Michael Healy-Rae (Kerry, Independent)
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198. To ask the Minister for Health the measures which will be taken to ensure protections remain in place for persons who rely on phased systems for medication dispensing, ahead of the planned removal of phased dispensing under the Community Pharmacy Agreement Act 2025; and if she will make a statement on the matter. [52446/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Community Pharmacy Agreement 2025 does not remove phased dispensing.

Phased dispensing was introduced in 1996 for patient safety reasons. The supply of medication in instalments can support patients prescribed certain high-risk medications who are at risk of medication misadventure if these medications were to be supplied on a monthly basis, as is the norm under the community drug schemes. Where a phased dispensing claim is submitted, the current requirement is that an item must be dispensed across multiple supply occasions. Community pharmacies receive additional payments in respect of phased dispensing.

Monitored Dosing Systems are systems that enable the individual medicine doses to be organised according to the prescribed dose schedule. These are sometimes referred to as blister packs. The State has never agreed to fund Monitored Dosing Systems.

However, a practice has built up whereby the use of Monitored Dosing Systems are charged as if for phased dispensing. The State has never agreed to this. Phased claiming was never intended to be used to submit claims in lieu of the provision of Monitored Dosing Systems.

Whilst Monitored Dosing Systems may have a role for some patients there is significant uncertainty around the robustness of the evidence supporting its use. The National Centre for Pharmacoeconomics carried out an evidence assessment which indicated that the evidence was, at best, equivocal to support such a programme.

Significant expenditure is therefore being incurred where it was never intended by the State. It has been agreed to introduce improved controls in this regard and to limit the use of phased dispensing to specified high risk drugs, where a patient safety concern may exist.

This is being done in a way which puts patient safety first and allows the State to repurpose €20m of funding to be used to implement new patient-centred services.

It remains open to pharmacies to charge patients for the use of Monitored Dosing Systems as a private service.