The end of the Drug Payment Scheme?

Last week the HSE issued the following statement to clarify the rumours that IVF meds were to be taken off the Drug Payment Scheme (under this scheme no individual or family pays more than €100 per month for prescription medication):

The HSE transferred a defined list of fertility medicines to the High Tech Scheme in March 2009. Unlike the Drugs Payment Scheme, the High Tech Scheme does not incur any markup but pays the pharmacist a patient care fee. Not alone did this transfer provide savings for the HSE, but it also enabled improved governance arrangements to be put in place.

The HSE indicated in its letter at the time to prescribers in registered fertility clinics that it considered three full cycles of IVF an appropriate benchmark for funding. Some established clinics in Ireland already operated such a benchmark to avoid hyper stimulation of the ovaries, which can have serious consequences for the lady.

Obviously, there has been outrage about this proposal.  IVF meds will now go up from €100 per cycle to about €4000.  It means the end of fertility treatment for many.  It seems the HSE has decided to hit a vulnerable group of patients in the hope that public opinion will not be on their side and the cuts will go largely unchallenged.  Their “reasoning” is so flawed, it makes me wonder if there are any medical people working within the HSE – I know of no clinic that operates a 3-cycle limit and the risk of hyper-stimulation of the ovaries has got nothing to do with the number of cycles a “lady” undergoes.  

Also, what does “three full cycles” of IVF even mean?  What if I don’t make it to egg retrieval?  Or embryo transfer?  What if I am doing an FET?  If I have had three cycles of IUI on a high dose of FSH (that would be me, the poor responder), does that mean I have used up all my goes?  In fact, as a very poor responder with zero risk of OHSS, shouldn’t I get unlimited goes?

I have written to the Irish Times to highlight the situation – letter is in today:

Madam, – The news that the HSE is to start making certain medications unavailable on the Drug Payment Scheme has come as a huge shock to those who could not otherwise afford necessary medications.

The first victims are infertility patients, who have been hit with the news that they will have to pay the full amount for IVF drugs if they need to have more than three rounds of treatment. This amounts to approximately €4,000 per cycle of IVF, up from the current monthly cost of €100, making fertility treatment unaffordable for most.

To add insult to injury, the reason the HSE has given for this – to avoid the risk of hyper-stimulation of the ovaries – is completely inaccurate and unrelated to the number of fertility treatments a woman undergoes.

What right does the HSE have to single out one particular group of patients and refuse to pay for their medication? Who will be next? – Yours, etc,

This is not just about infertility patients and whether or not the State should fund IVF (the State doesn’t pay a penny for any fertility treatment, apart from the funding of medication on the DPS). If the HSE is successful in targeting IVF patients, who will be next? Those who suffer from drug and alcohol-related illnesses? The mentally ill? If this becomes a political football, it can only end in one group of patients being pitted against another in a bid to fight their cause. It just cannot be allowed to happen.

Please sign the petition against these cuts.

39 Responses to “The end of the Drug Payment Scheme?”

  1. […] I said that the days of the drugs payment scheme  are numbered.  Fiona McPhilips at the Waiting Game, highlights a change in the scheme which will take IVF meds off the list of approved drugs. This […]

  2. Artblog says:

    Hey you, how’s the pregnancy going. No news in a while!

    x

  3. Fiona says:

    All going well thanks! Had big scan today at 22 weeks and everything looks great. Still a boy! We are in complete disagreement over names but James is on my side so I reckon all we have to do is stand our ground for the next few weeks until he gets sick of talking about it and backs down!

    Can’t believe you are so close now – your pregnancy has flown whereas mine has crawled, feel like I’ve been pregnant for at least a year!

  4. Denise says:

    Hiya Fiona, can’t believe you are 18 weeks away from #3! I think having James on your side is a winner, he is #1 after all.
    Rian is 6 mths now, he is so bloody cute!!! the child is sick of me kissing him, I can’t help myself. So is the due date January?
    Take Care
    XX

  5. Fiona says:

    15 weeks away now! Rian is so gorgeous and still so little – give all the kisses you can before he starts refusing them! Anna is good at kissing but only when she wants to. Due date is 23rd December.

  6. Claudia says:

    What a beautiful Christmas present. =)

  7. Denise says:

    Christmas Baby, how lovely! hope all is well with you and the family. My Dad arrives today from Ireland to meet Rian for the first time 🙂 Kian is beside himself.

  8. CNFC says:

    Hi Fiona, just checking in on you. How are you keeping?

  9. Fiona says:

    I don’t seem to be getting email alerts for comments any more so have missed a few.

    Denise – hope your dad’s trip went well and both your boys got to spend loads of time with him.

    Katie – I am keeping very well thanks! 29 weeks now. Have been meaning for ages to do a post on this pregnancy but am torn between wanting to document it and not wanting to go on about it too much. Will write an update soon.

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