E-drug: Prescription fees (cont)
These articles have some information:
Huttin C. A critical review of the remuneration systems for
pharmacists. Health Policy 1996; 36: 53-68
Moen E et al. Pricing and reimbursement of pharmaceuticals. A new
culture for the community pharmacist. Pharm World Sci 1998; 20(3):
Baumber N. Changing the balance between fee and allowance. Pharm J
1997; 258: 174-5.Ed. Prescription charges: change overdue? BMJ 1998;
In Norway there is a degressive margin (mark-up) for registered
drugs, I think the average mark-up now is under 15 %. There is in
addition two different fixed fees per prescribed package (i.e. if
e.g. two inhalers are prescribed, the fees apply to each of them).
Then there is an additional fee for controlled drugs the reason being
that there is more work involved in handling such prescriptions. The
margin and fees are the same regardless
of whether the drug is reimbursed or not. I think in general, in
Europe at least, the trend is towards degressive margins and
professional fees. There is no reason why pharmacists' income should
depend on them selling the most expensive products. The work involved
in dispensing is the same as for cheaper products. In addition, there
might be incentives for promoting generics. The rates are fixed by
the Ministry of Health in discussions with
the associations once a year, and last year's average turnover for
all pharmacies are used as basis for adjustments (all pharmacies have
to deliver annual accounts statements to the Medicines Control
Kirsten Myhr, MScPharm, MPH
Bygdoy alle 58B
0265 Oslo, Norway
Tel.: +47 22 56 05 85
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