Better Health for All

Women’s Health

Related to Tax-funded HRT (Hormone Replacement Treatment) Scheme:

16.04.2025 Department of Health Letter to Irish Pharmacies Re: Implementation of the budget 2025 HRT Scheme is available here.

This was announced Oct 2024 before the GE-2024 and is delayed expected from 01.01.2025, with issues in relation to necessary pharmacy agreements and uncertainty if there will be actual pharmacy ‘sign ups’ required for country-wide deployment by the revised 01.06.2025 date.

1. 14.04.25 Minister of Health Jennifer Carroll MacNeill confirmed there will be no HRT cost reimbursements from 01.01.25 (original promised start date) which is now expected to commence from 01.06.25 (new date announced). No budget is mentioned as reason for non-reimbursement. If this was publicly announced previously why was no budget already allocated or planned reimbursement?

2. Whether 01.06.25 commencing from is agreed with pharmacies and country-wide (every county) and is realistic. Dependency on pharmacies to individually ‘sign up’ is vague and tenuous. Can we have a public list of pharmacies ‘signed up’ to this scheme? It needs to be clear where to source these prescription items in advance of going to pharmacies. There are known shortage and issues of HRT products supply into pharmacies already. Pharmacy sign up may be slow and sporadic.

Feedback online ”Schemes like this, Free HRT, need to be agreed with those who will deliver them, before public announcements; this one is not, according to the pharmacies.”

3. €5 dispensary fee covered per product, ‘combined hrt’ has multiple products etc,. Is there a ‘confirmed list of HRT products and brands’ that can be dispensed under this scheme which GPs can prescribe? This will avoid squabbles in pharmacies so it’s clear what’s covered or not covered. Update there is a list of products allowed in HSE letter here. Also Minister of Health Jennifer Carroll MacNeill confirmed on radio Pharmacies will get a tenner for two products… so this is covered off.

Tom Murray, President of the Irish Pharmacy Union said the €5 fee per product dispensed is “not sustainable” given many pharmacies usually charge double that.

“Pharmacies are actually at breaking point. It’s at the point where it can’t take on any more services, and we’ve been asked to take on a service at a loss-making manner, and I don’t think pharmacists are going to do that.”

4. €1,000 grant per pharmacy signing up towards Pharmacy’s ”administration costs”. Preferably this could have been used for pharmacy discount, reimbursement to women who purchased HRT products since 01.01.25.

5. No inclusion for non-pharma non-hormonal treatments. This should be widened to include genuine alternatives used or a maximum amount allowance per month comparable to subsidised HRT. Some women don’t use HRT products and may have to purchase health alternatives which have no comparable cost cover.

6. GP visit cost is not covered which can be €70 or more depending on GP per visit. Prescriptions given for 3 or 6 months requiring regular GP and repeat prescription GP fees. This is a barrier to access this scheme in first place. In comparison the tax funded Contraceptives scheme GP cost is covered as well as the necessary meds.

15.04.2025: See The Journals article related to HRT scheme 01 June 2025 here.

Free HRT will be available for all women from 1 June 2025, as govt commits to covering dispensing costs.

Opposition TDs have slammed the announcement that women who paid for HRT in the months that the scheme has been delayed will not be reimbursed.

15.04.2025: Health spokespersons from Labour and the Social Democrats slammed this announcement. Labour’s spokesperson TD Marie Sherlock said that the government “must reimburse” women who had paid out of pocket for HRT this year, given that the scheme was originally meant to commence from 1 January. She said that women who had paid out for HRT “in good faith” were now being left “high and dry”.

16.04.2024 Post radio discussion see Irish Journal article here.

‘Very few pharmacists’ will sign up for free HRT scheme ‘because €5 dispensing fee is too little’.

As it stands, there is still no IT system in place where pharmacists could seek reimbursement of product for the free HRT scheme. It took nine months to set up a system when the free contraception scheme was introduced.

Maher is doubtful that a system will be up and running by 1 June. “It’s very, very complex to get something up and running in six weeks when you have no sign in from the sector that you’re asking to deliver. I really don’t know how this is going to happen.”

Victoria Jones, who runs a pharmacy in Coolock in Dublin, told The Journal that she will not be able to sign up to the scheme as it stands because it is “completely unworkable”.

“I want to, but I would have to let my staff go, and I can’t do that. I can’t keep my doors open if I do this,” Jones said.

She said that the cost of running a business “is becoming so much more that we just can’t do another loss-making scheme”.

30.04.2024.. Less than 5 weeks to June 1st there is still uncertainty and no information or list of pharmacies signed up. Also individual Drug Payment Scheme sign up is necessary before any signed up pharmacy can dispense free of charge.. Need to Apply here. (Apply for a Drugs Payment Scheme card if you pay more than €80 a month for approved drugs, medicines and appliances.) Unsure what happens if HRT prescription is under €80 or pharmacy can’t dispense total prescription, cognizant of HRT availability issues also, sometimes pharmacy will dispense partial prescription dependent on their stock levels.

Feedback online ”Having experienced the short supply of product and drip feed of prescriptions monthly ( or once enough patches for 3 weeks only ), the pharmacists will use this opportunity to dispense six times and collect fee each time rather than once every six months or am I being too cynical?”.

02.05.2024: Checked with 6 pharmacies, 4 in Athlone and 2 in Roscommon Town. All said No they are sorry, unable to sign up to the HRT scheme due to the issues known to the Government and Irish Pharmacy Union. It’s not agreed with their Pharmacy Union, not planned and aside from the dispensing fee €5 versus €6.50, HRT meds cost to pharmacy versus % that’s going covered by State is not clear or 100%. June 1st 2025 date is not a realistic or possible start date.

Conclusion: Women shouldn’t have to go around checking if pharmacies sign up to a HSE scheme that is meant to be available to them from June 1st and which is already 5 months delayed! Pharmacies make profits on many other products aside from state schemes. Women also spend in store on many items in addition to their prescriptions. Women are being seriously let down that this new scheme is so problematic for Gov, Pharmacy Union and individual Pharmacies to deliver.

Currently, I’m not aware of any list of nationwide pharmacies confirmed to sign up from June 1st. It’s been left to chance really and women using HRT may have to continue paying personally with no reimbursement mechanism for their GP prescribed HRT meds, as they may not have a pharmacy in their locality that has signed up or is delivering this essential and promised service.

• Strengthening of public health systems with better preventative care and mental health services.

• Prioritizing timely healthcare for elderly pensioners to eliminate prolonged waits especially in emergency and hospital settings.

• Carers allowance – Removing means-test barriers for carers (with GP approval to safeguard against undue influence) and patient consent.

• Improving Disability Services with greater choice, funding and Independent Living options.
• Addressing social determinants (economic and social) of health to ensure equitable access for all communities.
• Promoting sustainable healthcare practices and fostering health research and innovation.