Written answers

Wednesday, 8 December 2021

Department of Health

Medicinal Products

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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163. To ask the Minister for Health the medicines which are under consideration for addition to the long-term illness scheme. [60740/21]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The Long Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme. These conditions are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.

Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. There are no plans to extend the list of conditions covered by the Scheme at this time. However, the LTI scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.

In the meantime, for people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.

Under the Drugs Payment Scheme (DPS), no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The maximum payable under the DPS will be further reduced to €100 per month from 1 January 2022. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In addition, where an applicant is over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.

Persons may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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164. To ask the Minister for Health the cost of adding menopause medicine treatments by type to the drug payment scheme; and if he will make a statement on the matter. [60741/21]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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Under the Drug Payment Scheme (DPS), no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The maximum payable under the DPS will be further reduced to €100 per month from 1 January 2022. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes (including the DPS), in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.

Under the 2013 Act, there are formal processes which govern applications for the pricing and reimbursement of medicines - including that a company must submit an application to the HSE to have a new medicine added to the reimbursement list. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

I, as Minister for Health, have no role in these decisions.

The HSE does not reimburse medicines or agree reimbursement terms in advance of the completion of the required processes. Therefore, it is not possible to give the cost of adding unspecified menopause medicines to the formal reimbursement list in advance of these processes.

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