Supply and Reimbursement
The Irish Pharmaceutical Healthcare Association (IPHA) has worked for a long number of years with the State to ensure that in Ireland we have a single tier system of access to medicines, whereby all patients, regardless of income have access to the medicine which their doctor believes is best suited to their needs.
How medicines get to the patient
The medicine supply chain has 3 elements:
• The manufacturers, principally members of IPHA, who develop, manufacture and bring innovative medicines to the Irish market.
• The wholesalers who store and transport these medicines to hospitals and community pharmacies across the country.
• The community pharmacists who dispense the medicine to the patient.
How medicines are payed for
In Ireland, the State pays for approx. 80% of all medicines. The ultimate cost to the State of medicines dispensed in the community depends on which community medicine scheme the patient uses to access the medicines. There are 4 principal schemes which determine whether people get free or subsidized medicines:
• General Medical Services Scheme (GMS - medical cards): the patient receives their medicines after paying a €2.50 per item prescription charge (up to a maximum charge of €25.00 per family per month) and the pharmacist a dispensing fee but no mark up.
• Drug Payment Scheme (DPS): the patient pays a maximum of €144/month for medicines, the pharmacist receives both a mark-up and a dispensing fee.
• Long Term Illness Scheme (LTI): the patient receives medicines for specific conditions (e.g. diabetes, epilepsy) free of charge. As with the DPS the pharmacist receives a mark-up and a dispensing fee.
• Hi-Tech Scheme: the cost of these medicines is comprised of the ex-factory price, in line with the IPHA/HSE Agreement framework, a wholesale mark up of approx. 10% and a patient care fee paid of €62.03 paid to the pharmacist in the month when an item dispensed and €30.26 paid in months where no item is dispensed. Where the patient has a medical card or the medicine is for a specific condition covered by the LTI they do not pay anything, otherwise they pay the first €144 a month of the cost in accordance with the rules of the DPS.