Pádraig Rice (Cork South-Central, Social Democrats)
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690. To ask the Minister for Health if she will reverse the proposed changes to phased dispensing under the new community pharmacy agreement, which are due to come into operation on 1 January 2026; if her Department or the HSE assessed the impact of these changes on vulnerable patients to safely manage their medications; and if she will make a statement on the matter. [68087/25]

Pádraig Rice (Cork South-Central, Social Democrats)
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691. To ask the Minister for Health if she will suspend implementation of the proposed changes to phased dispensing under the new community pharmacy agreement pending full consultation with front-line clinicians; if she will undertake a risk impact assessment, specifically examining effects on vulnerable groups; if she will commit to co-designing revised criteria for phased dispensing with GPs, pharmacists, disability services, and patient groups (details supplied); and if she will make a statement on the matter. [68088/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 690 and 691 together.

The Community Pharmacy Agreement 2025 marks a significant milestone in the strategic collaboration between the Department of Health, the Health Service Executive (HSE), and the Irish Pharmacy Union (IPU). It sets out a comprehensive and ongoing pathway to modernise and expand the role of community pharmacy in Ireland’s healthcare system.

The Agreement is designed to support the delivery of safe, equitable, and efficient healthcare, and to ensure that community pharmacists are better equipped to contribute to national health priorities through structured engagement, sustainable funding, and integrated service delivery. The Agreement is available on the Department of Health’s website at the following link: www.gov.ie/en/department-of-health/publications/community-pharmacy-agreement-2025/.

There are currently no reimbursement arrangements under the General Medical Service (GMS) Scheme or the Community Drug Schemes for the filling of Monitored Dosing Systems, sometimes known as blister packs. Community pharmacies may offer, as a quality initiative, to provide a patient’s medicines in such systems and may charge for this. However, such is a pharmacy arrangement with the patient and is not a State funded service.

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.

During the substantial negotiations that resulted in the Community Pharmacy Agreement 2025, it was agreed between the State and the IPU that improved controls would be introduced to limit the use of phased dispensing to specified high risk drugs, where a patient safety concern may exist. The improved controls will ensure that phased dispensing payments are targeted to medications with the highest risk or potential for misuse.

In addition, under the Agreement, a Strategic Collaboration Group will be established from early 2026 which will provide a structured forum for dialogue and joint consideration of strategic issues shaping the future of community pharmacy in Ireland.

The Agreement also includes the establishment of a rolling annual medicines optimisation programme with dedicated annual funding. The Strategic Collaboration Group will be tasked with exploring the best way to utilise this fund.

In conclusion, the introduction of improved controls around phased dispensing is being done in a way which puts patient safety first and allows the State to repurpose funding to be used to implement new patient-centred services. Of course, it remains open to pharmacies to charge patients for the use of Monitored Dosing Systems as a private service.