somebody whose a member of the IPU can post the reason accounting for why chemists are closed today?  Is this part of their dispute - are you trying to back the HSE into a corner - is this a symbolic protest - rather irresponsible dont you think?  Where's your duty of care - to both private, GMS and community drug scheme patients?  

Yesterday, I went to a chemist to pick up a script.  An elderly person came in to order his script - he was a GMS patient. He said he'd come back tomorrow (ie. Aug 1).  The pharmacist told him he'd be better picking it up today (friday).  I asked the pharmacist whether they were withdrawing from the GMS/community drug scheme - she refused to answer!!!  Both pharmacies are listed on the participating pharmacies online list thats currently on with the HSE website.  How difficult is it for the HSE to publish a correct list - surely if notice of withdrawal was as vague as the HSE leads us to believe - there are ample surplus managers in the HSE who could have picked up the phone to ascertain who was and who was not participating.  It recalls the recent dispute by Dentists who also withdrew from the GMS - whose next - doctors??

We hear of a 34% cut in payments - and are unable to continue participating in the scheme - well I am sure that pharmacist would see no problem publishing their audited accounts to see exactly how much profit they are making from participation in the GMS community drug scheme.  Yet again patients are the ones who are disadvantaged.


----------



## mathepac (1 Aug 2009)

Here is the current HSE list of  "pharmacies [that] CONTINUE to be available to dispense medicines to patients and clients under the Medical Card and other State Drugs Schemes e.g. Long Term Illness Scheme."

[broken link removed]

I have no means of checking its accuracy, but it appears to be the only widely available source of information.

I don't think a partial re-hashing of the alleged causes / sources of the dispute is helpful as all the parties dispute the numbers produced by the other(s).


----------



## Sue Ellen (1 Aug 2009)

mathepac said:


> I have no means of checking its accuracy, but it appears to be the only widely available source of information.



I don't like moaning about this type of stuff but how long would it have taken for the HSE to put the lists in alpha order


----------



## samanthajane (1 Aug 2009)

I dont know i think it's better the way that it is. Everyone will know the area that they live in but how many would know the name of their pharmacy? ( i have no idea what the name of mine is and i've been in their loads of time)

 The county dublin could of been listed a bit better, had to go through the whole list to find that balbriggan only has one pharmacy available now.


----------



## annet (1 Aug 2009)

The list published on the HSE website is not accurate - and without re-hashing each sides view and disputed figures (which only serve their own purpose) there is no explanation of why pharmacies are closed today.... ok they may have withdrew from the scheme - but have they totally shut up shop.... I dont think so!


----------



## smiley (1 Aug 2009)

Its very odd that they closed up shop. Very odd indeed.

I get a script each month under the drugs payment scheme. My pharmacist is on strike from today also. I had no problem getting my script filled in another pharmacy who is bot on strike (Boots in fact). I tell you one thing they were very busy today and i imagine making a small fortune. My own pharmacist is going to lose a lot of money. Their strike is not effective.


----------



## sidzer (4 Aug 2009)

I am not a medical card holder but I personally won't be going to the pharmacist that I used to go to as he has pulled out of the scheme.

I live beside the border so I will either travel north and pay less or go to another pharmacist who has not pulled out of the scheme.

I don't like crossing the border to shop as my town has become a ghost town since last year but my money will never cross the counter of my FORMER pharmacy. 


The IPU will do their best to frustrate the supply of drugs in the hope that the people turn on the HSE / Government to force a climb down.

Our small crippled country can no longer afford the very generous mark ups that the pharmacist enjoyed.

Harney is 100% right here and she is getting my support on this one.


----------



## Purple (4 Aug 2009)

sidzer said:


> The IPU will do their best to frustrate the supply of drugs in the hope that the people turn on the HSE / Government to force a climb down.
> 
> Our small crippled country can no longer afford the very generous mark ups that the pharmacist enjoyed.
> 
> Harney is 100% right here and she is getting my support on this one.



I agree completely. Remember it’s the dispensing fee that has been reduced, not the massive mark-up that they get on the drugs.

If anyone is in doubt about the profits being made by pharmacists ask yourself this; how many of them have gone out of business over the last 5 years?


----------



## VOR (4 Aug 2009)

The Competition Authority should take a long hard look at the carry on of these so-called professionals. 
I am 100% behind Harney on this one.


