All chronic long-term illnesses require regular clinical reassessment by a medical professional. In circumstance where a prescription for medication is issued by the relevant medical professional, it has a maximum validity for twelve months. However, the priority for all healthcare professionals in the continued treatment of their patients is that the treatment offered is both appropriate and safe. Therefore, a prescription may be issued for a shorter duration as deemed clinically appropriate.
For six-month prescriptions issued on or after the 1 March 2024, pharmacists may be able to extend them for up to a maximum of another six months. They will exercise their professional judgement in considering such requests.
There are two schemes, administered by the Health Service Executive (HSE) which assist people with their medical costs – these are the General Medical Services (GMS) Scheme, and the Drug Payment Scheme (DPS). Reimbursable claims under both these schemes are based on prescriptions which are transmitted to the pharmacist.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the GMS Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the Health Service Executive (HSE).
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. Medical cards may be subject to review and medical reports may be needed to support the renewal or continuation of the eligibility.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for those who are not eligible for a medical card but incur ongoing expenditure on medicines. In some cases, when applying for a DPS card, a medical report for any family member who cannot maintain themselves may be required.
Reimbursements under the High-Tech Medicines Arrangement are based on prescriptions issued by hospital consultants – these cannot be extended by pharmacists. These require the continued care of hospital consultants and there are procedures in place to ensure that patients being dispensed medicines under this scheme are eligible for same.
It is important to note that the medical decision to prescribe or not prescribe any treatment for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process. In addition, Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
