More than 140 pharmacists will stop dispensing methadone to about 3,000 clients in Dublin today in a dispute between the Irish Pharmaceutical Union and the Health Service Executive (HSE).
The HSE has put alternative arrangements in place in 11 HSE premises around the city, and has set up a drug helpline (1800 459459) for clients on the methadone-maintenance programme.
A HSE spokesman said there was "a significant clinical risk of overdose" to clients who reverted to heroin instead of methadone, a synthetic substance used to treat withdrawal symptoms.
The IPU has called on the National Implementation Board to intervene in the dispute, but a HSE spokesman said he would not comment on this demand.
The dispute centres around the reduction of prices paid to pharmaceutical wholesalers, but IPU president Michael Guckian said the HSE had also failed to provide the necessary support to allow the methadone scheme to function effectively and safely.
"And the recent move by the HSE to unilaterally breach the financial basis of its contract with pharmacists is the straw that has broken the camel's back," he said.
More than half of pharmacists in the methadone programme in Dublin are involved in the dispute.
The HSE said there was "no justification" for any pharmacy to withdraw from the scheme on the basis of the reduction in prices paid to pharmaceutical wholesalers.
"Before the reforms detailed analysis showed that the current medicine wholesale mark-up in Ireland, at 17.66 per cent, was more than double the EU average," a HSE statement said. That will fall to 8 per cent in January and to 7 per cent in 2009.
Gretta Crowley, HSE local health manager, said the methadone service was completely unrelated to the reduction in drug prices, "and it is difficult to understand the rationale for some pharmacists to target this group of clients".
The IPU blames the HSE for causing the dispute, and warned that the methadone treatment scheme was on the verge of collapse.
Mr Guckian said pharmacists had no option but to take this action because they would be dispensing medicines to medical card patients at a loss if the reduced prices were introduced.
"Pharmacists feel that they are being forced out of the scheme as they simply cannot allow the HSE to ruin their businesses."
Mr Guckian said pharmacists would return to the methadone scheme as soon as the HSE found a process to engage in negotiations with pharmacists, as it had done with consultants.