----------



## Purple (4 Aug 2009)

VOR said:


> The Competition Authority should take a long hard look at the carry on of these so-called professionals.
> I am 100% behind Harney on this one.


Yep, GP's should be looked at next.


----------



## Teatime (4 Aug 2009)

Purple said:


> If anyone is in doubt about the profits being made by pharmacists ask yourself this; how many of them have gone out of business over the last 5 years?


 
Ask how many new ones have opened in last 5 years. They were a license to print money in boom years.


----------



## Purple (4 Aug 2009)

Teatime said:


> Ask how many new ones have opened in last 5 years. They were a license to print money in boom years.



Even with these small cut-backs they still will be.


----------



## macnas (4 Aug 2009)

The Pharmacists are using their customers to get at the HSE. If I did not get served in my usual Pharmacy then I would take my custom elsewhere. Boots is serving as usual?


----------



## annet (4 Aug 2009)

In answer to the previous poster - boots continues to meet the needs of patients in the community!  

On the newstalk this morning the IPU said that its members were noticing mistakes in the prescriptions that the emergency pharmacists were dispensing.  This is a rather serious issue - and if this allegation is at all true - has the IPU directed its members who notice these mistakes to help identify the pharmacists concerned and also make a complaint to the pharmaceutical society of Ireland - who license the professional practice of pharmacists in Ireland - as pharmacists have ethical standards via their code of conduct -  including to exercise due care and expertise before providing a product or service!


----------



## Purple (4 Aug 2009)

A bar code reader, a robot arm and the right packaging and storage set-up would remove all of these problems (and about 75% of the “work” that pharmacists do).


----------



## csirl (4 Aug 2009)

annet said:


> In answer to the previous poster - boots continues to meet the needs of patients in the community!
> 
> On the newstalk this morning the IPU said that its members were noticing mistakes in the prescriptions that the emergency pharmacists were dispensing. This is a rather serious issue - and if this allegation is at all true - has the IPU directed its members who notice these mistakes to help identify the pharmacists concerned and also make a complaint to the pharmaceutical society of Ireland - who license the professional practice of pharmacists in Ireland - as pharmacists have ethical standards via their code of conduct - including to exercise due care and expertise before providing a product or service!


 
Given that 100,000s of these are done every week, I've no doubt that mistakes are made. Are we talking about the typo errors you very often see in the recipients name/address or something more serious?

Though IPU should be careful that the pharmacists they target dont get the hump and start targetting their member's mistakes. 

Incidently, how would the IPU hear about these mistakes? Aren't patient records confidential?


----------



## DublinTexas (4 Aug 2009)

I’m sorry but I’m confused here, maybe someone could explain this to me.

A Pharmacy dispenses a script for someone how has a medical card (or other state drug scheme) and the pharmacy will receive the price of the medicine plus a dispensing fee from the HSE?

A Pharmacy dispenses a script for a person without a medical card and the pharmacy will receive only the price of the medicine (which is the same € as they are charging the state) but no dispensing fee.

Why would the state pay them a dispensing fee for the same action? Just because instead of cash/plastic the pharmacies has to invoice the HSE? In fact is the dispensing fee than not a surcharge for a different payment method?


----------



## gipimann (4 Aug 2009)

Isn't a dispensing fee built into the amount paid by a non-medical card customer when they get a script filled?   Doesn't that explain the difference in price between issuing 6 months meds in a single transaction vs issuing 6 months meds in 6 different transactions?   And perhaps why some pharmacists are reluctant to issue 6 months meds altogether.....?


----------



## annet (4 Aug 2009)

csirl said:


> Given that 100,000s of these are done every week, I've no doubt that mistakes are made. Are we talking about the typo errors you very often see in the recipients name/address or something more serious?
> 
> Though IPU should be careful that the pharmacists they target dont get the hump and start targetting their member's mistakes.
> 
> Incidently, how would the IPU hear about these mistakes? Aren't patient records confidential?


 
The IPU was informed by pharmacists - who became aware of these supposed incidents from former patients who came to them looking for their advice re the medication that was dispensed.   These incidents were not typo errors like name and address - they were alleged errors in the medication and dosage that was dispensed.


----------



## Mel (4 Aug 2009)

I take two types of medication every day, neither of which can be missed for even one day without feeling the consequences. I keep the prescription on file at my local pharmacy, who closed without notice this bank holiday weekend leaving me without both. I feel absolutely awful today and have been progressively worse since Saturday; Withdrawal symptoms from coming off one too quickly, and general effects of not taking the other which will be a lifetime necessity. 

