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Health minister asks department and HSE to review current approach to Cariban reimbursement

Women, doctors, and pharmacists have criticised the roll out of a new scheme.

HEALTH MINISTER STEPHEN Donnelly has asked his department and the HSE to review the current approach to the reimbursement of the drug Cariban. 

Women, doctors, and pharmacists have criticised the roll out of a new scheme to reimburse women with the cost of the drug that helps with severe sickness during pregnancy.

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

As part of a major campaign women impacted by severe vomiting – known as Hyperemesis Gravidarum or HG – called for the State to reimburse expenses for 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 – during pregnancy, HG is a lot more serious and can often mean multiple hospitalisations.

Budget 2023 set out that funding of €1 million would be set aside to facilitate reimbursement of the drug, however, since its implementation this year, criticisms have been levelled at the barriers that have been created for women. 

The new requirement is that the initial prescription must be from a consultant obstetrician.

Women have made the case that many do not have access to a specialist or obstetrician in the early weeks of their pregnancy, which is resulting in some women now having to present to emergency rooms of maternity hospitals in order to get a prescription.

Review initiated

A statement from the minister’s spokesperson to The Journal said:

“The Minister for Health has asked his Department and the HSE to review the current approach to the reimbursement of Cariban in order to ensure that women can access the product when they would benefit from it, while also ensuring patient safety is maintained.”

It has not been confirmed what form the HSE review will take, but it is expected it will be clinically led as the HSE position remains that as Cariban is an unlicensed medicine it must be consultant led.

Cork South West Deputy Christopher O’Sullivan, who recently raised the issues with the minister, said he is “very grateful” to the minister for revisiting the issue and initiating a review. 

In his communications with the HSE the minister said the two relevant points relating to this product are that GPs appear to already be prescribing Cariban without an initial prescription from a specialist, and that many women who may benefit from Cariban need access to it before their first consultation with their specialist/obstetrician.

Given these points, the minister has now asked the department and HSE to review the current approach.

O’Sullivan said he pledged last week to work closely with the minister to improve access to Cariban, after he was contacted by hundreds of women over the past few weeks who described the horrific experiences they’ve had with Hyperemesis. 

“It affects lives, your ability to work and damages mental health in cases of postnatal depression,” O’Sullivan said.

The issue was also raised in the Dáil this week, where junior health minister Anne Rabbitte agreed that some work around needed to be found so that women could have access to the life-changing drug. She also urged doctors to lobby drug companies to make applications for the unlicensed drugs. 

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