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How to Save Money on Your Prescriptions in Ireland


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Image 1: Generic Rx.

More and more people have been taking an ever closer look at their finances in an attempt to stretch their budget that little bit further. Despite a number of significant price drops in recent years, Ireland is still one of the most expensive countries to buy medicines in. To combat this, we will be taking a look at a couple of ways of reducing your medicines bill, so that you're not forking out any more than you absolutely have to.

For most goods and services the price calculation is pretty straight forward. It will typically consist of a cost price + markup + VAT. So for an item that costs €10 from supplier, the merchant will add a markup of say 30% and VAT at 21%, bringing the total price to €10 x 1.3 x 1.21 = €15.73. So if you want to buy two of these, you'll be paying 2 x €15.73 = €31.46. Simple right? So why is this important? Read on!

 

1. BUY IN BULK

There is one small, but critically important difference in the way we calculate prices of prescription medicines as compared to other goods. Knowing this trick, will enable you to make a handsome saving over the course of a typical six-monthly prescription.

To calculate the price of prescription medicine you must add up the cost price + markup + dispensing fee + VAT, thus arriving at the retail price. You will notice that there is a new element in this equation in the form of a dispensing fee. This fee will vary from pharmacy to pharmacy and you can expect it to be as high as €5 or as low as €3.16, so shop around and don't be afraid to ask.

Regardless of how much it is, this fee is where we can make our saving. The higher it is, the bigger the savings. You see most people get their prescriptions monthly, paying this fee every single time they come in. Over the course of six months this amounts to six fees per item, where it could really only be one or two fees per item, if they collected six or three months at a time respectively. Very importantly, this fee is charged per item, so you if have two or more items, then you are looking at some potentially very big savings.

Let's have a look at a very common scenario, where a female customer collects her monthly oral contraceptive pill Yasmin at the cost of €13.43 per month. Over the course of six months she will spend 6 x €13.43 = €80.58. If we dissect the €13.43 price, it is made up of a cost price of €6.62 + 50% markup + €3.50 dispensing fee. So had she collected the full six months at once, she would have only paid 6 x €6.62 x 1.5 + €3.50 = €63.08 for the same medicine, saving herself 5 dispensing fees worth 5 x 3.50 = €17.50 in the process.

Table 1: The Cost of Monthly Collections
Medicine Retail Price* Saving
Yasmin (21 x6) €80.58 €0
Yasmin (126 x1) €63.08 €17.50
Yasmin (63 x2) €66.58 €14.00

You may be asking yourself what about VAT? Well thankfully there is no VAT on oral medicine (i.e. tablets, capsules). You only need to worry about VAT when it comes to creams, ointments and ironically condoms (and there may be a few others).

Girls taking Ovranette on the other hand have mostly copped on to this, as the cost price of the pill itself is only 84 cent, that's right €0.84, so the total cost for a six months supply ends up being only 6 x €0.84 x 1.5 + €3.50 = €11.06. Compare this to the cost of monthly collections of 6 x (€0.84 x 1.5 + €3.50) = €28.56 and it's quite obvious why the vast majority collect the full six months of Ovranette at once.

Table 2: The Cost of Monthly Collections
Medicine Retail Price* Saving
Ovranette (21 x6) €28.56 €0
Ovranette (126 x1) €11.06 €17.50

2. BUY GENERICS

Another great way to make a saving is to buy generic medicines instead of the more expensive proprietary brands. It used to be very simple, whereby generics would always offer at least a 10-15% cost saving. This got turned upside down for a while after a massive 40% price drop on a large number of off-patent branded medicines in February 2010.

A generic drug must contain the same active ingredients as the original formulation. According to the U.S. Food and Drug Administration (FDA), generic drugs are identical or within an acceptable bioequivalent range to the brand-name counterpart with respect to pharmacokinetic and pharmacodynamic properties. By extension, therefore, generics are considered (by the FDA) identical in dose, strength, route of administration, safety, efficacy, and intended use.[3] (Wikipedia)

Having held off for as long as they could, generics have only very recently adjusted their prices downwards to match the brand name price reductions. As it happens, there is in fact very little price difference between the two at the moment, however, there are still plenty of exceptions making it well worth looking into. This is also something that you will want to keep a very close eye on in the future, as it is likely to offer even better savings going forward.

