Written Answers Nos. 296-312
296. Deputy Catherine Murphy asked the Minister for Health if Versatis patches will be reinstated to the drugs payment and medical card schemes (details supplied); and if he will make a statement on the matter. [8126/18]
Amharc ar fhreagraMedicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to do this in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long Term Illness and Drugs Payment schemes and the High Tech Arrangement – was approximately €1.8 billion in 2017.
To ensure patients receive the highest quality care, resources invested in medicines must be used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, greater efficiencies in the supply chain and the use of the most cost-effective treatments.
Lidocaine 5% medicated plaster is licensed for the symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia (PHN), in adults. It has been reimbursed in the community drugs schemes since 2010. The projected budget impact on introduction was low due to the specific licensed indication but total expenditure trebled between 2012 and 2016, from €9.4 million to over €30 million, mainly from off-license use for pain not associated with shingles.
An HSE Medicines Management Programme (MMP) review of this product highlighted that the clinical evidence for its use in PHN is limited due to lack of comparative data, and its value is uncertain for other types of pain. The National Centre for Pharmacoeconomics estimated that, in Ireland, only 5-10% of prescribing of this product has been for the licensed indication of PHN.
Following the MMP review, the HSE introduced a new reimbursement system for the product from 1 September 2017. This process supports its appropriate use, ensuring that PHN patients continue to receive this treatment. The HSE estimates that this protocol will reduce annual expenditure on this product by approximately 90%.
Under the protocol, all patients who were receiving antivirals for shingles were automatically approved for the lidocaine medicated plaster. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.
However, since 1 December 2017, non-shingles patients no longer automatically receive this item under the community drugs schemes. In August 2017, the HSE advised GPs and pharmacies of the changes and of treatment alternatives.
It is possible for non-shingles patients to be approved for the patch through the community drug schemes. The patient's GP should apply to the Medicines Management Programme through the online system, and the MMP will review the application and inform the GP of its decision.
I am advised that the MMP has received over 4,500 applications from GPs, of which some 10% have been approved. For many of the conditions applied for, prescribing of the patch was inappropriate, for example, for conditions such as deep venous thrombosis, angina, gout and endometriosis.
Where a GP’s application is rejected, it may be appealed. Of appeals to date, the HSE advises that over 50% have been accepted on clinical grounds.
Full details of the review are available on the HSE website at http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html.
This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
297. Deputy Thomas Byrne asked the Minister for Health if an appointment for a person (details supplied) will be brought forward. [8128/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for inpatient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
299. Deputy Kathleen Funchion asked the Minister for Health the number of persons in County Tipperary using the inpatient services in the acute psychiatry unit, Ennis regional hospital, County Clare. [8139/18]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
300. Deputy Noel Rock asked the Minister for Health the position regarding the shortage of the BCG tuberculosis vaccine; and if he will make a statement on the matter. [8143/18]
Amharc ar fhreagra305. Deputy Maureen O'Sullivan asked the Minister for Health the status of the BCG vaccine; if it will be made available in view of the importance of this pre-emptive vaccination; and if he will make a statement on the matter. [8159/18]
Amharc ar fhreagra336. Deputy Ruth Coppinger asked the Minister for Health the status of the availability of the BCG vaccine; the timeframe for stocks to be replenished; the way in which the backlog will be dealt with; and if he will make a statement on the matter. [8283/18]
Amharc ar fhreagraI propose to take Questions Nos. 300, 305 and 336 together.
The Health Service Executive continues to experience ongoing delays with the supply of BCG vaccine. BCG vaccine stock in all areas expired at the end of April 2015 and as of today this continues to be a problem for Ireland and other countries in Europe that use this licensed BCG vaccine. Since this problem became apparent, the HSE National Immunisation Office (NIO) has been in regular contact with the manufacturer of BCG vaccine to ascertain when the vaccine might be available. There is only one licensed supplier of BCG vaccine to Ireland and this vaccine manufacturer has informed the NIO that the BCG vaccine will not be delivered into Ireland until late 2018 at the earliest. The NIO and the Health Products Regulatory Authority (HPRA) have sought an alternative supply of BCG vaccine that meets safety, quality and effectiveness standards and that could be used in Ireland. To date no appropriate alternative manufacturer has been found. When there is confirmation of a date for a new supply, the HSE will be guided by the recommendations of the National Immunisation Advisory Committee on its administration.
301. Deputy Declan Breathnach asked the Minister for Health his plans to make the coronary artery calcium score test available as part of routine diagnostics for cardiac event risk; if his attention has been drawn to the fact that 70% of cardiac events are caused by plaque rupture which could be diagnosed early using this simple testing procedure; and if he will make a statement on the matter. [8145/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
302. Deputy Pat Deering asked the Minister for Health when a person (details supplied) will receive a psychology assessment. [8146/18]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
303. Deputy Pat Deering asked the Minister for Health the reason blister packs of tablets are now only provided by pharmacies for one week, which has been reduced from four weeks; if his attention has been drawn to the hardship this causes elderly persons that have no transport; and if he will make a statement on the matter. [8147/18]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
304. Deputy Peter Burke asked the Minister for Health if an appointment for an MRI scan for a person (details supplied) will be expedited; and if he will make a statement on the matter. [8151/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for inpatient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
306. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 1, CHO 1, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8170/18]
Amharc ar fhreagra307. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 2, CHO 2, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8171/18]
Amharc ar fhreagra308. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 3, CHO 3, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8172/18]
Amharc ar fhreagra309. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 4, CHO 4, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8173/18]
Amharc ar fhreagra310. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 5, CHO 5, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8174/18]
Amharc ar fhreagra311. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 6, CHO 6, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8175/18]
Amharc ar fhreagra312. Deputy Louise O'Reilly asked the Minister for Health the number of home help hours provided by each of the local health offices in community healthcare organisation area 7, CHO 7, in each of the years 2012 to 2017 and to date in 2018; and if he will make a statement on the matter. [8176/18]
Amharc ar fhreagraI propose to take Questions Nos. 306 to 312, inclusive, together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
