Dáil Éireann díospóireacht -
Wednesday, 29 Jan 2003

Vol. 560 No. 1

Written Answers. - Drugs Payment Scheme.

John Cregan

Ceist:

720 Mr. Cregan asked the Minister for Health and Children in relation to the many complaints being received regarding an increase in the monthly cost of the drug cost subsidisation scheme, the annual cost of drugs under the medical card scheme; the annual cost of drugs under the subsidisation of ?70 per month scheme; the details of costs over the past ten years; if increases in thresholds over the past five years can be traced; if increases are substantially over inflation figures; the reason the increase is justified; if it is accepted that those who constantly exceed the ?70 limit are being discriminated against; and if a more balanced system can be introduced realising that total costs are escalating. [1866/03]

Minister for Health and Children (Mr. Martin)

The drugs payment scheme, DPS, with a monthly threshold of £42, €53.33, replaced the drug refund scheme, DRS, and the drug cost subsidisation scheme, DCSS, in 1999. This scheme provided that families only had to meet the first €53.33 a month of spending on approved prescribed medicines. The DCSS threshold was £32, €40.63, per month per individual, and for the DRS it was £90, €114.28, per quarter for each eligible person and dependants. Under the DRS, the person paid for medicines at the pharmacy, and claimed a refund from the health board at the end of each quarter. There was no increase in the thresholds for the DRS or DCSS since 1991. The threshold for the DPS was raised from €53.33 to €65 with effect from 1 August 2002 and from €65 to €70 with effect from 1 January 2003.

The DPS has provided a fairer and more user friendly system than the previous schemes, particularly through the provision of monthly medicine budgeting for families, and has produced significantly greater overall benefit for patients. It introduced full reimbursement, at point of supply, of the cost of approved drugs above the monthly threshold. In line with quality customer service principles, there was no longer any need to pay first and then reclaim this expenditure from the health board, and, unlike the DCSS, everybody was eligible for the DPS.

The increases in the threshold of the scheme are running slightly ahead of inflation since August 2002. However, I would like to emphasise that the aggregate financial benefits for patients under the DPS are clearly significantly greater than the old schemes. The total patient benefit under the DRS and the DCSS in 1998 was £75 million in the last full year of operation. In contrast, the DPS subvention was £110 million in 2000, the first full year of operation, and rose to £140 million in 2001, an increase of 87% in three years.

The cost of the drug refund and drug cost subsidisation schemes for the years 1992 to end June 1999 and for the drug payment scheme from July 1999 to end December 2001, together with the cost of drugs, medicines and certain appliances for the general medical services scheme are set out in the following table.

Year	GMS	DRS	DCSS	DPS
	£	£	£m	£
1992	136,069,561	11,752,134	10.171
1993	139,602,579	13,235,334	13.014
1994	147,458,143	15,240,700	17.082
1995	159,612,350	17,483,410	22.527
1996	168,979,879	21,015,059	28.689
1997	182,645,515	24,452,827	35.859
1998	203,152,753	27,505,550	47.191
1999	229,300,498	25,250,489	27.813	40,431,188
	€	€	€	€
2000	338,802,725			140,598,362
2001	434,019,532			177,616,777