Free HRT to start in June but union slams new deal

On Tuesday, health minister Jennifer Carroll MacNeill announced a new deal funding products and fees in a concession to the pharmacy sector.

Free hormone replacement therapy (HRT) could now start from June 1, some five months after it was first expected, but concerns remain, with pharmacists saying the new deal is “not viable”.

Women have to sign up to the drug payment scheme before they can benefit from free HRT, with fees now also covered.

It follows a Budget announcement in October last year to fund just the products starting from January.

In response, the Irish Pharmacy Union (IPU) raised serious concerns about payment and structural gaps.

On Tuesday, health minister Jennifer Carroll MacNeill announced a new deal funding products and fees in a concession to the pharmacy sector. Prescription charges for medical card HRT patients no longer apply for products on a set list or replacements if they are out of stock.

“I have written to all community pharmacies today asking that they support and facilitate the women in their communities to access state-funded HRT products and medicines,” she said.

Pharmacists will be paid a €5 dispensing fee per HRT product given to eligible patients.

This includes women getting these medicines on medical card or other schemes as well as private patients. Each pharmacy will also get a one-off grant of €1,000.

“Under this new measure, women will have to pay nothing if their pharmacy signs up,” Ms Carroll MacNeill added.

However, the Department of Health said it regrets that “implementation of this measure” was not agreed with the IPU.

They offered this option or an alternative of a €3,000 one-off grant with dispensing fees to continue but said neither was accepted.

For the IPU, concerns remain about the €5 fee. It said this rate “has been frozen for 17 years” at a level set during the 2008 recession.

The IPU said “it no longer reflects the cost of delivering safe, regulated, and professional care” in pharmacies.

Tom Murray, union president, welcomed the move to funding products and fees.

“However, the proposed €5 professional service fee, a rate now in its third decade, is simply not viable,” he warned.

“This fee was already deemed inadequate as far back as 2022 for a similar women’s health initiative.”

Fees should be aligned with those paid-for products under the free contraceptive scheme, he added.

He said their suggestion was for “the IPU HRT community drug scheme, supported by a professional service fee of €6.50 per medicine”. It is “neither fair, sustainable, nor workable” to move to a state-funded programme without discussing inflation, rising service costs, or clinical complexities in the scheme.

“Pharmacists have led the call for HRT to be made freely available to women,” he added.

“Now the Government must ensure that this policy is delivered in a way that works in practice, not just in principle.”