Paul Donnelly (Dublin West, Sinn Fein)
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814. To ask the Minister for Health if there is a plan to provide support to those on a strict low calorie diet that was pharmacy/medically supervised given others can avail of an injectable weight loss programme on the medical card. [57019/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Health Service Executive (HSE) has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013.

A pharmaceutical company can apply to the HSE for reimbursement for a specific indication (use) of a specific licensed medicine. Medicines can have more than one licensed indication, and each indication represents a separate application.

In making a relevant reimbursement decision, the HSE is required under the 2013 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.

In some cases, the HSE Medicines Management Programme (MMP) may develop a Managed Access Protocol (MAP) for some medicines added to the reimbursement list. MAPs are used to identify patients or subgroups of patients who would most benefit from the specific treatment approved for reimbursement and for whom the clinical evidence of therapeutic benefit is strongest, and applications are reviewed by the MMP on a case-by-case basis.

Such is the case, for example, for the weight management medicine Saxenda (Liraglutide). The relevant circular can be accessed at: www.hse.ie/eng/staff/pcrs/circulars/pharmacy/pharmacy-circular-002-23-saxenda.pdf.

The Irish Public Health System provides for two categories of eligibility for persons ordinarily resident in the country, i.e., full eligibility (medical cards) and limited eligibility. Reimbursable claims for medicines on the HSE reimbursement list are based on prescriptions which are transmitted to the pharmacist.

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 under the General Medical Services (GMS) Scheme. Possession of a medical card entitles people to access prescribed medicines subject to the payment of a small prescription charge. 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. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment.

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.

Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.

There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the DPS threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.

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%.