S.I. No. 279/2013 - Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2013.


Notice of the making of this Statutory Instrument was published in

“Iris Oifigiúil” of 26th July, 2013.

I, JAMES REILLY, Minister for Health, in exercise of the powers conferred on me by section 9 of the Financial Emergency Measures in the Public Interest Act 2009 (No. 5 of 2009) (as adapted by the Health and Children (Alteration of Name of Department and Title of Minister) Order 2011 ( S.I. No. 219 of 2011 )), having complied with subsections (4), (7) and (13) of that section, with the consent of the Minister for Public Expenditure and Reform, hereby make the following regulations:

1. These Regulations may be cited as the Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2013.

2. In these Regulations—

“community pharmacy contractor” means a registered pharmacist, company or other body corporate, or partnership, that provides services to the Health Service Executive pursuant to an agreement to provide community pharmacy services to eligible persons under section 59 of the Health Act 1970 ;

“ex-factory price”, with respect to a particular drug item at a particular time, means the price of that item determined in accordance with the relevant agreements in force at that time between the Health Service Executive and the representative bodies of manufacturers and importers of such items;

“fridge item” means a drug item which must be kept in refrigerated storage conditions of between 2 and 8 degrees Celsius as stated in the summary of product characteristics for that item;

“ingredient cost” means—

(a) in the case of fridge items, the ex-factory price together with a wholesale mark-up of 12 per cent, and

(b) in the case of any other drug item, the ex-factory price together with a wholesale mark-up of 8 per cent;

“reimbursement price”, with respect to a particular non-drug item at a particular time, means the amount specified by the Health Service Executive in the list of reimbursable items which is published on its website;

“stock order”, with respect to drug items and non-drug items, means items which are supplied by a community pharmacy contractor to a general practitioner for the purpose of the general practitioner dispensing those items to, or using those items to treat, patients of that general practitioner.

3. These Regulations shall apply to payments in respect of services rendered by a community pharmacy contractor to or on behalf of the Health Service Executive under the General Medical Services Scheme, the Drug Payment Scheme, the Long-Term Illness Scheme, the European Economic Area Scheme, the Health (Amendment) Act 1996 Scheme and the High Tech Medicinal Products Scheme.

4. The payments (other than the reimbursement price of non-drug items) that shall be made to a community pharmacy contractor in respect of the services referred to in Regulation 3 from the date of the making of these Regulations shall be those specified in Schedules 1, 2, 3, 4 and 5.

5. The Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2011 ( S.I. No. 300 of 2011 ) are revoked.

SCHEDULE 1

Amounts payable for dispensing drug items and non-drug items (excluding drug items which are subject to extemporaneous preparation and compounding) under the General Medical Services Scheme, the Drug Payment Scheme, the Long-Term Illness Scheme, the European Economic Area Scheme and the Health (Amendment) Act 1996 Scheme

Description

(1)

Amount

(2)

Standard dispensing fee payable to a community pharmacy contractor under the General Medical Services Scheme, the Drug Payment Scheme, the Long-Term Illness Scheme, the European Economic Area Scheme and the Health (Amendment) Act 1996 Scheme per item dispensed under those schemes: — for each of the first 1,667 items dispensed by the community pharmacy contractor in a month — for each of the next 833 items dispensed by the community pharmacy contractor in that month — for each other item dispensed by the community pharmacy contractor in that month

€5.00

€4.50

€3.50

SCHEDULE 2

Other amounts payable under the General Medical Services Scheme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Phased dispensing fee — payable per drug item for each dispensing phase other than the first dispensing phase (for which the standard dispensing fee specified in Schedule 1 is payable)

€3.27

2.

Non-dispensing fee — payable per drug item not dispensed due to exercise of professional judgment

€3.27

3.

Fee per drug item for extemporaneous preparation of oral medication

€6.53

4.

Fee per drug item for extemporaneous compounding and dispensing of: — Powder — Ointment or cream

€19.60€13.07

5.

Reimbursement amount per drug item

Ingredient cost

6.

Allowance per drug item supplied further to a stock order

20% of ingredient cost

7.

Allowance per non-drug item supplied further to a stock order

20% of reimbursement price

SCHEDULE 3

Amounts payable for dispensing drug items which are subject to extemporaneous preparation and compounding under the Drug Payment Scheme, the Long-term Illness Scheme, the European Economic Area Scheme and the Health (Amendment) Act 1996 Scheme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Eye drops

€13.68

2.

Ear and nasal drops

€10.93

Mixtures

3.

Up to 100 ml

€10.94

4.

101 ml to 200 ml

€14.97

5.

201 ml to 300 ml

€17.04

6.

301 ml and over

€22.53

Lotions

7.

Up to 100 ml

€10.89

8.

101 ml to 200 ml

€15.24

9.

201 ml to 300 ml

€17.12

10.

301 ml and over

€22.74

Ointments and Creams

11.

Up to 30 g

€13.76

12.

31 g to 60 g

€18.64

13.

61 g to 120 g

€23.97

14.

121 g to 240 g

€28.90

15.

241 g and over

€34.27

Powders

16.

Up to 20 sachets

€20.44

17.

Thereafter per 20 sachets (pro rata)

€12.26

SCHEDULE 4

Other amount payable in respect of drug items dispensed under the Drug Payment Scheme, the Long-term Illness Scheme, the European Economic Area Scheme and the Health (Amendment) Act 1996 Scheme

Description

(1)

Amount

(2)

Reimbursement amount per drug item

Ingredient cost

SCHEDULE 5

Amounts payable under the High Tech Medicinal Products Scheme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Patient care fee payable per month to the community pharmacy contractor who has been nominated by a patient under the High Tech Medicinal Products Scheme where medicinal products prescribed under that Scheme are dispensed to the patient by the community pharmacy contractor concerned

€62.03

2.

Patient care fee payable per month to the community pharmacy contractor who has been nominated by a patient under the High Tech Medicinal Products Scheme where medicinal products prescribed under that Scheme are not dispensed to the patient in a particular month provided that where the prescription concerned is not dispensed to the patient concerned for more than 3 consecutive months the fee concerned is payable up to a maximum of 3 months only

€31.02

The Minister for Public Expenditure and Reform consents to the foregoing Regulations.

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GIVEN under my Official Seal,

24 July 2013.

BRENDAN HOWLIN,

Minister for Public Expenditure and Reform.

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GIVEN under my Official Seal,

24 July 2013.

JAMES REILLY,

Minister for Health.

EXPLANATORY NOTE

(This note is not part of the Instrument and does not purport to be a legal interpretation.)

These Regulations are to give effect to reductions in payments to Community Pharmacy Contractors as provided for in Financial Emergency Measures in the Public Interest Act 2009.