Pharmacist prescribing welcomed, but changes to phased dispensing may affect vulnerable patients

When phased dispensing is gone, vulnerable patients such as older people or those with reading difficulties or mobility issues may struggle to safely manage their medications. Picture: iStock

Vulnerable people such as those with dementia or literacy struggles will lose out under the Government’s agreement with pharmacists announced last week, but young families will benefit.

This mixed assessment of the Community Pharmacy Agreement 2025 is emerging as pharmacists around the country discuss the deal.

They have welcomed positive reforms, but have raised concerns.

Blister packs

Mark Jordan, a pharmacist and council member of the regulator Pharmaceutical Society of Ireland and who was speaking independently, said the fears centre on blister packs — the types of pre-formed plastic packaging used for some pharmaceuticals.

Tablets are put into plastic containers with seven or more parts for patients who struggle to safely manage their medications. One of his patients takes 19 tablets just in the mornings.

“In this agreement, as of January 2026, phased dispensing will be gone,” said Mr Jordan.

Funding was granted on a case-by-case basis, but now only a limited list of medications is eligible.

“That means there is a vast array of patient cohorts who will become fundamentally disadvantaged.

“They are some of the most vulnerable — people who have reading difficulties, people who have mobility difficulties, elderly disadvantaged people, or people with drug addiction issues.”

Patients could choose to pay, but he estimated that packs cost €20 to €50 to prepare depending on the number of pills.

“Say you have a patient, 88 years old, a widower, and he collects his trays weekly after he suffered a heart attack.

"So now I’m stuck: What do I do for this elderly man? Do I absorb the cost? Is he going to be able to manage the drugs on his own?”

Welcome for prescribing by pharmacists

The start of pharmacists prescribing has been welcomed, covering eight conditions such as sticky eye or conjunctivitis, cold sores, and urinary tract infections.

“It will turn pharmacies into a more robust clinical hub in the community,” said Mr Jordan.

“The young family that doesn’t have a medical card or can’t avail of other medicine schemes is going to really benefit from that.”

Patients will also gain access to the PPV23, or pneumonia vaccine, and bowel-screen kits. Women can renew prescriptions for the pill and similar contraception.

Pharmacist Sheena Mitchell welcomed these “really good” developments, but echoed Mr Jordan’s concerns. She said: 

I have a patient with dementia, and you would worry about handing them a month’s worth of medication, because they might not have the cognitive function to know what to do with it. 

Many homecare workers collect blister packs for clients at her pharmacy.

“They say they won’t give medication to the patients unless it’s in their blister pack, it’s a sad day for patients,” she said.

“I have heard some of my peers comment on the Government being happy to give the free HRT because it’s politically popular but they’re abandoning the vulnerable patients. It’s around the same cost.”

The agreement was hammered out after pharmacists agreed to roll out free HRT in return for a discussion on a 17-year pause on fee increases and other reforms.

This year, pharmacies will share up to €25m to boost services.

Irish Pharmacy Union president Tom Murray said the deal brings “long overdue investment” and is a major step forward for patients.