A bitter pill to swallow

WHAT'S THE STORY WITH THE PRICE OF MEDICINES?

When people complain about higher prices in Ireland, they tend to focus on groceries and clothes and, while the discrepancies in the cost of identical products between this jurisdiction and others in these areas can be pretty hefty, there are, at least, some ways to economise.

By shopping in the Aldis and Penneys of the retail world, consumers can undoubtedly cut costs and by swapping overpriced but instantly recognisable brands in favour of generic own-brand alternatives, a packet can be saved. There are, however, other areas where the price gaps between here and almost everywhere else is as great, if not greater, but consumer choice is significantly reduced and the ability to shop around almost non-existent.

While it won't come as a shock to many people to learn that Irish consumers pay considerably more than those living in other jurisdictions for many medicines - both over the counter and prescription - the extent of some of the price differences are truly shocking.

Everyday drugs such as aspirin and antibiotics routinely cost over 75 per cent less in Spain and the US than in the Republic and those who need to take such medication have no option but to cough up. Readers frequently point to the astonishing difference in price between low-dosage aspirin, which many people take daily as part of a "healthy heart" regimen. In this country low-dose aspirin requires a patient to visit a doctor twice a year for a six-month repeat prescription which is limited to 28 tablets per month.

The cost of a month's supply of the drug is €7.50 to which at least €100 a year has to be added in doctor's bills, taking the annual cost of low dose aspirin to €180. In the US, however, containers of low-dose aspirin containing 150 tablets sell for €5 and can be bought on drug store shelves without a prescription, so the annual price of the progamme is €12.

THE PRICE DIFFERENCESbetween over-the-counter medications such as paracetamol and aspirin can be equally shocking. In a Boots outlet in Liverpool recently, a reader was sold Sterimar nasal spray for £6.19 (€7.67). In Boots in Dun Laoghaire, the price of the product is €12. We contacted the store to find out more about the price differential but no one was available to offer any class of explanation.

It is not just in Boots where the differences are evident. Another reader was in London recently and came across an even more over the top, over the counter price discrepancy. "I bought Tesco own-brand 500mg Paracetamol caplets - in a box of 16 for 24p, which is around 30 cent," he writes.

At that price, the medication costs less than two cent a tablet - a packet of 24 Panadol costs in the region of €3 in most Irish chemists or 12.5 cent a tablet.

Such bargain basement prices are, however, unavailable to Irish consumers as own-brand medications are not commonly available here Unlike groceries, there is no difference in quality between the cheap own-brand products and the more well-known brands. This is because generic or own-brand medicines have to be shown to have exactly the same efficacy as more established brands before they are allowed on supermarket shelves for obvious health and safety reasons.

A spokesman for Tesco Ireland said that the reason its Irish stores were not selling own-brand medications, which have been on the shelves of its UK shops for several years, was down to licencing. He told Pricewatch that the licence application process was "intricate" but said that it was an area the store was "actively looking at and working towards. These things take time," he said.

Despite the absence of the store's own-brand cheaper alternatives in Irish shops, there are still some savings which can be made by not buying well-known brands when it comes to over-the-counter medications.

There are generic paracetamol brands available in this country which cost significantly less than the well-known brands. A box of 24 non-branded paracetamol costs around €2, while a similarly sized box of Panadol costs €2.85. A pack of 20 Motilium anti-nausea tablets, meanwhile, costs €9.49, while the generic equivalent, Domerid, is only €7.49. There is no difference in the active ingredients or the quality and efficacy of the products.

There are many other over-the-counter and prescription medicines that have cheaper alternatives and it always makes financial sense to ask your local pharmacist if there is a better value alternative available.

The availability of cheap own-brand medications is not the only anomaly to be found - another area in which Irish people are consistently being asked to pay over the odds is nicotine replacement therapies. Such products can be found on British supermarket shelves but their sale is confined to chemists in this state, a factor which critics say has served only to keep the prices artificially high.

The 15mg patches of Nicorette in a Dublin city centre pharmacy cost €23 while 105 pieces of the 2mg chewing gum costs €26.98. In British Tesco outlets, meanwhile, the patches cost £14 (€17) while the chewing gum costs £13 (€16), nearly €11 less than exactly the same product in the Republic.

WHILE IT MIGHT BEbetter for Irish smokers, both from a health and wealth perspective, if such products were more freely available, it is not that simple. The Irish Medicines Board is the regulatory body which overseas where and how drugs can be sold in this country.

It says that nicotine replacement therapies "should be used with caution" by patients with cardio vascular disease, severe kidney disease and duodenal ulcers, as well as a handful of other conditions. "Intervention at pharmacist level is important to ensure safe and appropriate use of these products," the IMB claimed.

It says that restricting NRT products to pharmacies "allows patients to receive specialist advice on the different dosage forms available, which provides greater assurance that the products will be used effectively and safely in accordance with individual patient needs." It said it had "no remit in relation to pricing or reimbursement, commercial or pricing influences are not factors in its assessment process".

Contrast this stance with the position of the Royal College of Physicians, Britain's oldest and perhaps most powerful medical college. Last week, it called for NRTs to be made cheaper and more appealing to encourage greater numbers to quit smoking. It wants a regulatory authority to be established which would make "low-cost, single-day nicotine packs" available from shops everywhere.