Healthcare costs - not insurance High cost of drugs in Ireland.

valery said:
I don’t think that’s the reason, EU pharmaceutical law applies to Northern Ireland since Brexit and prior to that applied to all Uk.
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That is one of the reasons. The centrally authorised route is only one way a medicines may be approved in the EU and is not the usual way for OTC medicines.

This link explains:

w w w.ema.europa.eu/en/about-us/what-we-do/authorisation-medicines#:~:text=All%20medicines%20must%20be%20authorised,route%20and%20a%20national%20route.

I'd post the link properly but I'm not allowed.
 
Protocol said:
Interesting.
So why aren't the own-brand cheaper OTC medicines for sale in TESCO or Boots in NI, available down south?
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Once a medicine has been approved by the EMA, a separate application for reimbursement is made to the HSE, which kicks off a whole other raft of other processes. There's good overview on the Fighting Blindness site for anyone interested.

For something like paracetamol, as far as I know the HPRA still provide marketing authorisation for its sale in Ireland. There's an old article here about the price differences with the UK (the IMB is the previous incarnation of the HPRA).

"...all products that are available in the UK cannot be marketed in Ireland because the medicine needs to obtain a license to ensure all regulatory requirements are met.

Tesco said that they are investigating the issue with the Irish Medicines Board (IMB). "We would like to bring more own-brand medicines to customers here," said a spokesperson."
 
We normally buy a 12 tab pack of Paracetamol included in our shop with Dunnes Stores. We pay between €1.80 and €2 per pack. I assume when we include our €5 off a €25 grocery spend we are getting a discount on the paracetamol also.

Just back from Spain yesterday. When there, we decided to buy a pack of Paracetamol because from memory we got these cheap in the past. The chemist wanted just over €4 for a 20 pack. So more expensive than Ireland.
 
You're literally comparing a chemist to a supermarket.
 
If you check your receipt, you'll probably find that the paracetamol is excluded from any discounting scheme.
 
I think a significant issue may be the difference in sales restrictions for paracetamol between countries. This is a long-standing public health policy to prevent harm from overdose. Across Europe pharmacies can sell anywhere from 8g to 30g without a prescription in one transaction while shops can sell 5g to 8g. Irish limits are 12g pharmacy, 6g shops, but UK is 16g pharmacy and 8g shops. This is why you see 12-packs in Ireland but 16-packs in UK, so Tesco can't just sell the UK ones here, they would have to produce specific packets for Ireland.
 
The question is why are there different restriction limits for the same medicine across Europe, and who benefits from this?

If the HPRA would provide authorisation for 16 tablet packs in Ireland, presumably Boots / Tesco could sell their own-brand paracetamol here. There is no greater risk to patient safety with a 12 vs. 16 pack size (see here), so it would seem the practice of having different limits for the same medicine benefits all market participants, bar the consumer of course.
 
Odea said:
I don't think they sell paracetamol in supermarkets in Spain. I was simply stating that paracetamol in Spain is not any cheaper than Ireland.
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If sales are confined to chemists, that in itself is going to make it a lot, lot dearer.
 

I don't think there is any mystery, collusion, or conspiracy here. The difference between countries are based on (highly effective) public health policy. Pharmacies, shops, and manufacturers have all lost out as these measures restrict sales, so they would welcome loosening the rules.

There is a lot of evidence that restricting packet size reduces harm and decreases costs to healthcare systems. The actual pack size varies because there are many other considerations that go into choosing the appropriate limit for each country. That paper is interesting but it does not say that there is no greater risk to patients safety and certainly no decision would be made on the basis of a single study.

I think part of the reason Ireland chose 12g and UK chosen 16g was because these are at the upper end of toxic dose and lower end of fatal dose range but the UK moved first so we were likely influenced by their success and the research at the time suggested tighter restrictions might be of benefit, which may explain our lower limit.

The risk is evident even in the language and approach here where people talk about consumer choice and savings when we are talking about poisons, not pensions or insurance.
 
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I wasn't suggesting any, I don't think the setup is by design to stymie competition, but at the same the status quo suits the market participants. There is no incentive for them to harmonise the limits, which would benefit consumers.
 
nest egg said:
I wasn't suggesting any, I don't think the setup is by design to stymie competition, but at the same the status quo suits the market participants. There is no incentive for them to harmonise the limits, which would benefit consumers.
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The limits are not set in order to benefit consumers, it's not like VAT on books. They are there to reduce the risk of harm/death from suicide and reduce the need for liver transplants. In an ideal world there would be a unified approach that would be appropriate for all jurisdictions and populations but that is not always possible with health policy. Maybe at some stage there will be enough data to make an EU-wide decision.

There is a lot of focus on OTC painkillers on this thread, and while they are important there is a danger of exaggerating the price differences and their influence on overall healthcare costs.
 
Yes, other than OTC painkillers, is it not the case that most, if not all, OTC are more expensive in RoI than NI?

Or else generic OTC are not available.

One example: Lorat.
 
Protocol said:
Yes, other than OTC painkillers, is it not the case that most, if not all, OTC are more expensive in RoI than NI?

Or else generic OTC are not available.

One example: Lorat.
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Yes it across the board - cold sore creams eg generic zovirax much cheaper in NI, branded nizoral shampoo can be bought in Sainsburys at a fraction of price of chemist here.
 
My wife recently needed a prescription filled. We called to 10 chemists in the Blackrock/Stillorgan area in the space of about 30 minutes. Only one of them had part of the prescription needed in stock, but the others didn't.

At the time I was thinking as I was driving around to each chemist....I could have picked up a box of paracetamol in each chemist. It sort of makes a joke of the limits.
 

The limits reduce "impulsive" overdoses where you could go into a shop and buy a large amount and very quickly consume them. Having to go to another shop takes time which is a barrier, then you have to make the decision to buy the next lot, another barrier, etc. Even a few minutes gives someone time to cool down, reconsider, maybe someone intervenes, etc. The restrictions have proven very effective.
 
arbitron said:
The limits are not set in order to benefit consumers, it's not like VAT on books. They are there to reduce the risk of harm/death from suicide and reduce the need for liver transplants...
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Absolutely, and the UK's objective is exactly the same are Ireland's, to limit the risk of harm. Ireland's body just happened to decide the answer was 12 tablets, whereas the UK's decided it was 16.

We share a common language with the UK, and have companies like Boots/Tesco which operate in both markets. In situations like this, the consumer loses out when the regulators come up with different answers to the same question.
 
In some good news: Pharmacists to be enabled to extend validity of prescriptions to a maximum of 12 months

Current limit is 6 months, so doubling the validity.

Should decrease the number of calls/visits to GPs for repeat prescriptions for blood pressure medication, cholesterol tablets, etc.

Lower cost for patients and GPs can spend the time saved seeing patients instead of signing prescriptions. Also less hassle for pharmacists who often have to turn people away if a prescription is out of date.
 
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