Written Answers. - Drugs Payment Scheme.
Gay Mitchell
Question:
232
Mr. G. Mitchell
asked the
Minister for Health and Children
the reason he proposes to increase the threshold from £32 to £42 per month before families can get a refund on the cost of prescribed drugs used in any one month; if he will review this decision; and if he will make a statement on the matter.
[5871/99]
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.
The new family scheme will have significant advantages over the existing drug refund scheme. Under the drug refund scheme, families and individuals pay the full cost of their prescription medicines and may, at the end of the quarter, claim reimbursement from their health board of expenditure over £90 in that calendar quarter. Many families and individuals have very heavy expenditure on drugs and medicines in a quarter and have to wait a further six weeks from the end of that quarter before they receive a refund. This can cause considerable cash flow problems for a significant number of families and individuals. This will not happen under the new drug payment scheme. 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. In addition, there are families where, although one member may qualify for a drug cost subsidisation scheme card, combined expenditure on medicines by other members, which can be considerable, cannot be recouped until the end of the quarter. With the new drug payment scheme, no family will have to pay more than £42 in any month for prescribed medicines. The new scheme will be of significant benefit to such families.
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 say £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 in 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 from £32 to £42, the position is that there has been no increase in the threshold for the existing schemes since 1991. It must also be borne in mind that the new £42 threshold in respect of the drug payment scheme refers to family expenditure in contrast to the existing £32 threshold in the drug cost subsidisation scheme, which relates to individual expenditure.
