Medical schemes cost State €1.2bn

PAYMENTS under the drugs and medical card schemes topped €1.2 billion last year, up almost 25% on 2001.

The payments were made to doctors, pharmacists, dentists and eye specialists for services provided to persons eligible under a range of public health schemes, including the medical card scheme and the drugs payment scheme.

The average payment under the GMS scheme to doctors per eligible patient was 221, compared to 169 in 2001 and to pharmacists it was 458, compared to 371 in 2001.

Estimated payments by the board this year are about 1.45bn.

In its annual report published today, the General Medical Services (Payments) Board said the increased cost reflected a growing and aging population and a rise in the number of claims processed.

Increased fees for doctors, pharmacists, dentists and eye specialists also contributed to the increase. Last year, more than €2.58 million people registered as eligible for benefit under the various GMS payments schemes, compared to €2.44 million in 2001.

Granting medical cards without means tests to persons aged 70 years and over also contributed to the growth in payments.

Payments for hi-tech medicines, such as anti-cancer and anti-rejection drug therapies rose by more than 19.52 million to 84.63 million.

Nearly half the population almost two million people availed of community-based services for which the board made payments.

More than 5,100 doctors, dentists, pharmacists and eye specialists provided services under the various schemes.

The board intends to prepare three-year projections of scheme expenditures so as to have an informed view of known trends over the medium term. Such an exercise will be valuable in assessing the potential impact of an aging population on the cost of the GMS scheme following its extension to the over-70s and the impact of increased prescribing rates.

At the year end almost 75% of pharmacies were submitting about 2.4 million claim items electronically each month.

Work also continued last year on the creation of a computerised national client eligibility index that will use the Personal Public Service (PPS) number to identify each member of the community.

The index has been used on a pilot basis in the North Eastern Health Board and a full roll-out to all health boards will begin this autumn and will be fully implemented by next year.

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