While assisted human reproduction (AHR) treatment, such as IVF, is not currently funded by the Irish public health service, as the Deputy is aware, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. Given the costs associated with certain fertility medicines, I am aware that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
Further to this support, a commitment to introduce the model of care for infertility, which was developed by officials in my Department in conjunction with the HSE’s National Women & Infants Health Programme, is included in the Programme for Government, “Our Shared Future”. This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary as part of the full range of services available in obstetrics and gynaecology.
Phase One of the roll-out of the model of care has commenced and involves the establishment, at secondary care level, of Regional Fertility Hubs in maternity networks, which will facilitate the management of a significant proportion of patients presenting with infertility issues.
Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system. Phase Two will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated, and the AHR legislation is commenced. Drafting of the AHR legislation is ongoing, in conjunction with the Office of the Attorney General.
It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years. The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.