I phoned today to arrange to take back my script and let them know what I thought of being left in the lurch like this all weekend. Although the service there is usually great, I will vote with my feet until they return to the DPS.


----------



## truthseeker (5 Aug 2009)

One of my local pharmacies closed.
This particular pharmacy is one of 3 branches. The owner kept his other 2 branches open and extended their opening hours, (from 10-6 to 9-9).
So he is not losing any money from the closed branch, because he is making it up on the extended opening hours in the other branches.


----------



## bren1916 (5 Aug 2009)

Well I for one will *NOT* be giving any business (however small, with a wife and 2 toddlers) to the ones that closed and would love to see other people of the same opinion do likewise.


----------



## Mel (5 Aug 2009)

jaybird said:


> This has been all over the news for days before the closures. Why not do something about it before then?


 
Blame it on a busy lifestyle and lack of interest in RTE news bulletins, but I was aware of a general fuss and refusal to operate on the various schemes; I wasn't aware they were planning to actually shut their doors.

BTW I'm feeling a bit better today, thanks for asking ;-)


----------



## DublinTexas (5 Aug 2009)

Does someone know how much dispensing fee the HSE pays?


----------



## Protocol (5 Aug 2009)

Yes.

Pharmacies earn:

a wholesale discount of maybe 8% (drug costs 100, wholesaler charges 117.64, pharmacy receives 117.64 from HSE, but the wholesaler gives a discount of 8-10)

a mark-up of 0% on medical card patients and 50% on DPS patients

a fee of 2.50-4.00 approx per transaction


----------



## dewdrop (5 Aug 2009)

Passed by Boots in Cork today at 4pm and no one at the dispensing counter..they are open for business.  The propaganda in this dispute is shocking especially when the sick are the victims.


----------



## annet (5 Aug 2009)

On RTE news this evening, Boots in the Pavillion was reported to be advising those people requiring non-urgent medication would not be able to have their scripts filled for 48 hours.... maybe, its time to consider compiling a list of those pharmacies that are dispensing medicine and those pharmacists who have not withdrawn from the GMS community drugs scheme but yet have shut up shop...


----------



## DublinTexas (6 Aug 2009)

Protocol said:


> Yes.
> 
> 
> Pharmacies earn:
> ...


 
Thank you protocol for this info, do you buy any chance also know what the charges than are for a normal dispensing act to a person that pays cash/credit card?


----------



## cork (6 Aug 2009)

Just a point to advise people to drop in their perscriptions into pharmacies for later collection.

 Pharmacies that earned massive mark ups and now refuse to deal with medical card curtomers are a thundering disgrace.

Prices of medicines in this country are a far too high.

Even basic stuff like paracetemol.


----------



## Protocol (6 Aug 2009)

I don't understand your question.

It doesn't matter how you pay for your prescription drugs: cash, debit or credit card.

What is relevant is whether you are a DPS patient or a medical card patient.


----------



## DublinTexas (6 Aug 2009)

Protocol said:


> I don't understand your question.
> 
> It doesn't matter how you pay for your prescription drugs: cash, debit or credit card.
> 
> What is relevant is whether you are a DPS patient or a medical card patient.


 
Sorry Protocol, I try to understand how much money pharmacies get to find out what the premium is the HSE is paying over a person paying his medicine on his own.


----------



## Protocol (6 Aug 2009)

*Example*

Drug is 85 ex-factory price. This price is set by Govt in negotiation with drug supplier / manufacturers.

There are 3 main wholesalers (1 owned by a group of pharmacies, another owned by a pharmacy chain parent company)

The wholesaler adds a margin / mark-up. This used to be a 15% margin / 17.64% margin.

So the pharmacy gets paid 100, known as the reimbursable cost.

But the wholesaler gives the pharmacy a share of their margin in the form of a discount. So the pharmacy actually pays 92.

Gross profit so far = 8.

Next, the pharmacy adds a retail margin. The margin is 0% for medical card patients, 50% for DPS patients.

They also earn a dispnsing fee. I'm not sure exactly how much this is, about 2.50-4.00 per item.

So it is fair to say that the DPS scheme acts as a subsidy to the medical card scheme (GMS).


"Paying on your own"? - all non-GMS patients are in the DPS scheme, where you pay the first 80? 100? per month. The State pay the balance.


