Paul Murphy (Dublin South West, Solidarity)
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237. To ask the Minister for Health if her attention has been drawn to a charge being placed on blister packs; and if she will instruct her Department to investigate the matter and reverse the decision. [68189/25]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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247. To ask the Minister for Health her plans to reinstate funding for pharmacy blister packs (details supplied). [68230/25]

Michael Cahill (Kerry, Fianna Fail)
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261. To ask the Minister for Health if she will liaise with the HSE and representatives of pharmacies to develop a system where patients, especially older patients can avail, free of charge of their prescriptions by way of blister packs, for ease and safety of medication administration; and if she will make a statement on the matter. [68363/25]

Michael Healy-Rae (Kerry, Independent)
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264. To ask the Minister for Health the reason a contract change between community pharmacies and the HSE will see the price of blister packs increase by 200% from 1 January 2026; and if she will make a statement on the matter. [68386/25]

Pearse Doherty (Donegal, Sinn Fein)
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265. To ask the Minister for Health if she is aware of pharmacy charges medical card holders pay for medication dispensed in blister packs; the impact the charges have on those on low incomes; and if she will make a statement on the matter. [68403/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 237, 247, 261, 264 and 265 together.

The Community Pharmacy Agreement 2025 was published on the 18th of September 2025, following the successful conclusion of negotiations with the Irish Pharmacy Union (IPU). The Agreement is supported by a €75 million new investment across 2025 and 2026.

The Agreement marks a significant milestone in the strategic collaboration between the Department of Health, the Health Service Executive (HSE), and the 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 available on the Department of Health’s website at the following link: www.gov.ie/en/department-of-health/publications/community-pharmacy-agreement-2025/.

It is important to note that 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 monthly, 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 in the pharmacy 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.

Phased dispensing support is currently available for medical card holders under the General Medical Services (GMS) Scheme for the following reasons:

Reason 1 - at the request of a patient's physician.

Reason 2 - due to the inherent nature of a medicinal product i.e. product stability and shelf life.

Reason 3 - where a patient is commencing new drug therapy with a view to establishing patient tolerance and acceptability before continuing on a full treatment regime.

Reason 4 - in exceptional circumstances where the patient is incapable of safely and effectively managing the medication regimen.

Under the Community Pharmacy Agreement 2025, from January 2026, phased dispensing under reason 1 and 4 will be limited to a defined set of high-risk medication classes. These are:

• Psychotropics;
• Opioids;
• Codeine; and
• Pregabalin and gabapentin.