Women to access pregnancy sickness meds through GP from August under HSE deal

Up until now Cariban had to be prescribed by a consultant, which was for a barrier to many women.

Christina Finn

WOMEN WILL BE able to access a severe pregnancy sickness medication through their GP from August under new deal struck by the HSE.

The Department of Health has confirmed to The Journal that a pricing and reimbursement deal has been reached with the licence holder of a drug called Cariban which helps treat severe sickness during pregnancy.

This means that Cariban will now be available with a prescription from a GP, and women will no longer have to attend a Consultant to access the medicine.

Following protracted delays, the drug will now be available through a GP prescription from the 1 August, The Journal understands.

The HSE is expected to issue a circular to GPs and pharmacists soon informing them of the new arrangements.

Health Minister Stephen Donnelly told The Journal:

“I am pleased to announce that Cariban is being added to the HSE’s reimbursement list. This is a very positive development as it means that GPs will be able to prescribe it.

“Up until now Cariban had to be consultant-initiated for the first prescription. This move will make it more accessible to women who need it. It is something I was asked to make happen by campaigners and I would like to acknowledge their efforts and advocacy.”

High cost

Cariban, which came at a cost of €3,000 for some women in the past, is used in the treatment of women suffering hyperemesis gravidarum (HG), a severe form of nausea during pregnancy.

It can result in hospitalisation for some women, 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 the medication, under an exceptional arrangement set up due to the medication being unlicensed in Ireland.

The drug was previously unavailable on the drugs payment scheme or medical card.

The initial changes came about following a major campaign driven by women impacted by severe vomiting – calling for the State to reimburse expenses.

Access barriers remained

While changes were made for the costs to be covered under the scheme, the new system was widely criticised as being over complicated by women suffering from the illness, GPs, consultant obstetricians and pharmacists.

The minister acknowledged that it was “not perfect” but was a temporary solution.

In February the minister wrote to the HSE and asked the it to review its protocols and remove any barriers to access that had been identified. It is understood he also wrote to the pharmaceutical company about beginning the process for the drug company to apply for a licence.

Campaigners criticised 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.

Donnelly confirmed to The Journal at the end of last year that engagement had begun between pharmaceutical companies and the Department of Health and that if a price could be agreed the drug could be made available through the GPs.

Patients and healthcare providers speaking up

Hyperemesis Ireland, a volunteer group supporting women suffering severe nausea and vomiting in pregnancy told The Journal:

“We are delighted to hear that from 1st August 2024, Cariban will be available under the DPS and medical card including via GP prescription, the most accessible doctor in early pregnancy for all maternity patients.”

The group said while they await clarity on some aspects of the implementation, “this is very welcome progress towards better access to treatment for HG”.

“This much-needed change is as a direct result of all the HG patients and healthcare providers who shared their experiences and spoke up. We look forward to working with them, and the HSE, on further improving treatment for HG,” the group said.

A statement from the Irish Pharmacy Union (IPU) today welcomed the HSE reimbursement approval for Cariban, stating that it will reduce the access barrier for patients as this medication will no longer need to be consulted initiated.

“It is also welcome news for prescribers and pharmacists as the bureaucracy of the application process has been removed, something that we have been seeking since the Minister announced the intention to fund this medicine as part of the Women’s Health Initiative in 2023,” it said.

The minister said he identified women’s health as a key priority for him during his term in office, highlighting that he has launched a free contraception scheme and expanded it to include women up to the age of 35.

Along with that, the first ever publicly-funded assisted human reproduction scheme was launched last year, along with publicly-funded specialist menopause clinics, fertility hubs and specialist endometriosis centres.