HEALTH MINISTER STEPHEN Donnelly has asked the Women’s Health Taskforce to examine options for funding a severe pregnancy sickness drug to make it more available to women.
The Department of Health established the taskforce in 2019 in a bid to improve women’s health outcomes and experiences of healthcare.
It is understood the minister wants to ease the financial burden and examine if there is another mechanism by which to fund the drug, known as Cariban, which can cost women up to €3,000 over the course of their pregnancy.
The drug is not available on the drugs payment scheme or by medical card.
It is hoped that the drug could be given out free of charge or else partially paid for; however no costings have been done yet.
The Journal reported earlier this week that the HSE had asked a medicine management group to “examine the appropriateness and feasibility of a patient specific arrangement” that would make the pregnancy sickness drug available to women who need it.
Women’s Taskforce
This review is taking place in tandem with the examination by the taskforce, it is understood.
The medicine management group are understood to operate under “rigid” parameters as to what they can and cannot approve.
Therefore, rather than solely rely on on the medicine management group’s review, the women’s taskforce will also be examining what new mechanism might be possible to fund the drug.
A recommendation from the medicine management group is expected to be sent to the HSE “in the coming weeks” on whether a “special arrangement” can be facilitated to give women access to Cariban.
Women impacted by severe vomiting, known as Hyperemesis Gravidarum or HG, have repeatedly called for the State to reimburse or lower the costs of Cariban.
HG can profoundly debilitate pregnant women; while many women suffer from regular morning sickness (which can actually occur at any time of the day) during pregnancy, HG is a lot more serious.
When asked in the Dáil on Thursday if exceptional arrangements could be put in place to give women access to the drug, Tánaiste Leo Varadkar said he was not familiar with the drug, but is familiar with how “serious and debilitating” HG is for pregnant women.
He committed to speaking to the health minister about the drug to see if there is anything that can be done to “speed up” the decision by the MMP.
Unlicensed
Health Minister Stephen Donnelly previously said the State could not reimburse the cost of the drug, despite Cariban being prescribed and available in the Coombe, Rotunda and Holles Street maternity hospitals, as the Health Products Regulatory Authority (HPRA) has advised that the drug is currently not licensed for use in Ireland.
However, it is understood that the minister has been engaged with his officials on the issue in a bid to find a solution.
In a statement to The Journal, the HSE said the MMP “is currently reviewing the available clinical evidence and would anticipate providing their recommendation to the HSE in the coming weeks”.
The HSE has also said that as Cariban is considered to be a food supplement rather than a medicinal product in Ireland, it cannot be considered for reimbursement as an Exempt Medicinal Product under the GMS and Community Drug Schemes, or reimbursement under Discretionary Hardship Arrangements.
The statement dumbfounded a number of pharmacists, who told this website they cannot understand how the drug could be classed as a food supplement.
The Irish Pharmacy Union (IPU) told The Journal that it has called on the manufacturers of Cariban to apply for a product authorisation on the Irish market so that the HSE is in a position to reimburse it in the normal way through the medical card and drug payments schemes.
It added:
In the meantime, pending an Irish product authorisation, the HSE should put in place exceptional arrangements to fund the drug in individual cases.
Pharmacies providing drug at cost
Some pharmacists who were tired of waiting for action to be taken decided to help women get access to the drug by offering the drug at cost price.
Paula Clancy of Stratus Healthcare Pharmacy in Waterford started the initiative of offering the drug at cost price, with other pharmacies following suit.
Speaking to The Journal, she said the owner of the pharmacy wrote a letter to The Irish Times last year calling for Cariban to be made freely available to women, stating that it is something they both feel strongly about.
While the cost can vary depending on the supplier and import costs, Cariban can cost around €80 per week. When it is at cost value it is around €40 per week – a significant saving for women, but not enough, said Clancy.
She said customers coming to the pharmacy with HG are “struggling” medically, adding that she had concerns about women ending up in hospital if the condition is not looked after.
While women are struggling medically, Clancy explained that customers they have seen are also struggling to pay for the shopping, the mortgage, childcare costs, stating that the cost of Cariban is significant.
She said women often “cut back” on the tablets they take, trying to spread them out over a longer time period, and can often go without taking them some days, meaning they will feel very unwell.
“It is a hard enough nine months without having to deal with all that as well,” she said
Clancy said she was laughing when she read that the HSE had classed the drug as a food supplement, stating that she couldn’t understand it.
Given the public pressure for the Government to step in and cover the cost of the drug, Clancy said “it would be bad taste if some effort is not made now”.
The campaign for the reimbursement of the costs has been ongoing for years. Women previously told this publication about their experiences dealing with HG, and how Cariban was the only treatment that worked for them.
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