Patients would contribute more for drugs under proposed policy

Patients would be asked to make a contribution towards the cost of their drugs and medicines under proposals for co-payments being considered as part of a Government policy assessment.A review of prescribing practices by doctors is also being looked at as part of measures to address the State’s bill for drugs and medicines, which is projected to reach €4 billion, more than twice the budget for the Department of Defence. Health officials told a meeting of a spending oversight group that Ireland covers more patient costs for medicine than other countries “due to the low monthly drug payment scheme [DPS] threshold [currently €80 per month]” and there being “no co-payment for long-term illnesses”.“This has an opportunity cost meaning that expenditure on drugs cannot be redirected to other elements of the health budget,” according to the minutes of a July meeting of the Health Budget Oversight Group.READ MOREIt is unclear as to the circumstances in which patients would be asked to pay more for drugs or the categories of medicines that could be involved. Officials are understood to be looking at the policies of other European countries as examples.Meanwhile, the Department of Health is to have a greater say on authorising recruitment in the health service under enhanced financial controls to be put in place later this week.Spending on non-clinical items to a value of more than €5,000 will, in future, need the personal authorisation of HSE chief executive Anne O’Connor.The spending controls are being sought by Minister for Health Jennifer Carroll MacNeill and Minister for Public Expenditure Jack Chambers due to concerns about overspending, with the HSE understood to have recorded a financial deficit of just under €700 million up to August.Earlier this month, Chambers said spending autonomy was being removed from four HSE regions – Dublin and South East; West and North West; South West; and Dublin and Midlands – where new recruitment restrictions are expected to be put in place under the new financial controls.[ Move to strip four HSE regions of spending powers is a dramatic Government policy shifOpens in new window ]In relation to clinical and patient service posts, the HSE will in future make a recommendation about recruitment for particular positions, which will be evaluated in the department to determine whether, for example, an appointee should work across a number of locations in a HSE region or be rostered over a six-day working week. The Government has repeatedly expressed concern with the rate of increase in drugs spending, with Carroll MacNeill stating “we can’t keep pace with it”.The policy levers that could be used to mitigate these pressures are being assessed by officials in the Department of Health, HSE and Department of Public Expenditure, official documents show. The assessment will consider measures for future expenditure on medicines including “considering payment caps, indication-based discounting, co-payments of medicines, managed access protocols, and/or a review of prescribing practices”, minutes of the oversight group’s July meeting state.