The provision of hormone replacement therapy (HRT) has been in the news in recent weeks, after a delay to the roll-out of a State-funded scheme.
What is HRT?
HRT is a prescription-based medicine used to relieve symptoms of menopause such as hot flushes, night sweats, mood swings, vaginal dryness and reduced sex drive.
There are different types of the HRT, with the medicine coming in tablet form, skin patches, gels and vaginal creams or pessaries. The medication replaces hormones that decline during perimenopause and menopause.
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And it was supposed to be freely available?
Yes, in Budget 2025, Minister for Health Stephen Donnelly announced the medicine would be freely available from January 1st.
Some €20 million was set aside for the scheme, while laws were passed before the dissolution of the last Dáil to allow for the scheme to be implemented.
The scheme, under the format chosen, would require women to pay for GP and pharmacy services in relation to obtaining these medicines, meaning it is just cost of the medicine itself that is covered by the State.
On average, the scheme would be expected to save women availing of it between €360 and €840 a year, based on current monthly payments.
But it’s after January 1st and it’s not yet available?
That’s the current issue at hand. The Department of Health has now said the goal is to introduce the scheme “as soon as possible”.
What’s the reason for the delay?
The Irish Pharmacy Union said it has written to and met the department on a number of occasions, beginning in October, outlining is concerns about the scheme.
According to the union, there are “significant implementation gaps”, such as a lack of guidance, no list of medication that will be covered and that a tested IT system is not in place.
Internally, however, the department has indicated the delay is related to a reluctance on the part of pharmacists to disclose how much they charge as a professional fee for their services.
How many people does this affect?
The scheme is for women who have been prescribed HRT by their healthcare provider and it applies to HRT products already covered by the Health Service Executive under relevant schemes such as the drugs payment and general medical services schemes, the department said.
Women typically enter menopause between the ages of 45 and 55. In Ireland more than 500,000 women are aged between 45 and 64, which is when women can be prescribed HRT, meaning hundreds of thousands of women could be eligible for the scheme.
While not all women need treatment, research by the department from 2022 shows almost one in five women in Ireland suffer severe symptoms from menopause.
For the purposes of the scheme, menopause is defined as the various stages for the treatment of menopause symptoms and includes perimenopause, post menopause, early menopause, premature menopause and medically induced menopause.
So then when will it be available?
That’s the ultimate question. Some pharmacists have warned it could be months before it’s in place, while the department said it was continuing to work with the HSE and pharmacists to ensure it is implemented “as soon as possible”.
On a positive note, it appears all sides are willing to meet and discuss the scheme to ensure its implementation. It’s clear, however, that there are a number of issues that must be resolved before this can happen.
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