This week, Minister for Health Jennifer Carroll MacNeill announced progress on the provision of free hormone replacement therapy.
What is HRT?
HRT stands for hormone replacement therapy, and is prescribed to treat the symptoms of menopause and perimenopause in women. It replaces the hormones that decline during the later years of a woman’s life.
There are different types of HRT treatment, which can come in the form of tablets, skin patches, gels and vaginal creams or pessaries.
What has been announced?
The Minister has announced that treatment will be made freely available to those who need it from June 1st. Until now, women who have been prescribed HRT medication have had to pay between €30 and €70 per month.
Were we not supposed to have this already?
Yes. The scheme was supposed to come into effect on January 1st, but was delayed due to ongoing negotiations between the Irish Pharmacy Union (IPU) and the Department of Health around how it would operate. The announcement in the budget covered only the cost of the medication, with €20 million allocated for this purpose. This meant that women would have had to pay a dispensing fee, which is a professional fee to pharmacists, of up to €10.
So what was the holdup?
The IPU said it had written to and met the department on a number of occasions, beginning in October, outlining its concerns about the scheme. According to the union, there were “significant implementation gaps”, such as a lack of guidance, no list of medication that would be covered and that a tested IT system not being in place.
Internally, however, the department said the delay was related to a reluctance on the part of pharmacists to disclose how much they charge as a professional fee for their services.
Is it all sorted now?
Well, not exactly. There are two issues at play here: the long-awaited provision of HRT and also concerns around transparency of pharmacy fees. Ms Carroll MacNeill announced at the start of the week that the Pharmaceutical Society of Ireland, the pharmacy regulator, will develop new guidelines on the transparency of pricing in respect of services provided by pharmacies – including dispensing fees. This will tackle one of the issues; the provision of HRT, however, seems to be a work in progress.
This week, the Minister has “asked” pharmacists to sign up to the scheme. She also announced that her department would provide a €5 dispensing fee for each HRT item, as well as a €1,000 one-off grant to every participating community pharmacy.
And are pharmacists happy with this?
In short: no. The union issued a statement describing the proposal as “unviable”, while the Department of Health said it “regrets that an agreed implementation of this measure could not be agreed” with the union.
According to the IPU, its issue is around the level of fee paid. “This fee, introduced during the period of financial emergency, has been frozen for 17 years. It no longer reflects the cost of delivering safe, regulated and professional care,” it said.
The IPU has called for a fee of €6.50, which it said is what pharmacists receive for the contraceptive scheme under which women aged 17 to 35 can receive contraception free of charge.
So if pharmacists have only been “asked” to sign up, what will this mean in June?
That really remains to be seen. It could result in some pharmacies opting into the scheme while others don’t, meaning women will have to shop around to find participating chemists. The IPU said it does not believe pharmacists will sign up to the scheme, but only time will tell.
