The HSE had to suspend its treatment programme for patients with Hepatitis C for a month in 2017 because it did not know the number of patients being treated and risked running out of money.
The programme was suspended at the end of July when the majority of its €30m budget had been used, according to report by the C&AG, published yesterday.
It was reinstated in September but treatment centres were told they could only select patients where the preferred drug, based on what offered best value, was being used to treat a particular strain of the virus.
In October 2017, the centres were told they could select patients for treatment based on those “in most critical need such as those with chronic liver disease”.
The report reads:
These measures continued through to the end of 2017 to ensure that the programme operated within budget for the year.
Ultimately, the programme treated almost 300 patients less in 2017 than the HSE had targeted, at an average cost of around 25% more per patient.
Around 1,072 patients commenced treatment in 2017, at an average net cost of almost €28,000. At July 2017, the cumulative net spend of the programme stood at €27.3m.
“This led to the temporary suspension of the programme by the HSE,” the report says.
The problem arose because of delays registering patients on the National Treatment Registry. Prior to a patient commencing treatment, each site is required to complete a treatment initiation form and submit this to the registry.
Approval for reimbursement is also required from Primary Care Reimbursement Service (PCRS) prior to treatment commencing.
The report says this information “is required on a regular basis as it assists the programme in monitoring the budget spend and ensuring that the budget at all times supports the number of patients selected for treatment”.
However, in relation to the early part of 2017, the HSE noted that these controls “did not operate as intended” ie a number of treatment centres did not notify the registry that a patient had commenced treatment and/or had commenced treatment prior to receiving reimbursement approval from PCRS.