I thank Deputy Kelleher for having raised this question. In the current financial environment the Health Service Executive is facing a challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, it has become necessary for the HSE to suspend certain products from its list of reimbursable items. These include glucosamine, omega-3 triglyceride products, orlistat, and gluten-free products.
Glucosamine is indicated for the management of symptoms of osteoarthritis. The National Centre for Pharmoeconomics has assessed the cost-effectiveness of glucosamine on two occasions and concluded that it did not offer value for money to the HSE. However, it should be noted that glucosamine products are available over the counter without prescription.
Omega-3 triglyceride products - for example, omacor - have been identified both nationally and internationally as not being cost-effective or being of lesser benefit to patients. However, these products are also available over the counter without prescription, as is orlistat.
Gluten-free products have become more widely available in supermarkets in recent years and tend to be significantly cheaper than products sold through community pharmacies. A supplementary welfare allowance adult diet supplement may be awarded by the Department of Social Protection to eligible persons. Persons wishing to apply for this allowance can do so by completing an application form which can be downloaded at http://www.welfare.ie/EN/Forms/Documents/swa9.pdf. Separate application forms are available for children on that site. For persons who are not awarded a diet supplement, moneys spent on gluten-free foods can be taken into account for tax purposes.
A full list of items available under the community drug schemes is available on the HSE's primary care reimbursement service website, www.pcrs.ie. If one goes on to that site, one should choose the "List of Reimbursable Items" option. In addition, the monthly updates, additions and deletions, to the product list are provided at the same location under "Updates to the List of Reimbursable Items and High Tech Scheme List".