Unfortunately many of us end up in hospital and when able are more than happy to be discharged, and do not pay close attention to our ‘discharge scripts’.
Hospital pharmacy services are delivered at a premium to the regular market. Their price includes in-patient services most patients do not ‘see’ as well as the convenience of walking out the door with a bag of meds tailored to a script; if you need 10 tabs and the standard box is 60 they rebox and relabel 10. Boxes and labels and chemists have costs.
Sometimes the packs are the regular ‘untouched’ generic products in their regular counts. In previous experiences that premium was usually double to triple the prevailing independent chemist prices (not Chemist Warehouse low prices). This time I advised the medical team I did not need the obvious meds they would prescribe as I had ample supplies, but it did not ‘click’ I should ask for a script to fill, not a filled script, on discharge for any others.
Today that lapse resulted in a charge of $15.65 for 10 tabs ($1.565 ea) of a common med that I was unable to find at a higher price than $12.99 for a box of 60 ($0.2165 ea) on the net. The low price was $7.99 for the 60 - a unit price of $0.1332 ea. The cost of 10 when the med is boxed in 60s? Beyond what I could explore.
$10 +/- may not be a big deal even if 4 times each stay for a frequently hospitalised person and that cost is incurred regardless of public or private. It seems a tidy ‘dividend’ extracted from people who are likely more vulnerable and accepting than normal.
Mr Z went to a private hospital for 2 nights. They asked me to bring his medication in unopened boxes, which just meant filling his scripts locally the day before.
In hospital they prescribed a new medicine which was supplied by the Pharmacy located nearby. My local chemist asked to see the invoice as a matter of interest - it was actually cheaper than his price (we are not pensioners). The pharmacist visited his hospital bed to explain to both of us how to take this new medicine and provided a printed information sheet.
However I have heard of people in Aged Care and hospitals being charged outrageous dispensing fees. A few stories are on this forum.
Recently stayed in hospital for a few days, and when about to be discharged the pharmacist came to see me with 3 packs of meds to take home but then decided I would only need 2 packs.
At the Discharge Lounge I was given the pharmacist bill which seemed a bit high to me and I queried it. In fact I was being asked to pay for the 3 packs instead of the two I was taking home.
It was soon resolved and the bill amended, although dearer than my usual scripts from chemist warehouse, but I think it shouldn’t have happened especially as most patients are still a bit drowsy from the pain killers etc and the extra charges could be overlooked or get more difficult with the passing of time to establish and explain exactly what had happened.
It is normal for patients to bring their ongoing scripts. I have never been required to bring unopened, just in the original boxes with dispensing labels. Same with supplements, magnesium for nocturnal cramps as an example. They go on ‘the list’ and all are usually locked in a drawer and given by a nurse. The rub is a new one, or if the patient does not have enough for the stay, or a discharge pack that is just accepted because of the moment.
That could be taken as the hospital being reasonable, or as the outside chemist being high priced. Did you check the typical prices for comparison?
Only one chemist in town (open 4 mornings a week). I could travel an hour to one of the “half price prescriptions” chemists, but choose to support our local bloke as he supports those who can’t travel. My experience with a warehouse chemist, when I was looking for paracetamol, was they immediately handed me the expensive branded product for $15.95, when I could buy it at $0.76 at the supermarket. It took some insisting to get the generic.
The flip side - competition requires a level of population large enough to support more than one provider.
Political expediency meets the needs of the 72% of Aussies who live in our major cities. Good fortune is some of the 18% who live in Inner regional areas will gain from like thinking. How best to equally meet the needs of those who miss out including the remainder of 10%?
Whether it’s health or broadband the outcomes become less favourable the greater the distance.
No argument but that is ancillary to the point of the costs of meds when discharged from a hospital. If a hospital pharmacy is less costly than the only chemist in town, that chemist might need to have high prices to stay in business or for the more cynical to deliver the income that chemist ‘deserves’, but the prices are high.
How to get them down? One way is a chemist operating in a grocery or sharing a business premises reduces overheads; would consumers respond with fear or glee? The Guild is another topic, as is how prices get set, neither for here.
Twice Mr Z has been discharged after an accident with no medication, just a script that had to be filled. Being the boonies, where everything shuts on a weekend, we had to find a chemist shop ASAP for his next pill, in both cases antibiotics that he had to continue taking.
First time we made it with only 10 minutes to spare. The next time there were none open, so I had to call around other towns to find one open with stock and detour our trip home to pick it up. I would have been happy with a charge to supply; it would have saved me many kilometres and stress. We could have gone straight home.
After the typical 6-8hrs in ED - because that’s all there is when one lives in the boonies one would hope for a little assistance as well as empathy on the way out. Been there, and although we have a choice of two chemists, one near to hone and one not too far, neither had one of the critical meds required. Having been caught prior both confirmed by phone before we headed home they did not have stock. The detour home was more time than miles.
No chance of any rort if the service is not available.
Apologies to @PhilT.
My experiences of discharge, outpatient or inpatient suggests the prescribing doctor will discuss the medications required after discharge with you. How that may evolve, apparently not always the experience one expects. Being offered the scripts would be best practice.
Many valid points have been made about a difference in the regions and remote areas where the costs and availability of meds have a different equation from those of us in metro areas.
My last hospital admission was about 10 years ago and the hospital had its own dispensary. I took the scripts there. Handy as I had no clothes with me and I could go down in a gown while waiting for Mr Z to arrive. Now they seem to outsource this, or only supply what is needed in hospital.
