THE VAST majority of the State’s 1.5 million medical card holders start paying for their medicines for the first time from today in the form of a 50 cent per item prescription charge.
Pharmacists, who opposed the introduction of the charge, have warned it will cause hardship for many patients, and could result in some not taking essential medication.
The charge will particularly affect long-term and heavy users of prescription medicines, although it is subject to a cap of €10 per month for each family.
Some categories of patient are exempt from the charge, such as hepatitis C patients, children in the care of the HSE, and those on the long-term illness scheme and high-tech drugs.
However, the Irish Pharmacy Union (IPU) pointed out yesterday that exemptions do not apply to many vulnerable groups.
The measure, which is expected to raise €24 million a year, was announced in last year’s budget and is being implemented on foot of legislation passed this year.
Minister for Health Mary Harney has said the charge is needed to raise money and to discourage “over-prescribing and the overuse of medication”.
Among those who will have to pay the charge are homeless people, residents of HSE-run and private nursing homes, residents of disability centres, terminally-ill patients receiving palliative care and psychiatric patients in the community.
Patients availing of the psychiatric scheme, who also have to pay the levy, will have to go to their GP after attending an outpatient clinic in order to get a GMS prescription. Previously the clinics could provide the patient with the prescription and have it dispensed in the pharmacy.
The HSE confirmed to pharmacists in a letter last week that homeless people not living in a residential centre were liable for the charge. Where homeless people are living in a centre, the accommodation provider has to pay the charge on their behalf and then make arrangements to collect it from residents.
The charge also applies to emergency prescriptions from hospitals, dental prescriptions under the dental treatment scheme and TB patients. Where people are prescribed items in different strengths and containers, such as happens with Warfarin patients, the charge will apply to each strength of the product.
Recovering heroin addicts will not have to pay the charge for their methadone prescriptions but it will apply to any other medication they are taking for their addiction.
The measure is the latest in a series of cost-saving or revenue-raising initiatives in the health service.
Last February the price of hundreds of common off-patent medicines dropped by 40 per cent after a deal between the State and pharmaceutical manufacturers. Last year the State cut the amount it reimburses pharmacists for drugs under the medical card scheme despite opposition from the sector.
Ms Harney has the power to exempt further categories of patient from the new charge if she chooses.
The IPU also criticised the lack of public awareness of the change and the absence of an advertising campaign. It predicted the charge would come as a shock to many medical card holders.
The union’s president, Darragh O’Loughlin, said: “Prescription levies have been abolished in other countries, including Northern Ireland and Wales, yet they are being introduced here.”
Taoiseach Brian Cowen defended the charge in the Dáil last July, noting that the McCarthy report on public expenditure cuts had recommended a €5 prescription charge.
Pharmacists are obliged by law to collect the levy.
