David and Goliath struggles between the Health Service Executive and individual patients have become common in recent years, but it is rare the HSE squares up against a big company in the way it is squaring up to Lloyds Pharmacy.
Over the past two months, the two sides have traded legal letters littered with claims and counterclaims about reimbursement from the HSE.
In the letters, seen by The Irish Times, the State body claims Lloyds is fraudulently claiming multiple payments that were supposed to have been phased over time, but relate to the provision of a month's medication to patients on a single occasion.
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Lloyds operates a system known as MyMed, which involves putting a patient’s monthly medication into four separate compartmentalised trays, one for each seven-day period. The drugs are supplied to a patient in a single visit to the pharmacy. Lloyds says dispensing in this way involves significant additional resources and dramatically improves a patient’s adherence to medication.
It claims it is entitled in such a case to both the first dispensing fee of €5 and three additional phased fees of €3.27 each. The HSE says when all medication is dispensed to a patient on the same date, Lloyds is entitled only to the initial €5 fee.
A MyMed patient increases dispensing fees by 66 per cent and can be worth up to €600 a year more to Lloyds than a regular customer, the company has told its pharmacists.
While Lloyds has maintained it isn’t doing anything different from other pharmacy chains, the HSE regards it as an outlier in terms of behaviour and claiming. It is clear from internal materials the company heavily promotes MyMed to its pharmacists and, by extension, to patients.
Lloyds aims to increase the number of patients for whom it claims phased dispensing fees from 9,600 to 11,800 by March, these materials show. Every pharmacist in each of its 90-plus branches has been given individual monthly targets. “The more you pack, the more you get paid,” the guide advises, before recommending “pampering days” and “goodie bags” to attract new patients.
“MyMed is one of those projects that tick all the boxes. It’s unique to us, it makes a real difference to patient health, it generates margin . . . it’s in all our interests to stay focused on growth.”
Both the HSE and Lloyds have dug in their heels since this row started, leaving little room for either side to back down without loss of face. But with Lloyds losing out on substantial fees each month since they were stopped by the HSE, the prospect of court action is increasing.
