I thank the Deputy for his question. He will be aware that I secured funding of €1.3 million in budget 2023 to provide reimbursement support for Cariban, which I think is at the heart of his question. Cariban has been available since the beginning of the year for women suffering from hyperemesis, which is a severe form of nausea and vomiting during pregnancy that affects about 1% of pregnant women. I believe the number of women who have been approved for the product is 144 as of today.
This is slightly ahead of projections in terms of the funding allocated. Because Cariban is an unlicensed it is being handled in line with the established procedures around clinical governance. This is that the initial prescriber of Cariban to the patient must be a specialist or a consultant and subsequent prescriptions can come from a GP.
It has been brought to my attention, very reasonably, that some women are saying they need access to some form of treatment, be it Cariban or something else, before the 12-week appointment with an obstetrician. There is a request it would simply be a GP who would provide the initial prescription. I have gone back to the Department with that suggestion. The initial response I got back from the Department and the HSE was for unlicensed products. Cariban is an unlicensed product and the company has never applied for it to be licensed in Ireland. Personally I think it should do this as a priority, but the company has not done so, and because of that for clinical governance reasons it falls within the established framework, which is prescription by a consultant. Nonetheless, based on the obvious issue raised concerning access and timing to see an obstetrician, I have asked that this be reviewed to see if there is a clinically appropriate formula that can be put in place to provide access quicker when pregnant women need it, rather than when they can get access to an obstetrician.