Dáil Éireann Debate, Tuesday - 13 December 2022
573. Deputy Marian Harkin asked the Minister for Health if he will consider issuing medical cards to those suffering with the genetic medical condition congenital adrenal hyperplasia (details supplied); and if he will make a statement on the matter. [61835/22]
View answer575. Deputy Marian Harkin asked the Minister for Health if he will consider including the condition congenital adrenal hyperplasia in the long-term illness scheme; and if he will make a statement on the matter. [61849/22]
View answerI propose to take Questions Nos. 573 and 575 together.
The Government is committed to ensuring that healthcare in Ireland is both accessible and affordable.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement for medicines under the community drugs schemes is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics.
The Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.While there are no plans currently to extend the list of illnesses covered by the LTI scheme, the scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.
There are two schemes operated by the HSE which protect people from excessive medicine costs, the Drug Payment Scheme (DPS) and the General Medical Services (GMS) Scheme.
Under the DPS, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested, is available to anyone who is ordinarily resident in Ireland, and significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the GMS scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
