Dáil Éireann Debate, Thursday - 13 June 2013
224. Deputy Róisín Shortall asked the Minister for Health the position on generic substitution when the least expensive substitute medicine is unavailable to a particular pharmacist; and if he will clarify in these circumstances if a top-up fee will apply to medical card holders in respect of the more expensive substitute medicines available to the pharmacist. [28570/13]
View answerIt is a matter for each pharmacy to determine what medicines it holds in stock. Currently if a patient has a prescription specifying a branded medicine, they will receive that branded medicine from the pharmacist. If a pharmacy does not have a particular medicine in stock the patient may request the pharmacy to order the medicine or alternatively seek the medicine in question from another pharmacy.
The provisions of the Health (Pricing and Supply of Medical Goods) Act 2013 relating to the substitution of interchangeable medicines and reference pricing are expected to be commenced shortly. The Act enables patients to opt for lower cost interchangeable medicines. In general terms, when a pharmacist is presented with a prescription for an interchangeable medicine, which is not the subject of a clinical exemption, the pharmacist is obliged to offer the patient the opportunity to agree to substituting the prescribed product with an interchangeable medicine which is in stock in the pharmacy and is of lower cost to the patient or the HSE, as the case may be. The patient may either accept the interchangeable medicine offered by the pharmacist or opt to receive the branded interchangeable medicine where prescribed. Alternatively, the patient may opt to go to a different pharmacy to receive a less expensive interchangeable medicine.
The Act also allows the HSE to set a reference price for groups of interchangeable medicines. Medical card holders will only face an additional charge where a reference price has been set for a group of interchangeable medicines and the medicine dispensed is priced higher than the reference price and is not the subject of a clinical exemption. It is expected that all pharmacies supplying items to patients under the GMS and community drugs schemes will have products available at or lower than the reference price and therefore patients will not incur any unavoidable costs under this legislation.
Under the Act, when the HSE sets a reference price for a group of interchangeable medicines, pharmacists must be given four weeks' notice before the reference price takes effect. If a pharmacy does not have a medicine available at or below the reference price the patient may request the pharmacy to order a suitable medicine or alternatively seek a lower cost medicine from another pharmacy.
