HSE says multiple payments issue being investigated before leak

The controversial practice of some pharmacies claiming multiple payments in respect of single prescriptions was under investigation before it was leaked to the media, the Health Executive has said.

At no time has the HSE been approached by a whistleblower in relation to the controversial practice, it said.

A spokesman said criticisms made by Dáil public accounts chairman, Fianna Fáil TD John McGuinness, who has expressed alarm that the HSE learned of the issue from a whistleblower, were therefore “erroneous”.

He said the HSE’s primary care reimbursement service began an examination of phased dispensing in April and put in place a formal inspection process on a number of pharmacies prior to any contact with the HSE from the media.

The HSE is to be called before the committee next month in relation to the controversy. This follows revelations last Friday that Lloyds, the largest pharmacy chain the State, claimed up to four fees in a month in respect of a single prescription dispensed in one visit.

Mr McGuinness has said the committee would seek an explanation from the HSE as to how this happened and over what period of time it had occurred.

Lloyds has denied any wrongdoing in its claiming of phased fees in respect of a single prescription dispensed in one visit and has insisted its approach is no different from other pharmacy chains.

The HSE is now expected to examine whether or not any other pharmacy chains are claiming phased dispensing fees in respect of large numbers of payments.

Lloyds operates a system known as MyMed, which, in the case of a four-week drug supply, involves putting a patient’s medication into four separate compartmentalised trays, one for each seven-day period.

The drugs are all supplied to a patient in a single visit to the pharmacy.

Dispensing fees

Lloyds claims it is entitled in such a case to both the first dispensation fee of €5 and three additional phased dispensing fees of €3.27 each.

The HSE, however, contends that when all medication is dispensed to a patient on the same date, Lloyds is entitled only to the €5 dispensing fee per prescription item.

Internal promotional material seen by The Irish Times shows that branch managers were encouraged to promote MyMed among patients, with a resulting 66 per cent increase in dispensing fees.

Darragh O'Loughlin, secretary general of the Irish Pharmacy Union – which does not count Lloyds among its members – said phased dispensing of this type was appropriate for a small minority of vulnerable patients.

Organising a patient’s medication in this way involved considerable work and time on the part of a pharmacist, who could not be expected not to be remunerated for this.

However, it was never intended that phased dispensing would serve as a mechanism for improving fee income, he added.