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Call for zero VAT rate to be applied to HRT for women in menopause

The Department of Health has suggested that all non-oral medication on the HSE’s formal reimbursement list could benefit from a zero VAT rate.

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THE GOVERNMENT HAS been urged to remove VAT from hormone replacement therapy (HRT) to improve equality of access to these products for women experiencing menopause.

A zero VAT rate already applies to oral medication, but the Department of Health has suggested that all non-oral medication on the HSE’s formal reimbursement list could benefit from a similar measure.

Yesterday the Department of Finance published its Tax Strategy Group Papers, which outline measures that could be included in the Budget and their costs. 

The papers noted that a zero VAT rate could be applied to  injections, infusions, liniments, ointments and transdermal patches. Fine Gael TD Emer Higgins has said this action should be considered for hormone replacement therapy (HRT) for women experiencing menopause. 

“This would be very much in line with the overall government policy to reduce the cost of medicines and would be a great boost for women who depend on HRT, for many of whom the cost is prohibitive,” she said.

The cost of HRT medication is covered under the medical card scheme and the Drugs Payment Scheme which caps the amount a person spends each month on prescription medication at €80. Patients who are not availing of either of these schemes can expect to pay between €20 and €30 per month for HRT. 

Higgins pointed out that access to HRT has also recently been a “significant challenge” for women. 

The Irish Pharmacy Union (IPU) has been calling on the Minister for Health to follow the lead of the UK and allow pharmacists to dispense substitute HRT products without a prescription and without having to resort to a GP. 

“This measure will mean women can be offered another product at the pharmacy to relieve their symptoms, if their normal HRT is out of stock,” the IPU said. “This would save time for patients, pharmacists and doctors and help alleviate the huge anxiety felt by women over supply and access to essential treatments.”

In a statement to The Journal, the Health Products Regulatory Authority (HPRA) said it has been continually monitoring the supply situation for HRT products over the last months and have received information that further deliveries and increased supply are planned during the remainder of 2022.

“In the case of the Estradot range, Novartis, the company that places these HRT patches on the market, confirmed that its task force on the HRT issue has reviewed the supply situation and in line with current increased trends, has ordered more product to be manufactured,” it said.

Novartis has stated that it has increased orders significantly over the past several months and supply is improving, with intermittent supply across all strengths. Novartis plans to be able to consistently meet this full revised increased demand across all pack strengths by mid-October 2022.

“In the case of Evorel 50mcg Transdermal Patches, another range of HRT patches, supply is expected to resume in late September.”

The HPRT said ther forms of HRT products remain available and that it is continuing to engage with the suppliers to obtain updates and remains open to expediting regulatory procedures to enable supply of additional stock, where possible.

Broader VAT removal

The Department of Finance Tax Strategy Group Papers stated the Department of Health has noted that a broader zero VAT rate on non-oral medications would be in line with the Programme for Government, which contains a commitment “to reduce the cost of medicines, including via generic prescription, where appropriate, and to set a fair price for drug reimbursement”.

The Department of Health also noted that Ireland’s national tobacco control policy, Tobacco Free Ireland, contains a recommendation to advocate for the removal of VAT on Nicotine Replacement Therapy.

The estimated cost of the removal of VAT on all non-oral medicines on the HSE’s formal reimbursement list  is approximately €145 million per year.

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