“This is the first time I have ever emailed or reached out to anyone regarding an issue of any kind on consumer pricing or anything in this arena,” begins a mail from a reader called Kieran. “However, this one in particular stands out for me as wrong on so many levels. It would be good to get your view.”
He has noticed that when he has gone into his local McCabes Pharmacy to collect a script, “they have not given me the full script. Only one month of a six-month script.”
He says he has asked them “to give me the full script [but] they continued to give me one month. Surely it makes no sense for me to go back to the pharmacy six times?”
He wonders if the reason he is given one month as opposed to six months is the dispensing fee. “Why charge one dispensing fee when you can charge six?”
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He is also concerned that he has “no way of knowing what my medicines cost – only at a total level when I collect them. As far as I can see, the only industry in the world that does not have to show its pricing is pharmacies for dispensary drugs. Why is this? Why does every industry in the world have to show their prices and not pharmacies?
When his GP asks where to send a script, “I just say the one nearest me as I cannot make a decision based on price. I have no clue what the price is! My local pharmacy can essentially charge me anything and I have no way of checking or doing any research in advance.”
[ Drug costs a top concern for consumers as over-the-counter medicine prices riseOpens in new window ]
He also says he does not typically get an itemised receipt for his scripts. “The last time I picked up a script, I asked for a receipt and I got a receipt with just the total amount and no breakdown, so I have no idea of what the cost of anything is. This has to be anticompetitive and wrong. Surely this is the only industry in Ireland where consumers cannot make an informed choice on price?”
Our reader raises a number of issues here, the first of which are the dispensing fees – the price a pharmacist charges for handling and preparing medications. These can range from €5 per script to more than €10 for private patients, depending on the pharmacy.
It is a different story when it comes to prescriptions that are filled under public schemes, which make up more than 80 per cent of the prescriptions filled by most community pharmacies across the State. They have dispensing fees that are set by the State and many of them have been at the same level since the economic crash almost 20 years.
While our reader is entirely correct to say that a pharmacy that insists on someone getting their prescription filled monthly instead of in a block can charge more in dispensing fees, the profit motive is not the only thing at play.
Another issue is the management of the drug supply chain. As many as 400 commonly prescribed drugs are in short supply in Ireland, and a considerable amount of a pharmacist’s time is spent sourcing those drugs or generic alternatives for their patients.
The problem of shortages would be exacerbated if some patients started getting six months – or even 12 months – supply in one go, which would most likely see others unable to get the drugs they need in advance.
Another issue worth highlighting is wastage. A person might be prescribed a six-month course of a particular drug that they find they can’t take for whatever reason after a week or two. Had they filled the full prescription at the start, they would ultimately have wasted money and the expense of producing drugs would also go to waste.
And then there are concerns about having large quantities of some drugs in people’s homes where they could – in the worst-case scenario – represent a poisoning hazard.
That is not, however, to say that pharmacists don’t make more money by dispensing drugs monthly as opposed to every six months – they do.
Perhaps what is needed is more transparency in the sector, which would at least allow pharmacists and those they serve to have conversations about what works best.
It does seem unfair that a drug that is widely available and comes with a very low risk of side effects and little or no other dangers should be drip-fed to those who need it, not only costing them money but forcing them to make unnecessary journeys to their local pharmacy.
When it comes to pricing transparency, it is worth noting that pharmacies do display prices for everything they sell except for prescription medications.
And we should also point out that changes might be coming. Earlier this month, Minister for Health Jennifer Carroll MacNeill announced that the Pharmaceutical Society of Ireland (PSI) was developing guidelines on price transparency in Irish pharmacies.
“I believe patients don’t have clear visibility of the fees they are paying for services such as dispensing services when getting their prescription medicines dispensed,” Carroll MacNeill said.
She suggested the fees patients were paying for medicines and associated services were “not well understood and not as clear as we should expect in 2025”.
The Minister said it was a “proportionate response” and expressed the hope pharmacies would “support their patients, proactively, with clear information on the nature and quantum of charges levied”.
Given that our reader mentioned McCabes, we contact the pharmacy chain with some questions. How much does it charge private patients for dispensing a single one-month prescription and does it facilitate customers who wish to fill three months or six months of a prescription at the same time? Does it charge a single dispensing fee equivalent to the charge imposed for one month?
Finally, if a multi-month prescription is not facilitated, why not?
This is the full response.
“The dispensing fee can vary from item to item and is influenced by many factors including medicine requested, the type of consultation required, time to prepare etc. If you would like more information, please call into your local pharmacy and they can advise you of the cost of your prescription.”
