Dr. Susan O'Dwyer:

We agree it is great that funding has been put forward but structures are in place with regard to the PCRS and the HSE that affect how that works in practice. Often, when new medicines are brought to the market, some specific restrictions will be put on their supply in terms of funding. That is to control spend in many cases. On Cariban, the structure that has been put in place means women have to go to a consultant in the first instance. The very first prescribing of Cariban needs to be consultant initiated. After that, patients can go to their GP and their second, third and subsequent prescriptions can be GP initiated if necessary. Once the initial approval is in place, the GP can follow on with that prescribing.

Patients can come to the pharmacy from the hospital, with consultant approval, if they are private patients. If they are medical card patients, they have to do that step where they go to their GP, get the drug written on the medical card prescription and then come to the pharmacy. There are many barriers along the way. There are barriers to access in lots of places. We welcome the funding for Cariban but the systems in place to realistically have it approved in practice, and women actually accessing it, put too many restrictions in place and delay access for those women.