atients enrolled in Ireland’s Community Drugs Schemes may have difficulty getting their prescriptions filled from August 1, as more than 1,100 community pharmacists have said they will stop dispensing medicines under the SchemesHSE from that date.
The pharmacists’ action follows following a move by Mary Harney, the Minister for Health and Children, to cut payments to pharmacists under the Schemes by 34%. Early this week, the Health Service Executive (HSE), which is responsible for providing health and personal social services for everyone living in the Republic, will publish information on its website and in newspapers on pharmacies that will be open for Schemes business. The Executive has also urged the pharmacists to reconsider their decision.
The HSE's chief pharmacist, Kate Mulvenna, said: “we are asking pharmacists who have chosen to terminate their contract to assist us in ensuring minimal disruption to patients who need access to their medications. By handing over prescription records to their clients, on request, and by identifying to the HSE patients who may require extra supports, pharmacists can help ensure that their clients can continue to access their medications."
On June 18, Ms Harney announced that payments to pharmacists through these Schemes would be reduced this year by 55 million euros to 495 million euros, under the Financial Emergency Measures in the Public Interest Act 2009. Pharmacists’ payments would include an element of wholesale discount and be broadly equivalent to the amount which they received in 2006, she said.
“The cost of the drugs and medicines under these schemes - including ingredient costs, payment for wholesale delivery and pharmacy dispensing fees and retail mark-ups - has doubled since 2002 and totalled over 1.68 billion euros in 2008,” said the Minister. “Put simply, it should not cost 640 million euros to get 1.04 billion euros of drugs from the factory gate to the patient. The rapid escalation in cost must be curtailed. An average of a 12.5% increase each year over six years in costs is not sustainable.”
“With many people having lost their jobs, and wages and incomes being reduced throughout the economy, it is not unreasonable to bring income to pharmacies from state sources back to the level of three years ago,” she added.
At an emergency meeting in Dublin last week, held by the Irish Pharmacy Union (IPU) president Liz Hoctor said the crisis could be resolved and the Minister could still secure her savings if she sat down with the Union to discuss the matter before August 1. “Pharmacists want to help the Minister reduce the national medicines bill, but the way the Minister is doing this will simply not work. It will undermine patient services, force thousands of job losses and widespread closure of pharmacies. We can help the Minister make her savings but not on these terms,” she said.
The meeting was also told that the HSE’s contingency plans to distribute medicines to patients from August 1 will not work. “The HSE has neither the experience nor the means to adequately replace the pharmacy network. It is unrealistic to expect sick and elderly patients to travel to centralised hospital dispensaries to get their medicines from people they don’t know,” said Darragh O’Loughlin, a pharmacist in Galway and vice president of the IPU.
- In 2008, says the HSE, 1.74 billion euros in taxpayer funding was spent in providing medications and appliances under the Schemes, consisting of 1.1 billion euros paid to manufacturers plus 640 million euros in distribution costs paid to wholesalers (110 million euros) and pharmacists (530 million euros) to distribute them.
Fees earned by pharmacists are to be cut by: around 30 million euros as a result of the removal of additional fees related to the automatic entitlement, no longer in operation, to medical cards for people aged over 70; and around 30 million euros as a result of a reduction in fees paid under the various Schemes to reflect the government's decision to reduce professional fees by 8%.