Irish consumers are getting fed up with paying more than the rest of the world for prescription drugs – whose fault is it, and what can be done, asks CONOR POPE.
OVER THE last 18 months, consumers in the the Republic have grown increasingly angry over the price differences between identical products selling in supermarkets and clothes retailers north and south of the border.
In recent weeks, a price war of sorts has closed the euro/sterling gap but it is all quiet on the prescription drugs front. The difference in the price of generic and branded medications in the Republic and the UK remain shockingly high, with some commonly used drugs costing as much as 20 times more in the Republic.
Fine Gael’s health spokesman Dr James Reilly has put a figure on how much more these over-priced medications are costing. In a statement issued last week, he estimated that the Department of Health could save up to €100 million a year if the prices of nine commonly used generic drugs were reduced to match UK prices. Such drugs will soon be more common in Irish hospitals after An Bord Snip Nua said more should be used, saving taxpayers €30 million.
“My research shows that the Irish taxpayer is being ripped off, with Irish generics costing up to 20 times more than their UK equivalents,” he said. “It is abundantly clear that if these savings were expanded over the entire drugs bill, hundreds of millions could be saved annually. This represents billions over the last 12 years of this incompetent Government.”
But how do these billions of euro translate into everyday prices for consumers in the Republic? The ex-factory price of the generic ulcer drug Omeprazole is €1.11 in the UK and €20 in Ireland. Lansoprazole, another ulcer treatment, costs €2.44 in the UK and €21 in the Republic.
Retail prices paint a similar picture. A month’s supply of Zoton Fastab, used to treat ulcers and reflux, costs €38 in Dublin and £6.50 (€7.50) in Enniskillen. A single Bonviva tablet, taken once a month to relieve the symptoms of osteoporosis, costs €27 in France compared with €60 in Ireland. A year’s supply of low-dose aspirin will cost an Irish patient at least €80 but in the US a year’s supply costs €5. And a month’s supply of generic Omeprazol, also used to relieve the symptoms of reflux, costs €48 per month in the Republic but just €3.50 in Spain.
The list goes on and on. Dozens of readers have contacted The Irish Times to complain about high prices here. “Spain is excellent value for drugs,” wrote one. “The price difference is usually between 25 and 50 per cent. It is particularly galling when the drug manufacturer is the same, the box is the same and the only difference is the language on the pamphlet in the box.”
“Between France and Ireland there is a price difference of between 50 and 75 per cent,” said another. “Many more drugs are available over the counter in France.”
But who’s to blame? The drug manufacturers claim to be doing everything in their power to make sure consumers get a fair deal and blame the high prices on those who dispense and distribute the drugs.
Not true, say the pharmacists, who dismiss suggestions that they are in any way responsible for people paying over the odds for medicines.
They blame the manufacturers and the Government for restrictive regulations.
The Competition Authority doesn’t blame anyone, but says the Government has a responsibility to bring about price cuts by reducing the prices it pays for medicines. And the Irish Medicines Board, which mandates that many drugs available over the counter elsewhere require a pricier prescription here, says it has nothing to do with pricing.
Dr Reilly lays the blame squarely at the door of the Government. It has a pivotal role in pricing as it sets the “trade price” for prescription medicines at a manufacturer level, establishes the margins for wholesalers for distributing medicines to pharmacies and hospitals, and approves the dispensing-fee system for pharmacists. It also pays 80 per cent of the value of all prescription drugs.
“The higher prices here come from lazy deals done by the Government. In fairness to the pharmacies, the prices I have quoted are wholesale so if that is the starting point then the game is already up,” Dr Reilly said.
According to the Irish Pharmaceutical Healthcare Association (IPHA) , the body representing manufacturers of new medicines, when the last agreement was reached between the industry and the State on medicine prices in 2006, it “accepted that it had to play its role in ensuring that value was provided”.
In the wake of that agreement being reached, it was predicted that prices would fall by as much as 30 per cent between 2006 and 2010 but consumers have yet to feel the benefits of the savings.
The IPHA insists the “price components which remain out of line with European norms are those for the distribution and the dispensing of the medicines” and has welcomed Minister for Health Mary Harney’s plans to reduce margins paid to pharmacists and wholesalers. The minister claims the move will save €55 million this year and €133 million in a full year.
Under the proposals, the Government will reduce the “wholesale mark-up” reimbursement price paid for delivery of drugs to community pharmacies from 17.66 per cent to 10 per cent and lower the dispensing fees paid to pharmacists as well as scrapping a €33 million payment made to pharmacists for dispensing to patients over the age of 70.
The Irish Pharmacy Union (IPU) is furious and more than 700 pharmacists – half the pharmacists in the State – say they will stop dispensing drugs to medical-card patients in two weeks unless the cuts are reconsidered.
Internet prescription shopping
ONE ROUTE many people may be considering travelling down in search of cheaper prescription drugs is via the web. Online pharmacies have grown into a big business in the US, the UK and continental Europe but it’s against the law to buy drugs online and the Irish Medicines Board has a rigorous policing system in place.
Last week Pat O’Mahony, chief executive of the Irish Medicines Board (IMB) said a total of 299,053 tablets, 55,789 capsules, 24 litres of liquids and 36.5kg of creams were seized last year, being illegally imported after they were ordered on the internet.
The IMB works closely with customs officials when it comes to tracing drugs being bought over the web, but the risk of getting caught is not the only problem. According to the IMB, up to 50 per cent of drugs bought online could be counterfeit and consequently pose a serious risk to health.