I assume the Deputy is referring to the article from the National Centre for Pharmacoeconomics published in the Irish Medical Journal, entitled Patient Co-Payment for Prescription Medicines Across Europe — How Do We Compare? As is clear from the article, direct comparison with systems in other European states is not straightforward. Belgium, Denmark, Finland, Ireland, Norway, Sweden and the United Kingdom operate various types of set co-payment schemes. Co-payment levels range from €132 per annum in the UK to €2,500 in Belgium. France, Italy and the Netherlands do not require co-payments, although there may be insurance scheme premiums for patients. In Germany, co-payment is based on a percentage of income and there is no annual co-payment ceiling in Spain, Portugal or Greece.
In Ireland, the drugs payment scheme, DPS, significantly benefits families and individuals without medical cards who, either regularly or occasionally, have large drug bills. No individual or family has to pay more than €78 per month for prescribed, approved drugs and medicines. Any costs over €78 are paid by the State. Therefore, no DPS patient has to pay more than €936 a year towards the cost of their medication. Tax relief is available on this expenditure at the taxpayer's marginal rate. The cost of the scheme has risen from £111 million or €140 million in 2000, the first full year of operation, to €192 million in 2002, the latest figure available. The number of people covered under the DPS at the end of December 2002 was 1.32 million, compared to 1.16 million at the end of 2001.
There are no co-payments under the medical card or long-term illness schemes, as medicines are available free of charge under those schemes. This includes patients who are unable to contribute to the cost of their medicines because of undue hardship, anyone over 70 years of age and anyone with a specified chronic illness. These schemes cover 32% of the population.
My Department is currently examining a range of policy options relating to pharmaceutical expenditure, including increased use of generic medicines, pricing and reimbursement structures for the community drug schemes and pharmacoeconomic assessment of reimbursable medicines.
