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Mechanical medication dispending must not cause additional costs for the patient

Equality not implemented

The way in which municipalities and intermunicipal joint authorities take care of mechanical dispensing of medicines is in many municipalities unlawful, because it must not cause additional costs for patients, believes Ombudsman Petri Jääskeläinen. The different practices followed by municipalities likewise mean that patients are not treated on a basis of equality.

Several municipalities are changing over or have already changed over to a system of mechanically dispensing medicines to clients receiving treatment at home or in serviced dwellings. Under this system, a pharmacy supplies the patient's medicine divided into doses and packed in batches meeting 1 - 2 weeks' needs. 
 
The aim is to improve the safety of treatment with medications and reduce wastage. Pharmacies independently determine the fees they charge for this service.

In some municipalities patients themselves pay the full cost of mechanical dispensing, in other municipalities a portion of the cost, whilst in a few places the municipality bears the cost.

Medication dispensing is a municipal task

Ombudsman Petri Jääskeläinen points out that distributing medicines is one of a municipality's statutory duties, because what it involves is a health service in the meaning of the Health Care Act.

"This means that a municipality can not exclude its clients from the obligation to distribute medicines and transfer responsibility for arranging this to patients themselves together with pharmacies and at the patients' own expense."

A municipality has various alternative ways of arranging its statutory tasks. It can take care of manual dispensing of medicines itself or purchase a mechanical dispensing service from a pharmacy.

"If a municipality uses an outsourced service, this must not cause additional costs for the patient," the Ombudsman points out.

The Ombudsman took his stance on the matter as a result of a complaint. Criticism in the complaint focused on, among other things, inequality of patients and the fact that the fees charged by pharmacies varied from one municipality to another.
 
According to the complainant, the pharmacy had charged €5.40 a week for the service in 2010 and a year later €10.90. In addition, a fee was charged for every week, although the medicines were batched only every once a fortnight. 

Ombudsman Jääskeläinen has asked the Ministry of Social Affairs and Health to instruct municipalities and intermunicipal joint authorities to arrange mechanical dispensing of medicines on a basis of equality and lawfully.  He has asked the Ministry to inform him, by 30.6.2013, of what measures have resulted from his expression of opinion.


Additional info will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358 (0)9 432 3377.