asked the Minister for Health whether he considers the present drugs refund scheme under which the State carries 100 per cent of the cost of drugs over £28.00 effectively removes any economic incentive from doctors or patients to economise on the nature and cost of drugs prescribed in excess of that sum; and whether he will consider proportionate subsidies related to health categories a preferable system for cost control.
Ceisteanna—Questions. Oral Answers. - Drugs Refund Scheme.
4.
Since the £28 is a cumulative figure, arising possibly from a number of doctor visits, it is unlikely to encourage the prescribing of unnecessary medication.
A scheme which would relate the amount to be refunded to the condition being treated, with varying proportions depending on the category of illness, may not have the desired results. It would require extensive investigation, checking and calculating which would generate additional staff costs and almost certainly result in greater delays in making payments.
Has the Minister considered any other means of altering prescribing practices in view of the growing concern at the high cost within the health services of drugs and also in view of the fact that the Trident report recommended a change in the system of purchasing which would have involved in a move away from the £28 system in the case of the drugs scheme?
Broadly speaking, I am concerned that people who have constant regular monthly drug bills of £25 to £30 a month get no refund, whereas a person who has a particularly expensive episode of illness and automatically gets a refund of the total cost over £28 probably would not merit absolute concern. There is no doubt that £30 a month every month is quite expensive and no refund is available, but the provision of assistance for such persons without adding to the administrative costs or increasing the delay in refunds would be extremely difficult to arrange. The £28 is usually made up of about four to five items on an average of about three prescriptions. It would be extremely difficult to devise another system. We examined it at great length.