The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
I wish to advise the Deputy that no reimbursement programme currently exists for the reimbursement of medicinal cannabis oil products.
However, patients who have a valid medical prescription for medical cannabis and a Ministerial licence and who have sourced a cannabis-based product may submit an application to the HSE for reimbursement approval.
The HSE has advised that in the previous situations where it considered reimbursement support appropriate, the following steps were completed.
- The patient’s consultant is satisfied that all therapeutic options have been exhausted and is prepared to accept the responsibility for monitoring the patient’s response to the cannabis product.
- A prescriber applies to the Minister for a Ministerial license and this is granted.
- The consultant completes an Individual Reimbursement Form, setting out the therapeutic benefit for the patient. It is important that this is completed in sufficient detail for therapeutic benefit to be demonstrated.
- The Individual Reimbursement Form is considered by the Medicines Management Programme (MMP).
- On review of the documentation, the MMP makes a recommendation for or against reimbursement support for the patient to the HSE, under the patient's eligibility, and informs the Primary Care Reimbursement Service (PCRS) of that recommendation.
If approval is given, the PCRS, when authorised to proceed, will make the necessary arrangements to cover the costs involved for the patient.
Three patients have a Ministerial licence and have been approved by the MMP for their product and travel costs to the Netherlands to access a product on which the patients had been stabilised and for whom therapeutic benefit was established for seizure control.
There are 10 further applications open at present which are awaiting a decision.
Medical practitioners and patients are encouraged to consult the Department of Health website for information on medical cannabis, including clinical guidance on the use of medical cannabis. This information can be found at the following link: https://health.gov.ie/blog/publications/cannabis-for-medical-use/.
It is important to note that the decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient.
As Minister for Health I have no role in this clinical decision-making process and Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.