Andrew Doyle (Wicklow, Fine Gael)
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Question 78: To ask the Minister for Health and Children if he will ensure that fair reimbursement for medical card services is made to pharmacists, especially those in rural areas with a high medical card carrying population. [26744/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Community pharmacists are reimbursed for dispensing under the GMS and community drugs schemes under the terms of the Community Pharmacy Contractor Agreement with the Health Service Executive (HSE). The following reimbursement rates apply for dispensing under these schemes:

GMS Medical Card — dispensing fee ranging from €3.27-€18.83 per item.

Drug Payment, Long Term Illness, Hepatitis C (HAA) and EEA Schemes — dispensing fee ranging from €2.86-€32.92 per item.

The majority of dispensing transactions under these schemes would attract dispensing fees at the lower end of the fee ranges outlined. Under the DPS and LTI schemes, community pharmacists also receive a mark-up of 50% on the ingredient cost of each item dispensed.

In addition to the foregoing, pharmacists also benefit from discounts on wholesale supply. Information provided to the HSE recently, in the context of determination of revised wholesaler pricing arrangements, indicates that discounts available to pharmacists range from 12% (approx) for larger urban pharmacies and chains, to 2-3% for smaller and rural pharmacies.

While certain pharmacies in rural areas may have a higher proportion of medical card dispensing I understand that, in general, the majority of rural pharmacies would dispense under all of the schemes, in addition to their private dispensing business.

In line with ongoing reform of all aspects of the pharmaceutical supply chain, the HSE will be seeking to reform the pricing structure for the GMS and community drugs schemes, to achieve greater value for money consistent with patient safety and continuity of supply. This will involve the separation of the price of drugs and medicines dispensed in community pharmacies from reimbursement for professional services, through the introduction of a flat fee arrangement across all the schemes. The aim is to achieve a fairer and more transparent fee reflecting the level of service provided.

In order to address concerns by community pharmacists regarding the implications of recent legal advice on competition law, a process of dialogue was established under Mr Bill Shipsey S.C. to examine available options for advancing pharmacy contractual negotiations in compliance with Irish and EU competition law. This process is continuing.