Duncan Smith (Dublin Fingal, Labour)
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106. To ask the Minister for Health if he plans to make hormone replacement therapy, HRT, medication free for persons going through menopause; and if he will make a statement on the matter. [61093/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal Reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

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. 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).

The HSE reimbursement list is the same for the General Medical Services (GMS) scheme and the Drug Payment Scheme (DPS). Therefore, some hormone replacement therapy (HRT) medications are available to medical card holders under the GMS scheme, subject to the statutory prescription charge. These same HRT medications are also available under the DPS, which ensures that no individual or family pays more than €80 a month towards the cost of approved prescribed medicines.

While there are no plans to make the provision of HRT products free of charge, the VAT rate for non-oral forms of HRT will be reduced to zero from 1 January 2023, as announced in Budget 2023. This should reduce the cost of these forms of HRT for private patients who need them.

In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.

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 circumstances where an applicant is still 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.

Finally, individuals 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%.