WORK IS UNDERWAY to ensure that women with severe sickness during pregnancy can access medications with a prescription from their GP rather than a consultant.
In an interview with The Journal, Health Minister Stephen Donnelly has said “engagement” between the department and the pharmaceutical companies is underway.
While not naming the companies that are in commercial discussions, he confirmed that he wants to see medications being made available to women through GP prescriptions in the first half of 2024.
The condition, which is known as hyperemesis gravidarum (HG), can result in hospitalisation, with one senior professor at the National Maternity Hospital stating that some women with HG are choosing not to continue with their pregnancy due to the severity of the condition.
Women in Ireland have only in the last year been approved for reimbursement of a medication called Cariban, which are prescribed to ease severe sickness during pregnancy.
The drug was previously unavailable on the drugs payment scheme or medical card.
A major campaign was pushed forward by women impacted by severe vomiting – calling for the State to reimburse expenses, which can cost up to €3,000 over the course of a pregnancy.
While changes were made for the costs to be covered under the scheme, the new system has been widely criticised by women suffering from the illness, GPs, consultant obstetricians and pharmacists.
Campaigners have queried the rationale behind the HSE requiring a consultant having to initially provide the prescription to women, stating that some women do not see a consultant until their 12-week visit.
Some women will develop HG prior to 12 weeks and have to pay to see a consultant in order to get a prescription. Others are choosing to go to emergency departments of maternity hospitals in order to get a script for the medication from a consultant obstetrician.
Cariban is the first-line medication for the illness, but other medications, or a combination of medication, can work for many women. However, many of the other alternatives, like Cariban, also require a consultant prescription from a consultant.
Since the onset of complaints when the new system opened in January, Health Minister Stephen Donnelly initiated a review into the scheme to see if issues could be overcome. The review is completed but has not been published.
Following on from the review, Donnelly confirmed to The Journal today that engagement is now underway between pharmaceutical companies and the Department of Health to ensure that a number of medications that treat severe sickness during pregnancy can be put on the reimbursement list.
This is a list of all the medicines or aids that are provided under the medical card or Drugs Payment Scheme.
Donnelly said, if achieved, it will mean women will be able to visit their GP for a prescription rather than having to see a consultant.
The minister acknowledged that the “temporary process” he put in place earlier this year is “not perfect”.
“I think the criticisms of it are very fair, in that it’s obstetric-led and women have to wait maybe 12-weeks to see their obstetrician and they may need it before then,” he said.
“So we want this prescribed by GPs. In order for it to be prescribed by GPs, it has to be on the reimbursement list.
“There are several products, regardless of the trade name, that have that active ingredient, that have that effect, and so what we want to see is them [medications] on the reimbursement list. Then we just do it through the GPs,” said Donnelly.
While he said the new scheme was “warmly welcomed” as a first step, there was a “caveat” where patients said “it’s not there yet”.
“They’re right, so we want to get that resolved,” said the health minister.
In order for GPs to be able to prescribe the medications, the pharmaceutical companies need to apply to the HSE to be put on the reimbursement list.
“There needs to be negotiations to see if a price can be agreed, maybe it can, maybe it can’t, and then it’d be available through the GPs,” Donnelly said.
Responding to the development this evening, Hyperemesis Ireland, a group of women and healthcare professionals, founded in 2017 to support pregnant women with the condition, said:
“We are encouraged that the HSE are now engaging with pharmaceutical companies in order to make this first-line medication available to all HG patients through their GPs.
“It is heartening to hear the minister acknowledge that the current scheme to access doxylamine/pyridoxine, while it has been a welcome step, discriminates against patients in the public maternity system.
“All HG patients deserve equitable access to treatment, especially when early access can prevent some of the most difficult and costly complications of the condition. We hope that quick progress can be made in 2024, and in the meantime, HG patients and healthcare providers navigating the current process can find information and support via hyperemesis.ie.”
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