The existing drugs cost subsidisation and drug refund schemes will be merged into one new drug payment scheme with a threshold of £42 per month per family unit.
The primary aim of the new drug payment scheme is to bring about important improvements in the existing schemes. The new scheme will effectively merge the best elements of the two existing schemes and is designed to significantly improve the cash flow situation for families and individuals incurring ongoing expenditure on medicines.
From the introduction of the new scheme no individual or family will have to pay more than £42 per month for prescribed medicines. It means that families and individuals will, for the first time, be able to budget for the cost of medicines. Families and individuals will know that, whatever the size of their drugs bill, they will not have to pay more than £42 per month.
The fact that the drug payment scheme will operate on a monthly basis has distinct advantages over the current drug refund scheme. Under the drug refund scheme, a family or an individual could, for example, in one month have expenditure of £80 but no expenditure in the other two months. They would not have been entitled to a refund. Under the new scheme, they will only have to pay £42 in that month.
There are no qualifying criteria for inclusion on the new drug payment scheme. Where expenditure by a family or an individual exceeds £42 per month on prescribed medicines, the balance will be met by the State. This is in contrast to the old DCSS scheme, where patients had to be certified by their doctor as suffering from a condition requiring ongoing expenditure on medicines in excess of £32 per month.
With regard to the increase in the threshold, there has been no increase in the threshold for the existing schemes since 1991. It must also be borne in mind that the new threshold refers to family expenditure as opposed to the existing threshold in the drug cost subsidisation scheme which relates to individual expenditure.