----------



## Dicette (6 Aug 2009)

There seems to be a geographical element to this dispute (eg North-West/Wexford seem to have high proportion on non-participating pharmacies) - any particular reason for this and is it likely to become more widespread?

I have just been prescribed very expensive drugs and signed up to the DPS scheme last Thursday - fortunately all of my local pharmacies are still participating in the scheme.


----------



## DublinTexas (6 Aug 2009)

Protocol said:


> *Example*
> 
> Drug is 85 ex-factory price. This price is set by Govt in negotiation with drug supplier / manufacturers.
> 
> ...


 
Thanks protocol that is very helpful, now I understand better what this fuzz is about.


----------



## truthseeker (6 Aug 2009)

Protocol said:


> "Paying on your own"? - all non-GMS patients are in the DPS scheme, where you pay the first 80? 100? per month. The Stae pay the balance.


 
Just to clarify, a non GMS patient must apply to be in the DPS scheme - it does not happen automatically. All non GMS patients are entitled to be in it, but not all are (I am not for instance).


----------



## gipimann (6 Aug 2009)

annet said:


> On RTE news this evening, Boots in the Pavillion was reported to be advising those people requiring non-urgent medication would not be able to have their scripts filled for 48 hours.... maybe, its time to consider compiling a list of those pharmacies that are dispensing medicine and those pharmacists who have not withdrawn from the GMS community drugs scheme but yet have shut up shop...


 
Edit: Sorry Annet, I misread the last part of your post - my reply doesn't answer your question so I've deleted it.


----------



## DublinTexas (6 Aug 2009)

truthseeker said:


> Just to clarify, a non GMS patient must apply to be in the DPS scheme - it does not happen automatically. All non GMS patients are entitled to be in it, but not all are (I am not for instance).


 
I’m with you there truthseeker, I was also not fully aware of the DPS.

Now I already printed the DPS application form and am sending it out today.


----------



## truthseeker (6 Aug 2009)

DublinTexas said:


> I’m with you there truthseeker, I was also not fully aware of the DPS.
> 
> Now I already printed the DPS application form and am sending it out today.


 
With all this publicity (which is the only reason I ever heard of DPS) there will probably be a whole wave of people joining up who never knew about it before.


----------



## Protocol (6 Aug 2009)

DublinTexas, Truthseeker,

are you saying that you or people you know have been paying more than the DPS limit each month for presciption drugs?

Surely the pharmacy should tell you?

*Also, I can't believe that people don't know about this scheme.*

It's mentioned in the Budget each year, as the Govt often increase the limit.

It's also mentioned in many pharmacy windows.

I see a notice in many pharmacy windows:

*"We accept:*

*GMS medical cards*
*LTI*
*DPS"*

By the way, people can also get tax relief on the 80 or 100 cash payment that they have to pay each month.


----------



## Protocol (6 Aug 2009)

HSE info:

[broken link removed]

DPS application form:

[broken link removed]


----------



## truthseeker (6 Aug 2009)

Protocol said:


> DublinTexas, Truthseeker,
> 
> are you saying that you or people you know have been paying more than the DPS limit each month for presciption drugs?


 
I cant say Ive had a terribly expensive prescription month recently but last year I can remember one month where between expensive antibiotics and some other bits it did come to more than 100 euro.



Protocol said:


> Surely the pharmacy should tell you?


 
Yes, thats what I was thinking.



Protocol said:


> Also, I can't believe that people don't know about this scheme. It's mentioned in the Budget each year, as the Govt often increase the limit.


 
I never knew about it before the recent publicity. I have certainly heard the term DPS in the past but had no idea what it was about or that I was eligible. 



Protocol said:


> By the way, people can also get tax relief on the 80 or 100 cash payment that they have to pay each month.


 
I knew about that, but only in the past couple of years, I had never even heard of a MED 1 up to a couple of years ago.

I accept its my own responsibility to find out about these things, I suppose for the past 10 years or so I just worked, got my wages, paid for medical stuff if it came up and went along in blissful ignorance that there was any alternative but for me to pay my own way.


----------



## Romulan (6 Aug 2009)

People should vote with their feet.

I for one will be walking by nearest pharmacy which is not dispensing and going to the one that remained open.

