Irish prescription charges will rise from 1.50 euro to 2.50 euros per item from December 1, raising an estimated 43 million euros a year, says the government.

The increased charge, part of the 2014 Budget announced this week, is “intended to address rising costs in the medical card scheme and to influence to some degree demand and prescribing patterns,” says the Department of Health, which forecasts that 65 million items will be dispensed under the scheme this year.

The Budget also increases the monthly prescription charge cap for medical cardholders from 19.50 euros to 25 euros per person or family.

It is projecting additional savings of 50 million euros in 2014 resulting from the implementation of generic substitution and reference pricing, on a phased basis. Priority is being given to medicines which will achieve the greatest savings and, initially, 20 active substances - equating to around 1,500 individual medicines and accounting for 57% of the overall ingredient cost of off-patent drugs - will be reviewed.

Also, reference prices for atorvastatin products - the first drugs included on the List of Interchangeable Medicines - will be implemented from November 1.

The Budget projects savings of 28 million euros to result from price reduction agreements negotiated by the Department and the Health Service Executive (HSE) in 2012 with the pharmaceutical industry, in addition to over 120 million euros in savings this year.

It also includes provisions for 10 million euros savings from removing products from the reimbursement list of the General Medical Services (GMS) and Community Drugs Schemes (CDS); the HSE will now consider which products should be removed.

And a further 113 million-euro saving is expected next year from a review of medical cards “probity,” aimed at “ensuring that those who are entitled to medical cards continue to hold them and that those who are not entitled…do not,” says the Department.

The higher prescription charges have been condemned by patients’ and carers’ groups, who point out that they will particularly impact older and chronically ill people who are on a variety of medications and could lead to such patients rationing their treatments.

Meantime, the Budget’s introduction of free general practice care for children up to and including five years of age, at a cost of 37 million euros, has met with a mixed response, with the Irish Medical Organisation (IMO)’s GP committee dismissing it as “a political stunt.”