Dear Colleagues, if we look at the historical process in our country regarding the pricing of magistral formulas prepared in our pharmacies; the first Official Ottoman Drug Tariff was prepared after 30 years of work and debate, but unfortunately its lifespan lasted only one month.
Another regulation, which determined the method to be followed to set the price of medicines prepared in the pharmacy and was prepared to prevent price discrepancies among drugs, entering into force in 1895, was the Drug Tariff (Le Tarif des Pharmaciens).
During the Ottoman pharmacy era, since there was no official price tariff, pharmacists set the prices of the medicines they prepared according to tradition and their personal views. This practice led to different prices being charged for the same prescription at different pharmacies and even bargaining. The fact that one pharmacy charged 50 kurus, another 20 kurus, and a third 31 kurus for the same prescription led the public to become suspicious of pharmacists.
Pharmacists argued that the implementation of an official price list would facilitate their work, strengthen their financial situation, prevent unfair competition, and enhance their prestige among the public. Following strong demands in this direction and extensive efforts, the “drug tariff” prepared by a special commission established by the Civil Medical Council (Meclis-i Tıbbiye-i Mülkiye / Conseil des Affaires Médicales Civiles) and pharmacist representatives entered into force in May 1895. Under this tariff, the determination of the drug price was based on the principle of compensating the pharmacist’s professional (art-science) fee, rather than taking a fixed profit on the raw materials used in drug preparation.
Shortly after the tariff was put into effect, the public, newspapers, and some pharmacists began to lodge severe complaints that drug prices calculated according to the new tariff were excessively high. Thereupon, the Government suspended the implementation of the drug tariff and decided that the tariff should be reviewed and necessary amendments made by a special commission to be established.
Thus, the first Official Ottoman Drug Tariff, prepared after 30 years of work and debate, unfortunately lasted only one month.
Today, looking at Belgium as an example of the different pricing methods applied to magistral formula calculations in Europe; a reform regarding magistral preparations came into force in Belgium as of April 2014, introducing new prices and pharmacy compounding fees exclusively for magistral preparations. Accordingly, pharmacists are remunerated based on an “all-inclusive” formula that incorporates the type of preparation, time spent, ingredients, and materials. Under the new regulation, all magistral preparations are divided into 3 distinct categories, each corresponding to a different fee based on the time spent.
1- Simple preparations (capsules, solutions…) 20 minutes, 12.93€
2- Dermatological preparations (creams, lotions…) 32.5 minutes, 21.03€
3- Difficult-to-prepare preparations (suppositories, ovules…) 50 minutes, 32.35 €
In our country, however;
As a result of the efforts of our professional organization, with the Ministry Approval of the Ministry of Finance dated March 23, 2011 with the provision “Article 14: the fees specified in the tariff and its appended schedules shall be republished at the beginning of each year by adding the revaluation rates published by the Ministry of Finance”, the problem experienced regarding revaluation was resolved and the annual updating of the Magistral tariff was guaranteed.
However;
Although it was stated with the latest Ministry Approval dated March 23, 2011 that “It has been deemed appropriate that the Magistral tariff prepared by our Association, which is currently in force and used in the pricing of magistral medicines prepared in pharmacies, shall be updated for regulations to be made after this date by applying the revaluation rates determined by the Tax Procedure Law General Communiqué published annually by the Ministry of Finance pursuant to Tax Procedure Law No. 213, and published by the General Directorate of Pharmaceuticals and Pharmacy without the need for a new approval,” despite this statement, unfortunately, from that date until today, the magistral tariff has not been updated at all; an immediate restructuring of the magistral tariff is urgently required because the magistral tariff fails both in terms of content and in providing a fair return for the pharmacist’s labor, and also because the raw material prices in the tariff remain far below the figures invoiced to pharmacies by supplier companies.
We pharmacists, masters of the art of healing, remind that the Magistral tariff was last updated on March 23, 2011; and we urgently demand from our professional organization that the Magistral tariff be enriched in terms of ingredients to meet today’s modern magistral formulas, and that pricing allowing pharmacists to receive the rightful return for their professional fee be established.
Wishing you a good week…
Source: Dr. Mahmut Tokaç “Kırmızı çizgi”
Exp. Pharm. Ahmet Nezihi Pekcan
Pekcan Pharmacy – Konya
[email protected]
Tel: (332) 3520657
http://www.majistralformul.com/