Its time people stood up to this bull****


----------



## damson (6 Aug 2009)

I know someone who's a pharmacist and saw this thread. They feel there are many misunderstandings and questions here, and would like an opportunity to answer them. However, they do not have the capacity to post in Letting Off Steam. They therefore asked me to link to some information that is part of another discussion on boards.ie, and encourage people to raise any questions they have over there, so they can answer them.
The posts on boards.ie that they felt would help answer many of your questions are copied below. However, the overall thread on boards has far more detail and can be found here. It's a huge thread and growing fast. As it started back at the beginning of July, you may wish to skip to the last few pages to focus on what is going on at present.



> *Radia on boards.ie: *
> The pharmacists aren't striking. They were given only two choices by the HSE - keep your contract, with a reduced payment (typically 34% reduction) or give 30 days notice to end your contract.
> 
> Depending on the mix of business and the ability to take the hit, some pharmacists stayed in (Boots being an example; I presume they have huge bulk buying power for things like hair colours etc which is the bulk of their business and can afford to take a hit on prescriptions). Others (especially small rural pharmacies who rely on prescriptions for the majority of their business and don't have enough cosmetics etc to cross-subsidise it) rejected the contract. They simply wouldn't receive enough money from the schemes to pay their rent, staff wages, electricity bills etc. Continuing to trade, knowing you are doing so at a loss, is called reckless trading and is illegal.
> ...


 


> *Frodi on boards.ie*
> Just further to the earlier question as why are pharmacies closed.
> 
> I am a pharmacist who has terminated my contract and I am closed. (This is why I now have time to read and post here again)
> ...


 
This previous thread here on AAM has information from pharmacists about the financial side of things which should address some of the questions and misunderstandings above.

Hope this helps.


----------



## csirl (6 Aug 2009)

I think the above is a load of one sided PR.

Question for pharmacists?

1. How come a load of independent companies want to collectively negotiate prices? What about competition law?

2. Why do we need loads of small pharmacies - in my area there multiple examples of small pharmacies trading next door to one another and loads of small pharmacies within walking distance of one another all with very similar prices? How come the prices are similar? How come the better ones havent come out on top and expanded - do we really need to have pairs of pharmacies next door to one another?

3. Why cant I get my prescriptions at a pharmacy counter in my local Tesco, Dunnes, Superquin etc. from a PAYE pharmacist and pay for them at the till with the rest of my groceries?


----------



## damson (6 Aug 2009)

If you want answers, I think you really need to post in the boards thread where pharmacists can respond. I don't think any pharmacists are able to post here in Letting Off Steam.


----------



## annet (6 Aug 2009)

damson said:


> If you want answers, I think you really need to post in the boards thread where pharmacists can respond. I don't think any pharmacists are able to post here in Letting Off Steam.


 
This issue was originally posted in the threads but was shifted to letting of steam.  I am sure that pharmacists can post their own Q&A thread.... and if they feel the need to re-hash stats go ahead.... but maybe they could answer why the pharmacies who are listed on the HSE website as participating in the GMS and community drug scheme are closed since Saturday... tell us have these pharmacists withdrawn from the GMS/community drug scheme, yes or no.... and if yes why are these pharmacies not open to private non-DPS patients?  Was the letter that these listed pharmacists gave to the HSE giving notice of their intention to renew/or not renew their contract of participation in the community drug scheme ambiguous?  Did patients not have the right to know that pharmacists were shutting their doors on Saturday and where was pharmacists "duty of care" to patients so that they could make alternative arrangements?  Have any pharmacists who are members of the IPU actually noticed errors and flaws in the dispensing of medication from the HSE emergency dispensaries... do they have a professional obligation to report these incidents under their code of conduct.... and what action did these pharmacists or the IPU take to actually report these incidents either to HIQA or the Pharmaceutical Society of Ireland who regulates your practice?


----------



## damson (6 Aug 2009)

Seriously annet, if you want answers from pharmacists you need to ask these questions over on http://www.boards.ie/vbulletin/showthread.php?t=2055608548 (or read the most recent pages at the end of that thread). There's a very vigorous debate going on over there. Brendan and the other AAM mods have previously made it very clear that people can't just post in other sections to overcome the fact they haven't got posting rights in the Letting off Steam section.


----------



## annet (6 Aug 2009)

Had a look at boards.ie ... and might just post and ask these questions.  There's a similar thread on politics.ie.


----------



## Protocol (6 Aug 2009)

csirl said:


> I think the above is a load of one sided PR.
> 
> Question for pharmacists?
> 
> ...


