Some pharmacies charge almost double for basic drugs than their cheaper competitors

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A survey of almost every pharmacy in the country revealed huge variation in the cost of basic drugs, with some stores charging almost double the price of their cheaper counterparts.

The survey picked up prices for a range of drugs at 1,353 pharmacies across the country, including for staples such as paracetamol and aspirin.

He found that for many products, the price was significantly higher for chain pharmacies than for independent pharmacies. As for the price variation, this meant that the same quantity of aspirin, to take an example, could cost as little as €4.62 and up to €9.12.

A team from the Royal College of Surgeons in Ireland (RCSI) carried out the study, initially contacting 1,529 pharmacies by phone and email.

He then collected the average price of 12 drugs listed among the 1,353 that provided responses and found significant variations.

“Evidence was found of significant price variation in community pharmacies,” the research team said.

There was also evidence that some community pharmacies were not following regulatory guidelines on drug price transparency.

“Policy measures such as mandatory price transparency or fixed prescription drug prices could help address these pricing issues.”

The study, titled Variation in prescription drug prices in community pharmacies: a national cross-sectional studysaid: “Historically, Ireland has some of the highest retail prices for prescription drugs in Europe. Between 2009 and 2016 there was a sharp increase [out of pocket] payments in Ireland; much of this increase is attributed to prescription drugs.

“In addition, prescription drugs have been described as a major cause of unaffordable expenditure for the Irish public. Up to 60% of the Irish population is not covered by state schemes, which provide prescription drugs subsidized or free prescriptions and pay for prescription drugs. Therefore, prices and price changes affect them directly.”

The 12 drug samples used in the study included a preferred drug, designated in the HSE’s Preferred Drug Initiative, an expensive drug costing more than double the average cost per item of £16.78, a proprietary drug, a drug likely to be prescribed on an acute/punctual basis and a less commonly dispensed drug.

It revealed that the most expensive 10% of pharmacies can be more than twice as expensive as the cheapest 10% of pharmacies when it comes to the price of drugs for sale.

“The largest relative price difference was for Eltroxin (levothyroxine [can treat thyroid hormone deficiency]); the average price offered was €13.21, 35% more than the HSE reimbursement price of €9.80,” he said.

“In absolute terms, the greatest difference was found for famciclovir [an anti-viral drug]where the average offered price of €46.00 was €8.69 higher than the HSE reimbursement price of €37.31.

In terms of price variation, aspirin was the drug with the greatest variation in listed price; the 90th percentile price of €9.12 was 97% higher than the 10th percentile price of €4.62.”

The study found that a range of discounts were offered by pharmacies and no pharmacies displayed their prices online. More than a third of pharmacies were identified as a chain or franchise and for nine of the 12 drugs the difference was statistically significant, with the prices provided by chain pharmacies being higher than those from independent pharmacies.

“Better transparency could encourage people to choose different pharmacies for each of their prescription drugs,” he said, adding, “Another way to address price disparities would be to legislate so that the public can benefit from the same (or similar) agreement for that which the HSE has with pharmacists; a fixed price for medicines and a variable dispensing fee which is based on the number of items a pharmacy dispenses in a month .”

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