Cost ‘a barrier’ to the full take-up of respiratory medicines

A new study has shown the amount of money spent on respiratory medicines has fallen over much of the past decade, and the Government could provide the drugs free to all patients for between €20.2m and €33.8m a year.

The study, A Review of Respiratory medicines Expenditure in the Primary Care Reimbursement Services 2005 — 2015

, analysed data from the Primary Care Reimbursement Service schemes and shows total expenditure peaked in 2009 and has been falling since, with the level in 2015 of €135.25m below that of 2006 and similar to the spending back in 2005.

It also found that 87% of respiratory medicines in the primary setting are funded by the Government through its public schemes and that 13% of respiratory medicines are funded privately.

Author Jackie O’Dwyer, who has a master’s in health economics from University College Cork, referenced a number of barriers to full take-up of respiratory medicines, including the cost of the medicines in some cases.

It also referred to Ireland’s rapidly ageing population and the fact that chronic diseases are responsible for 76% of deaths in Ireland, with four out of 10 hospitalisations in Ireland in 2011 either directly or indirectly due to four of the main chronic diseases — cancer, cardiovascular disease, respiratory disease, and diabetes.

“Irish research shows that there are several factors for a low adherence rate — one of which is access to medications and treatments and another is the cost of medications,” it said.

“It found that there were higher adherence rates in those who were on medical cards than those that had to pay or co-pay themselves.”

This is despite the costs of vaccinations and nebulisers rising but then falling over the period under review.

According to the report: “The extra cost in order to provide all respiratory medicines through public schemes could range from between €20.2m to €33.8m. As respiratory disease are chronic diseases and some are part of the chronic disease management programmes this extra cost could be paid through the LTI [Long-Term Illness] scheme.

“This could result in the removal of an adherence barrier, i.e. cost of medications.”

The research, carried out in collaboration with the Irish Asthma Society, is expected to be published in the Irish Journal of Medical Science in the coming weeks.


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