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Sunday 24 September 2023 Dublin: 17°C The health minister said more women have applied for the drug that was expected.
# severe vomiting
HSE review to allow GPs prescribe Cariban drug for pregnant women continuing, says minister
Stephen Donnelly confirmed that the budget allocation for the scheme will be surpassed.

HEALTH MINISTER STEPHEN Donnelly has said work is ongoing to see how women who suffer from severe sickness during pregnancy can get medication through a GP prescription.

Speaking to The Journal yesterday in Mullingar, where he was opening a new ambulance centre, the minister said he still believes the best solution to problem is for it to become a licensed product. 

The minister also confirmed that the €1.1 million allocation for the new scheme, which came into effect in January, will be surpassed due to the number of women applying for reimbursement exceeding expectations. 

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. 

Budget 2023 set out that funding of over €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.  

Last month, a consultant obstetrician at the National Maternity Hospital and assistant professor at UCD, Professor Mary Higgins said women experiencing severe vomiting illness during pregnancy are suffering from mental health issues, with some choosing not to continue with their pregnancy. 

GP prescription

Hyperemesis is a “normal complication of pregnancy – a pretty horrible one” but GPs should be allowed to prescribe for the drug, argued Professor Higgins.

Currently, under the new Government scheme, women must get the initial prescription from a consultant and cannot get it from their GP. This is one of the main criticisms of campaigners and has resulted in the minister asking the HSE to review the situation. 

The minister was blasted by Social Democrats Wicklow TD Jennifer Whitmore in the Dáil on Thursday, when she asked for an update on the HSE review, however, she was met with the same reply she received two months ago. 

Hyperemesis Ireland, a campaign group representing women with the illness, has criticised the minister for the lack of urgency, stating that two months after a review was announced, there has been no further information. 

“Does a review even exist,” the group recently asked. 

When asked for an update yesterday, Donnelly said the HSE is continuing its review, but provided no timeline as to when a solution will be found for women. 

Applying for a licence

Due to Cariban being an unlicensed product (as the company has never applied for a licence), the minister said “ultimately, the sustainable resolution to this would be for the company to apply for the product to be licensed”.

Campaigners maintain that this is a moot point as there are a number of unlicensed products for other illnesses already covered by Drugs Reimbursement Scheme. 

“We are looking at how we can bring it down to a GP prescription. 

“What we want to see is, we want to see the company, I believe it’s a Spanish company, applying for a license and then we can simply process this the way we we process anything else,” he said.

“I’ve asked the I’ve asked the HSE to take a look at that,” he said. 

Donnelly said he wants it to become “just completely normal for women in Ireland to be able to get this with a prescription from their GP and state funders,” he said. 

When asked what the solution is if the company, with the encouragement of the HSE, still do not apply for a licence, the minister said:

“Well, let’s try and do that first. And it would be odd I think for them not to want to apply seeing as we’re doing this with them. But let’s see what other solutions might be required at that point.” 

Budget allocation breached

As of 27 March, 847 applications for the drug reimbursement have been received, with 825 women approved for the drug. 

Donnelly has said that the prescriptions are somewhat ahead of what was envisaged. 

He told The Journal that the €1.1 million set aside in Budget 2023 will be exceeded, as a result. 

“The run rate on the money allocations was higher than the allocation… so more of it was being prescribed than was expected,” said the minister.

He added “it’s not something we would want to cut off mid year” and budget allocations will be looked at again in the autumn. 

The drug cost is also something the minister said the HSE is looking at, stating that in Ireland it retails for significantly higher than it does in some other European countries.

“For this to be sustainable, obviously we need to get value for money. And if other countries around Europe are paying significantly less for it,” he said, adding that bringing the price paid for the drug is something also being looked at. 

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