The position is that, with effect from 1 July 1999 the existing drugs cost subsidisation and drug refund schemes will be merged into one new drug payment scheme, with a threshold of £42 per month per family unit. Where expenditure by a family or an individual exceeds £42 per month on approved medicines, the balance will be met by the State.
The primary aim of the new drug payment scheme is to bring about important improvements in the existing schemes. The new scheme will effectively merge the best elements of the two existing schemes and is designed to significantly improve the cash flow situation for families and individuals incurring ongoing expenditure on medicines.
The new drug payment scheme is for everyone. To qualify under the old drugs cost subsidisation scheme, patients had to be certified by their doctor as suffering from a condition requiring ongoing expenditure on medicines in excess of £32 per month. There are no qualifying criteria for the new scheme.
Under the drug refund scheme, families and individuals pay the full cost of their prescription medicines and may, at the end of the quarter, claim reimbursement from their health board of expenditure over £90 in that calendar quarter. Many families and individuals have very heavy expenditure on drugs and medicines in a quarter and have to wait a further six weeks from the end of the quarter before they receive a refund. This can cause considerable cash flow problems for a significant number of families and individuals. From the introduction of the new scheme, no individual or family will have to pay more than £42 per month for prescribed medicines. It means that families and individuals will, for the first time, be able to budget for the cost of medicines. Families and individuals will know that, whatever the size of their drugs bill, they will not have to pay more than £42 per month.