Prices of widely-used prescription drugs vary across Ireland by as much as 199%, a new survey has revealed.

The study, by the National Consumer Agency (NCA), found that the percentage differences in prices charged to private customers for the 39 medicines surveyed vary from 37% to 199%, depending on the mark-up and dispensing fee added by the pharmacist. The average percentage difference in price across all products nationally was 56%.

The largest percentage variation for a single prescription drug within an area was 122% (27.26 euros) for AstraZeneca’s Losec MUPs 20mg (28), in Waterford, while the second highest was 112% (22.37 euros), in Dublin, for Takeda’s Zoton Fastab Tabs 30mg (28).

When the average prices of all 39 products were aggregated across all the areas surveyed - Cork, Dublin, Galway, Limerick and Waterford - Dublin was found to be the most expensive area, at 4.4% above the national average, while Galway was the least expensive, with prices 4.5% lower than the national average.

The study also found that a range of different policies relating to dispensing fees apply across pharmacies. Some change a standard fee, others vary the fee with the price of the drug and in some cases no dispensing fee is charged at all. For pharmacies which do apply a dispensing fee, this was found to range from 3.15 euros to 7 euros.

Commenting on the study findings, NCA chief executive Karen O'Leary noted that many private customers may not be aware of these price differences, and she urged them, especially patients on long-term medications and who do not meet the criteria for the various state-funded drug schemes, to compare the costs of medicines in their local area  before selecting a pharmacy.

In the course of the study some pharmacists had indicated that, in some circumstances, prices could be reduced, she added. For example, some pharmacies told the survey that they reduce the overall cost for their customers by not applying the dispensing fee, or by applying a single fee on a number of prescription drugs.

Consumers should therefore speak to their pharmacist to see if these reductions are available, particularly if they are making regular purchases, Ms O'Leary advised.

Meantime, another survey has found that private customers in the Republic are paying up to 18 times more than the prices charged in Northern Ireland for the same generic drug. 

Ireland's Health Service Executive (HSE) pays 3.50-5.00 euros for every prescription dispensed to medical card holders, but private consumers in the country are paying 166-168 euros for olanzapine (Eli Lilly's Zyprexa), 18 times the 9.30 euros which the drug costs private customers in Northern Ireland, according to a report in the Sunday Business Post.

Private consumers in the Republic also pay up to 15 times as much as those in the North for sumatripan (GlaxoSmithKline's Imitrex), at 62-63 euros compared with 4.05 euros, 12 times as much for atorvastatin (Pfizer's Lipitor) at 26-34 euros versus 2.87 euros, and up to 10 times as much for lamotrigine (GSK's Lamictal) at 47-64 euros compared to 6.40 euros, it says.

Professor Michael Barry, who was appointed as head of the HSE's new national drug purchasing programme three months ago, told an Irish radio programme that it was "very difficult to defend" the situation exposed by the Business Post. Prices of generics should be 50%-90% lower than the proprietary drug's price, but Ireland has not had an effective generic drugs market "for many, many years," he said, speaking to RTE's Morning Ireland programme. 

Prices of generics are set through negotiation and "clearly it hasn't been possible to negotiate with the generic manufacturers," he said, but added that the Health (Pricing and Supply of Medical Goods) Bill 2012, now going through the Oireachtas (parliament), will enable the HTE to introduce reference pricing for drugs considered to be interchangeable.

With medicines spending in the Republic again heading toward 2 billion euros for 2013, "I don't think we have any choice but to tackle this area,” said Prof Barry.