Wednesday, 13 July 2022
Department of Health
Medical Aids and Appliances
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
The HSE have advised that International Normalised Ratio (INR) self-testing strips such as CoaguChek® are not reimbursable under the General Medical Services (GMS) and Community Drug Schemes. Equipment such as machines are also not reimbursed by the HSE Primary Care Reimbursement Service (PCRS) under Community Drug Schemes.
Whilst a range of diagnostics are available on the Reimbursement List for use in Diabetes, a change in HSE policy would be required to expand this to other therapeutic areas such as INR testing ancillaries.
On very rare occasions, CoaguChek® strips were approved for reimbursement in the most exceptional circumstances under Discretionary Hardship Arrangements where it was clear that there was no other option for the patient i.e. the person was bed bound or could not travel to the INR clinic.