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budget 2023

Cariban: Drug to help women who suffer severe pregnancy sickness to be available by January

Cariban is prescribed and available in the Coombe, Rotunda and Holles Street maternity hospitals and has been for many years.

WOMEN WHO SUFFER from extreme sickness during pregnancy will get access to a life-changing drug free of charge by January, according to Health Minister Stephen Donnelly. 

The drug, known as Cariban, is currently unavailable on the drugs payment scheme or medical card.

Women impacted by severe vomiting, known as Hyperemesis Gravidarum or HG, have called for the State to reimburse Cariban, which can cost up to €3,000 over the course of a pregnancy. 

HG can profoundly debilitate those who suffer with it. While a majority of women experience regular morning sickness (which can actually occur at any time of the day), HG is a lot more serious and can often mean multiple hospitalisations.

Yesterday’s budget set out that funding of €1 million would be set aside to facilitate reimbursement of drug. 

Cariban will be fully reimbursed when prescribed by a consultant obstetrician for the treatment of Nausea and Vomiting during Pregnancy (NVP), The Journal has been advised.

However, questions have been asked by campaigners as to why their GP cannot provide the prescription. 

Speaking to The Journal this afternoon, the health minister acknowledged those whose advocacy on the matter had put the issue “front and centre”, stating that it is through this advocacy that the provision was included in Budget 2023. 

“We are going to put the clinical pathways in place now,” said Donnelly. 

The minister said he sought a report from a specialised group within the Department of Health as to how it might work that this drug could be dispensed to women. 

“What they have recommended at the moment is that it be made available on prescription from a obstetrician, from a treating obstetrician. I want to look at that now,” he said, adding that some people are asking “legitimate questions” as to why their GP cannot prescribe the drug.

“We will also have to engage in negotiations with the suppliers [of the drug],” he added. 

“The issue we have to address is, as it is not a prescribed medicine, we can’t just add it to a list and drop it into an existing process,” said Donnelly. 

“So it is just going to take a little bit of time to reach agreement,” he added. 

Cariban is prescribed and available in the Coombe, Rotunda and Holles Street maternity hospitals and has been for many years. 

However, one of the obstacles to the State reimbursing for the drug is the Health Products Regulatory Authority (HPRA) advised the minister that Cariban is currently not licensed for use in Ireland.  

To be considered for a license in Ireland, the company marketing the product needs to make an application to the HPRA.

Where a medicine is not authorised in Ireland, a licensed wholesaler may import it if it has been prescribed by a doctor for a patient under his or her care. 

The decision to prescribe or not prescribe any treatment for an individual patient is a decision for the treating clinician, in consultation with their patient, it is understood. 

There were also issues in the past when the department classified the drug as a food supplement, something it later u-turned on

Responding to whether €1 million will be enough funding as many women pay thousands for one course of the drug over the nine months of pregnancy, the minister said: 

“What I can tell you is whatever is the amount of money that is required, that meet the clinical criteria, we will make that amount of funding available.”

When asked when women can expect to have access to the drug, he said:

“Certainly I would hope to have that in place by January.”

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