So let's have a look at a few examples of how we can save money on generic medicines. Proton pump inhibitors or PPIs have always been one of the more expensive medicines that many just can't do without. Lansoprazole is available from four different companies, three of which are generics. As you will see, not all generics are priced the same. At the moment two of the three are actually more expensive than the original! Prices* are listed in the tables bellow.

*Prices are only estimates, as all calculations assume a middle of the range €3.50 dispensing fee, which varies between pharmacies. This does not affect the price difference. All prices are subject to change. Prices accurate as of September 2011.

Table 1: Lansoprazole 30mg
Medicine Name Retail Price* Saving
Zoton 30mg Fastab (28) €41.56 €0
Lanzol 30mg Caps (28) €41.92 €-0.36
Zomel 30mg Caps (28) €36.58 €4.98
Zotrole 30mg Gast. Res. Caps (28) €43.57 €-2.01

A decent saving can also be made on Omeprazole 20mg.

Table 2: Omeprazole 20mg
Medicine Name Retail Price* Saving
Losec Mups 20mg Gast. Res. (28) €26.72 €0
Ulcid 20mg Caps (28) €20.96 €5.76

We can also find examples where the roles are reversed, like in the case of another PPI Esomeprazole. The generic brand Nexazole 20mg will set you back €2.93 more than the original Nexium 20mg.

Table 3: Esomeprazole 20mg
Medicine Name Retail Price* Saving
Nexium 20mg Tabs (28) €35.93 €0
Nexazole 20mg Gast. Res. Caps (28) €38.86 €-2.93

Another example of this is a very popular anti-inflammatory painkiller Diclofenac 50mg.

Table 4: Diclofenac 50mg
Medicine Name Retail Price* Saving
Difene 50mg Caps (56) €8.50 €0
Diclac 50mg Gast. Res. Tabs (56) €11.03 €-2.54

Like we said above there are also plenty of examples where you won't be saving yourself more than a few cent, like in the case of Ramipril 5mg and Amlodipin 10mg.

Table 5: Ramipril 5mg
Medicine Name Retail Price* Saving
Tritace 5mg Tabs (28) €11.60 €0
Ramic 5mg Caps (28) €11.44 €0.17
Ramilo 5mg Tabs (28) €11.44 €0.17
Ramitace 5mg Tabs (28) €11.44 €0.17
Table 6: Amlodipin 10mg
Medicine Name Retail Price* Saving
Istin 10mg Tabs (28) €18.08 €0
Amlid 10mg Tabs (28) €17.78 €0.30
Amlist 10mg Tabs (28) €17.78 €0.30
Amlotan 10mg Tabs (28) €17.78 €0.30

But let's end on a high with a few examples of some very nice savings on generic medicines.

Table 7: Rosuvastatin 10mg
Medicine Name Retail Price* Saving
Crestor 10mg Tabs (28) €35.14 €0
Rosuva 10mg Tabs (28) €31.19 €3.95
Table 8: Diclofenac 75mg
Medicine Name Retail Price* Saving
Difene DR 75mg Caps (56) €27.20 €0
Diclac 75mg Pro. Rel. Tabs (56) €13.66 €13.55
Table 9: Azithromycin 250mg
Medicine Name Retail Price* Saving
Zithromax 250mg Caps (6) €31.97 €0
Azromax 250mg Tabs (6) €22.24 €9.74
Azithromycin Clonmel 250mg Tabs (6) €20.15 €11.82

This is only a very small sample of generic drugs available. For your specific medicine talk to your pharmacist. If you wish to avail of these prices though, you will first need to ask your doctor to write your prescription generically, so that instead of a brand name like Zoton, it will say Lansoprazole or instead of Crestor it will read Rosuvastatin (Image 1).