Wednesday 21 March 2018

Smart Consumer: What's the best medicine for those costly prescription bills?

Savvy shopping will help you save big on your pharmacy spend, writes Celine Naughton

Celine Naughton

Whether you've got a gumboil, a sore toe or a bellyache, paying through the nose for a pill to cure what ails you can be a right pain.

And if you have a chronic illness and don't have a medical card, prescription bills can become a serious burden on your finances.

Added to this plight for the Irish consumer are the huge mark-ups on the wholesale price of prescription drugs in Irish pharmacies.

A report in this newspaper last week revealed that mark-up rates in Irish pharmacies are higher than those in other countries such as Britain and Sweden, for instance.

Now more than ever, savvy shopping really can be the best medicine.

If you're on long-term medication, you may have already noticed a price drop in recent times. February 2010 saw the cost of 300 popular medicines slashed by as much as 40% when, following talks with the Government, the Irish Pharmaceutical Healthcare Association (IPHA) reduced the price of long-established medicines which had come out of patent.

Overnight, somebody who had paid €27 for a course of antibiotic Klacid LA, for instance, now paid €10.26, including the pharmacy's dispensing fee.

In these cases, the established brand may offer the best value, but for many drugs, the generic alternative is the cheapest option.

Before your next pharmacy visit, check out these ways to lighten your load:


In most cases but not all, generic drugs are cheaper than the proprietary brand. Start by asking your doctor to prescribe the generic name of the drug, if appropriate, rather than the proprietary brand.

"If a doctor prescribes a particular brand of medication, the pharmacist is obliged by law to dispense the branded product, unless the doctor says otherwise," says Kate O'Flaherty, Head of Communications and Pharmacy Practice Development with the Pharmaceutical Society of Ireland (PSI).

"If the doctor writes the generic name of the drug, the pharmacist can dispense a generic product."


As well as different mark-ups on wholesale prices, pharmacies charge a dispensing fee which varies from one shop to another, typically anything between €3.50 and €5.

Don't be afraid to ask what the dispensing fee is and what the total cost will be. Better still, save on the legwork by ringing pharmacies in your area to see what your prescription will cost.

If you can get a better deal up the road, go ahead, or at least give your pharmacist a chance to match the competition.


Most people get their prescriptions monthly, which means they pay a dispensing fee each time.

If you're on long-term medication and your doctor issues a prescription for a three or six-month supply, get the whole lot in one go.


Don't waste money by picking an over-the-counter (OTC) medicine at random.

There are lots of different kinds of antihistamine on the market, for instance. Tell your pharmacist what you want it for. They will know which formulation will be most effective for your symptoms.


"Since last November, all pharmacies in Ireland are obliged to have a private patient consultation area, so whether you want to discuss cost, health matters of a private nature or anything else in confidence, you should feel free to ask, 'Can I speak to you in private?'" says Kate O'Flaherty of the PSI.

As a first port of call in health matters, having a private chat with your pharmacist can sometimes save you the cost of a GP visit, typically €55-€60, if all you need is an OTC product to relieve the symptoms of common ailments, usually with the caveat of seeing your GP if symptoms persist.

The range of medicines and services offered in pharmacies is also expanding.

"Since February this year, the morning-after pill has been available directly from pharmacies, so this cuts out the cost of a GP consultation," says Kate O'Flaherty.

"Further legislation is currently being drafted to allow pharmacies to provide some medications previously available on prescription only."


Avoid dodgy drugs online. One thing both doctors and pharmacists agree on is advising consumers not to be lured into buying cheap medicines from obscure sources on the internet.

You don't know what you're buying, where or how it's made and what harm it can do to you. Caveat emptor.

State Schemes

If you don't have a medical card, find out from your HSE office whether you qualify for the Long Term Illness Scheme.

This allows people suffering from certain conditions to get free drugs, medicines and surgical appliances and it is not income dependent.

Alternatively, you may also get partial cover under the Drugs Payment Scheme which covers the cost of prescribed medications over the first €120 a month.

Plans for the future

Under a new system called Reference Pricing, the HSE is to draw up lists of all branded and generic drugs which have the same active ingredients.

The State will pay only for the cheapest version for medical card holders, and if the patient wants the more expensive one, he or she will have to pay the difference.

It is part of the Health (Pricing and Supply of Medicines) Bill which, according to a spokesman for the Department of Health, "will give effect to a commitment in the Programme for Government to introduce reference pricing and greater use of generics to reduce prices for both the State and patients."

The IPHA which represents the pharmaceutical industry has responded cautiously to this move.

"There is no evidence that reduced prices lead to generic prices also coming down," says a spokesman. "We also have serious misgivings about a doctor prescribing a branded medication and then a pharmacist being able to offer a different one.

"It could lead to some patients missing or changing their medication, because they're familiar with the old brand. It could also potentially lead to an interruption in supply in medicines if some companies felt compelled to withdraw their product from the market."

Irish Independent

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