Dáil Éireann díospóireacht -
Wednesday, 29 Sep 1999

Vol. 508 No. 1

Written Answers. - Drug Treatment Services.

John Bruton

Ceist:

429 Mr. J. Bruton asked the Minister for Health and Children the long-term illnesses which have the highest average annual drug costs; the drug costs on average for long-term illnesses which are covered by the existing long-term illness scheme; the drug costs for long-term illnesses not included in the existing scheme; and if the drug costs on average are higher for the illness included than for those excluded. [17337/99]

Minister for Health and Children (Mr. Cowen):

I should explain at the outset that there is a range of schemes designed to help people with the cost of drugs and medicines. Where an individual or family has a significant level of ongoing expenditure on medical expenses due to a long-term medical condition, these expenses may be reckoned in determining eligibility for a medical card. In some cases a medical card may issue to a family member on a personal basis. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board to decide. The long-term illness scheme entitles patients to free drugs and medicines which are prescribed in respect of a specific schedule of illnesses. This scheme has not been extended since the 1970s and there are no plans to expand the number of illnesses or conditions covered by the scheme, having regard to the fact that the needs of individuals with significant or ongoing medical expenses are met by other community drugs schemes. In this regard, the most recent community drugs scheme is the new drug payment scheme which replaced the drug refund scheme and the drug cost subsidisation scheme from 1 July. Under this scheme, individuals or families need pay no more than £42 per month on approved prescribed drugs and medicines, regardless of the total cost of these medicines.

The cost of drugs for any illness or condition is dependent upon the price of the drugs prescribed for the individual patient and the volume of drugs prescribed. Long-term illnesses can also pose difficulties in definition. For example, some patients might have chronic chest complaints but would only require medication at certain times of the year. Other patients may require medication to treat a condition for some time and then go on to make a full recovery. Conditions such as heart disease can affect a considerable number of patients, who would have varying treatment requirements. In addition, the figures available under the drug cost subsidisation scheme, which catered for patients with ongoing medical conditions, are inclusive of all drugs prescribed for the patient and contain the cost of drugs unrelated to the primary condition. The figures available under the drug refund scheme relate to reimbursement of family expenditure on drugs. It is not possible, therefore, to specify the long-term illnesses which have the highest drug costs or to properly compare drug costs with drug costs of conditions included in the long-term illness scheme.

Under the long-term illness scheme, the conditions which had the highest average drug costs per patient in 1998 were as follows:

Phenylketonuria	£3,841 average drug cost per patient
Parkinsonism	£3,482 average drug cost per patient
Multiple Sclerosis	£915 average drug cost per patient.

The average drug cost per patient under the long-term illness scheme in 1998 was £621.

Bernard Allen

Ceist:

430 Mr. Allen asked the Minister for Health and Children the reason the Southern Health Board is refusing to supply a product (details supplied) under the drug subsidy scheme; and the reason its position has changed in view of the fact that it allowed this to be supplied up to recent times. [17338/99]

John McGuinness

Ceist:

489 Mr. McGuinness asked the Minister for Health and Children the reason certain drugs like Quinine and Oroeite have been excluded from the South-Eastern Health Board drugs refund scheme; if, in view of the cost of these drugs, his Department will ensure that they are included; and if he will make a statement on the matter. [17885/99]

Nora Owen

Ceist:

499 Mrs. Owen asked the Minister for Health and Children if the case of a person (details supplied) who is taking a particular medicine, not covered under the drug refund scheme, for a very rare condition will have her case examined with a view to having this medicine covered; and if he will make a statement on the matter. [17899/99]

Minister for Health and Children (Mr. Cowen):

I propose to take Questions Nos. 430, 489 and 499 together.

The drug cost subsidisation and drug refund schemes were merged into one new drug payment scheme with a threshold of £42 per month per individual or family unit on 1st July. A common list of reimbursable medicines was introduced for the GMS scheme and the drug payment scheme. Previously, medicines which were not available to medical card holders under the general medical services scheme were reimbursed under the community drugs schemes. In general, these were over the counter items and vitamins and cough bottles such as those referred to by the Deputies. The introduction of the common medicines list ensures equity between the general medical services and the drug payment schemes in relation to the range of medicines paid for by the State under both schemes.

In order for any item to be included in the common medicines list it must comply with a published list of criteria. These range from criteria on the uses for and licensing of medicines to the pricing of products. One of the criteria also stipulates that the products should not be advertised or promoted to the public. In addition, over the counter – OTC – products in general are not available under the schemes. With regard to quinine, I should also say quinine sulphate is authorised for use in this country for the treatment of malaria and for no other indication.

The list of drugs, medicines and appliances available to GMS patients, as specified in the current GMS code book – including all updates – and with some additions, forms the common list of items for both the GMS and the new drug payment scheme. I am satisfied that the common list provides a comprehensive range of the most modern therapies. This common list of items is of course subject to ongoing review and is amended on a monthly basis as new items are added to the list.