 
No price competition as:

Govt and suppliers agree on ex-factory price
Govt set the wholesale margin
Govt set the pharmacy cost price
Govt set the retail margins
I suppose a pharmacy is free to not charge the full margin, but I doubt this happens.


----------



## Latrade (7 Aug 2009)

Protocol said:


> DublinTexas, Truthseeker,
> 
> are you saying that you or people you know have been paying more than the DPS limit each month for presciption drugs?
> 
> ...


 
Group me in the didn't knows and found out the hard way. I largely didn't know because I've never needed prescriptions until late last year. This is somewhat relevant to the debate, at least in my opinion.

I needed a month's prescription of what turned out to be an expensive medications. It would be €120 for the month. Just on that price: cost price for the pharmacist here for that specific drug is €20 per pack, 2 week supply in the pack therefore for the month's supply cost to pharmacist €40 cost to me €120. Incidentally the cost over the border for the same drug and in the same quantity is €1.20, and incidentally again the drug is now generic, wonder if the generic versions are being prescribed.

So that's the cost and mark up on that drug. when I went to pick up the drug, it was the last week of the month and the pharmacist (not the actual one he was filling in for holidays) stated in a concerned voice that this was a very expensive drug and why don't i just get half now so I only pay €60 and then get the rest in two weeks. Sounded fair enough so did as advised.

Of course only when picking up my second half did the usual pharmacist mention the scheme and gave me a leaflet. Unfortunately it had to be over €80 in a calendar month and as the pharmacist had advised half and half, I didn't qualify. Caveat Emptor.

I still think a mark up from €40-€120 isn't bad business. This doesn't include the rebates from the supplier to the pharmacist either. 

All this fuss is about the medicard scripts. What proportion of the pharmacists' business is actually from medicard scripts?


----------



## Ceist Beag (7 Aug 2009)

Whatever anyone thinks about who is right, the bottom line as far as I'm concerned is that once again Mary Harney has failed in her job. As the manager she is reponsible for this farce and it has proven once again that she cannot manage. Anyone with a bit of cop would not have let it get to this stage, they would have ensured that everyone bought into whatever change was coming, through dialogue, long before the change came to pass. She tried to railroad this change through by bullying and now has a mess on her hands. I don't really care which side is right, as the manager she is responsible for sorting it out and she is failing miserably.


----------



## Sunny (7 Aug 2009)

Ceist Beag said:


> Whatever anyone thinks about who is right, the bottom line as far as I'm concerned is that once again Mary Harney has failed in her job. As the manager she is reponsible for this farce and it has proven once again that she cannot manage. Anyone with a bit of cop would not have let it get to this stage, they would have ensured that everyone bought into whatever change was coming, through dialogue, long before the change came to pass. She tried to railroad this change through by bullying and now has a mess on her hands. I don't really care which side is right, as the manager she is responsible for sorting it out and she is failing miserably.


 
Sometimes as a manager though, you have to force things through. It's not always possible to manage through concensus and agreement. Her job is to manage the health services as she sees fit. I am glad to see her stand up to the pharmacists if she thinks what she is doing is right. Now I wish she would do the same with the other vested interest groups in Health.


----------



## csirl (7 Aug 2009)

Protocol said:


> No price competition as:
> 
> Govt and suppliers agree on ex-factory price
> Govt set the wholesale margin
> ...


 
My understanding is that the core of this dispute is that the Government would prefer to tender for pharmacy services throughout the country. If it is tendered, it would lead to lower prices due to competition between pharmacies as obviously not all pharmacies would be successful in a tender competition.

The current position is that every pharmacy in the country has a "right" to be in the scheme and there is no real competition between them - they charge a margin which is agreed centrally with their professional body. Pharmacists see that a move to a competitive situation would mean lower prices and hence lower profit margins and also a large proportion of them getting nothing if unsuccessful in the tenders. The pharmacists are trying to protect their positions and this is essentially at cost to the State and their customers.

Now I also believe there are some side issues in the dispute that are adding to the confusion such as the mark-up on drugs. The use of wholesalers instead of buying direct from the drug producers - therefore creating an artificial wholesale market with consequential artificial mark-ups. And the usual issues such as restrictions on entry into the pharmacy business which mean that you dont have pharmacy counters in your local supermarket as happens in other countries.


----------



## fobs (7 Aug 2009)

The stakes have just been raised as RTE reports

http://www.rte.ie/news/2009/0807/pharmacy.html


----------

