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Prescription charges affect medicine usage on the medical card scheme – study

The study, funded by the Health Research Board, and co-authored by researchers in University College Cork (UCC) and Trinity College Dublin, tracked how the 50c and €1.50 prescription charges impacted on how patients take their medications.

Using anonymised data from the national pharmacy claims database, which holds data on every single prescription filled in the medical card population, the authors found that after the 50c prescription charge in 2010, adherence of all medicines included in the study was reduced. The reduction ranged from 2 per cent to 5 per cent for most essential medicines. The exception was anti-depressant medicines which dropped by 8 per cent. The reduction in adherence to less-essential medicines ranged from 2 per cent to 10 per cent.

After the €1.50 charge, the reduction in adherence to most essential medicines was generally smaller than seen for the 50c charge, except for anti-depressant medicines which dropped by 10 per cent. In contrast, the reduction in adherence to less-essential medicines was larger after the €1.50 charge than seen after the 50c charge, except for sedative and anti-anxiety medicines where a drop of less than 1 per cent was seen.

Lead author, Dr Sarah-Jo Sinnott, who conducted this research as a research pharmacist and PhD student on the HRB Scholars Programme in Health Services Research based in the Department of Epidemiology and Public Health, UCC, commented: “We found that the charges had a larger impact on whether people continued to take ‘less-essential’ medicines such as painkillers and medicines used to treat stomach acid than it did on people taking “essential” medicines, such as those which lower blood pressure and cholesterol or for diabetes. The exception to this pattern was that large reductions in the use of anti-depressant medicines were found.”

Prof Helen Whelton, senior author of the paper and now Dean of the School of Dentistry, University of Leeds, UK, said the study, which was published in the journal Pharmacoepidemiology and Drug Safety, provides good evidence for policy makers to help understand how prescription charges affected medication use.

“Now that we know the extent to which these charges have affected medication adherence, we need to assess if there has been an impact on health outcomes such as heart attacks and stroke in the Irish medical card population. The findings concerning medication use in depression also require further research, as does the new increased charge of €2.50 per prescription item. The information presented in this paper demonstrates the potential of routinely collected data to answer important policy questions for patient benefit. The development of health services research, such as this, has the potential to contribute to smarter, patient centred health policy and more effective and efficient health services in the future.”

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