Pharmacists dispensing fees

A wholesaler margin is then set on the supplier s price, a pharmacist margin is applied to the wholesaler s price, and a pharmacist dispensing fee is also added, determined by the Pharmaceutical Benefits Remuneration Tribunal. Patients pay the co-payment (and any premiums) to the pharmacist when the PBS-listed medicine is dispensed, with the balance of the cost of the product being paid to the pharmacist by the government. 

A dispensing fee (a set amount paid to a pharmacist by the plan administrator per prescription order filled) that is added to the ingredient cost of the medication. This fee covers preparation and labor costs. 

The federal government has used its position of dominant funder in the prescription market to negotiate prices for medication that historically have been 30-40% lower than in the United States and Western Europe. Wholesale distributors and pharmacists are allowed to add specified mark-ups, and pharmacists also receive a professional dispensing fee resulting in the PBS dispensed price. In 1999, the average PBS dispensed price was 26.35, which equated to 3.65% of average weekly earnings. 

State Medicaid programs reimburse the pharmacist after a drug is dispensed to a Medicaid enrollee (235). States pay a freed dispensing fee and an amount to cover the cost to the pharmacy of the prescribed drug. The median dispensing fee in 1990 was 4.10 (287). 

Where a tariff system based on capitation with dispensing fees is introduced for pharmacists, one should be alert to any subsequent increase in the number of prescriptions dispensed, as pharmacists may find it more profitable to break down a single prescription into two or more dispensing acts, each of which will earn a fee. 

The Minister of Health appointed a pricing committee with representation from the Departments of Trade and Industry and Finance and the Competition Commission. The committee had pharmacists, lawyers, health economists, pharmaco-economists, academics and consumer representatives, but no industry representation. Their mandate was to establish a new regime of total transparency in the pricing structure of all prescription medicines and over-the-counter products. The committee would also set up regulations for logistics and dispensing fees, international benchmarking of pharmaceuticals and pharmaco-economic evaluation of medicines. 

The proposed dispensing fees were revised upwards over time as pharmacists complained that their business would be imsustainable (Table 11.1). The lowest tier has stayed below RlOO (US 8.50) and the fixed fee was reduced, but the dispensing fee has been revised upwards with the adjustment of the percentage of the total medicine price. In the top tier of products above R799.85 (US 67.80), the fee has also been adjusted upwards through a revision of both the fixed component and the percentage of the medicine price... 

An extra fee will not be charged for unit doses (single dispensing pack) versions of products provided they have already been approved in a large pack-size. This was done at the request of the hospitcd pharmacists to encourage companies to market unit doses because hospital pharmacists deliver on unit basis rather than on a pack basis. 

OBJECTIVES To maintain good patient relations To ensure the prescription form presented relates to the named patient To ensure safe dispensing To ensure details on the reverse of a prescription form are correctly filled out, and any applicable fee is collected To ensure effective communication between patient and pharmacist... 

The bill was labeled an act to provide for the registration of, with collectors of internal revenue, and to impose a special tax upon all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations. Rather than making opium or cocaine illegal, the Harrison Act instead allowed doctors and pharmacists to continue to prescribe narcotics, and manufacturers and importers to continue to meet this demand, provided that they registered with the internal revenue office and paid the fee of one dollar per year. (At the time cocaine was incorrectly labeled as a narcotic. )... 

South Africa s attempt to control prices at wholesale level has elements of a fixed professional fee but with a fixed maximum, based on a tiered scale that considers the price of the product. At retail pharmacy level, the professional fees are also fixed, on a tiered system that endeavours to promote the dispensing of cheaper products. Over-the-counter products are exempted from controls, but pharmacists cannot benefit from discounts as they do in Europe. 

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