While Minister has confidence in a State-funded scheme, IPU says professional services fee is ‘unviable’
Minister for Health, Jennifer Carroll MacNeill TD, recently set out how the Budget 2025 Hormone Replacement Therapy (HRT) initiative, which is designed to give patients access to HRT products and medicines at no charge to them, will be implemented, and has been developed.
Minister Carroll MacNeill commented: “I have written to all community pharmacies… asking that they support and facilitate the women in their communities to access State-funded HRT products and medicines.
“In doing so, I am committed to supporting each participating pharmacy by paying them a €5 dispensing fee per HRT medicine/product dispensed to all eligible patients, including those existing patients under the GMS/DPS Schemes and for all other patients prescribed HRT (‘private patients’), and a €1,000 once-off grant to every participating community pharmacy.”
Commencement
“I have set 1 June as the date for commencement of this support. This will allow participating pharmacies time to be ready to facilitate the free
HRT scheme to their customers. This means that women would be able to access the product and medicines at no charge, including dispensing fees in participating pharmacies, from the 1 June. This is an advancement on the Budget 2025 measure which covered the cost of the medication only, and the women would have had to pay for the dispensing fee. Under this new measure, women will have to pay nothing if their pharmacy signs up.”
The HSE recently notified all community pharmacies of the reimbursement arrangements, the process for participation, and the mechanism to receive the €1,000 grant. An information campaign was set to commence last month providing further information for patients. The prescription charges for medical card- holders in relation to HRT medicines and products on the reimbursement list would also be abolished.
The Department of Health said it “regrets that an agreed implementation of this measure could not be agreed with the Irish Pharmacy Union, despite engagement over many months”.
Options
To try to find a resolution to the remaining issue regarding dispensing fees, the Minister said she offered the IPU the option of:
- A €5 dispensing fee per HRT medicine/product dispensed to all eligible patients, including those existing patients under the GMS/DPS Schemes and all other patients prescribed HRT (“private patients”) to be funded from the combined allocation for 2025 for pharmacy and HRT, and a €1,000 once-off grant to every participating community pharmacy.
Or:
- A €3,000 once-off grant to every participating community pharmacy. Community pharmacies may then have continued to apply dispensing fees as before, having regard to existing arrangements.
These offers did not lead to an agreement with the IPU, said the Minister.
‘Shared ambition’
Meanwhile, the Irish Pharmacy Union (IPU) acknowledged the Government’s decision to fully fund HRT for women, including a professional service fee for pharmacies. This change is the direct result of sustained advocacy by pharmacists on behalf of women following the 2025 Budget announcement. It reflects a shared ambition to remove cost barriers to essential menopause care, said the Union.
However, the IPU warned that the proposed professional service fee of €5 per medicine is not viable. 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,” said the IPU.
“The Department of Health itself acknowledged the inadequacy of the €5 fee in 2022 when it introduced the Free Contraception Scheme. Following consultation with the IPU, a professional service fee of €6.50 was agreed for that initiative. The services provided under the proposed HRT scheme are more clinically complex and like all pharmacy services, are professionally delivered. There is no reason why these two women’s health programmes should be treated differently,” said the Union in its response.
IPU President Tom Murray commented: “The IPU welcomes the Government’s stated ambition to improve access to HRT. However, the proposed €5
Asking pharmacies to move from a private model to a State-funded one without addressing inflation, rising service costs or the clinical complexity involved is neither fair, sustainable nor workable’
professional service fee, a rate now in its third decade, is simply not viable. This fee was already deemed inadequate as far back as 2022 for a similar women’s health initiative.”
‘Financial loss’
“Asking pharmacies to move from a private model to a State-funded one without addressing inflation, rising service costs or the clinical complexity involved is neither fair, sustainable nor workable. Community pharmacies are ready to deliver this important service, but not at a financial loss. Without a fair and sustainable model, this scheme risks falling short of its aim.”
Throughout months of engagement, the IPU said it has put forward a practical and fully implementable solution — the IPU HRT Community Drug Scheme, supported by a professional service fee of €6.50 per medicine.
Aligning the professional service fee for HRT with the existing Contraception Scheme would bring coherence to publicly-funded women’s health services, the Union added. It would also support smooth patient transitions and give pharmacists the confidence to participate. “This would help guarantee access for all women, regardless of location.”
“Pharmacists have led the call for HRT to be made freely available to women. Now the Government must ensure that this policy is delivered in a way that works in practice, not just in principle,” said Mr Murray.
