A proposal by the National Association of General Practitioners for doctors to dispense medicines directly to patients has caused concern among pharmacists. The association plans a feasibility study into members supplying commonly prescribed medicines such as antibiotics and blood pressure tablets to patients.
However, the Irish Pharmaceutical Union has cried foul on any encroachment on its medicines dispensing territory which is worth in the region of €2.7 billion a year. It cites the risk of prescribing errors and a financial conflict of interest as reasons to oppose the move.
“Patients would legitimately fear that where their GP was profiting directly from the choice of medicine prescribed, their treatment may be influenced by the profit motive. This is not in the interests of the patient or of the healthcare system which must ultimately cover the cost,” it said.
In fact, there is no impediment to fully registered doctors dispensing medicines. The dispensing of medicines by doctors is covered by the Medicinal Products (Prescription and Control of Supply) Regulations 2003. Regulation 20 (3) says doctors and dentists may supply prescription and non-prescription medicinal products to their patients in the course of their professional practice.
Doctors in isolated parts of the Republic have special contracts with the Health Service Executive when they work in designated dispensing practices. For many years, rather than receive a written prescription, patients with medical cards in these practices have received their regular medication directly from their general practitioner.
Perhaps the most important question is, cui bono? Doctors stand to increase their income and may look forward to a modest profit on the arrangement. Patients gain convenience and may benefit from competitive pricing. Medical Council ethics rules should ensure no conflict of interest and that patients are informed in advance of the cost of dispensed medicines.
The exchequer may benefit from a modest reduction in its overall drugs bill. And pharmacists are likely to continue to dispense the bulk of medicines in Ireland.