Some pharmacies charging almost double for basic medicines than cheaper rivals
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A survey of almost every pharmacy in the country has found a huge variation in the cost of basic medicines, with some stores charging almost double the price of their cheaper counterparts.
The survey captured prices for a range of drugs in 1,353 pharmacies around the country, including for basic items such as paracetemol and aspirin.
It found that for many products, the price was significantly higher for chain pharmacies compared to independent pharmacies. As for price variation, it meant the same quantity of aspirin, to take one example, could cost as little as €4.62 and as much as €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.
It then gathered the average price for 12 listed drugs from the 1,353 which provided responses, and noticed significant variations.
"Evidence was found of significant price variation in community pharmacies," the research team said.
"Policy measures such as mandated price transparency, or fixed prescription drug prices could help address these price issues."
The study, entitled Variation of prescription drug prices in community pharmacies: A national cross-sectional study, said: "Historically, Ireland has some of the highest retail prices for prescription drugs in Europe. Between 2009 and 2016, there has been a large increase in OOP [out of pocket] payments in Ireland; a large portion of this increase is attributed to prescription drugs.
"Furthermore, prescription drugs have been described as a major cause of unaffordable expenditure for the Irish public. Up to 60% of the Irish population are not covered by State programmes, which provide for subsidised or free prescription drugs and pay OOP for prescription drugs. Therefore, prices and price variation are directly relevant to them."
The 12 sample drugs used in the study included a preferred drug, designated in the HSE's Preferred Drug Initiative, an expensive drug costing more than twice the average cost per item of €16.78, an on-patent medication, a medication likely to be prescribed on an acute/once-off basis, and a less commonly dispensed medication.
It found the top 10% most expensive pharmacies can be more than twice as expensive than the 10% of pharmacies that are cheapest when it came to the price of the medicines for sale.
"The largest relative price difference was for Eltroxin (levothyroxine [can treat thyroid hormone deficiency]); the average quoted price was €13.21, which was 35% higher than the HSE reimbursement price of €9.80," it said.
"In absolute terms, the largest difference was found for famciclovir [an anti-viral drug], where the average quoted price of €46.00 was €8.69 higher than the HSE reimbursement price of €37.31.
The study found a range of discounts were offered by pharmacies and that no pharmacies displayed their prices online. More than a third of pharmacies were identified as a chain or franchise and that for nine of the 12 drugs, the difference was statistically significant, with the prices provided by chain pharmacies higher than those from independent pharmacies.
"Improved transparency could encourage people to choose different pharmacies for each of their prescription drugs," it said, adding: "Another way of addressing price disparities would be to legislate so that the public can avail of the same (or a similar) agreement to the one the HSE has made with pharmacists; a fixed price for medications and a variable dispensing fee which is based on the number of items a pharmacy dispenses in a month."