Abstract
BackgroundAs the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing. The GMS scheme covers approximately 37% of the Irish population in 2011 and entitles them, inter alia, to free prescription drugs and appliances. This paper projects the effects of future changes in population, coverage, claims rates and average claims cost on GMS costs in Ireland.MethodsData on GMS coverage, claims rates and average cost per claim are drawn from the Primary Care Reimbursement Service (PCRS) and combined with Central Statistics Office (CSO) (Regional and National Population Projections through to 2026). A Monte Carlo Model is used to simulate the effects of demographic change (by region, age, gender, coverage, claims rates and average claims cost) will have on GMS prescribing costs in 2016, 2021 and 2026 under different scenarios.ResultsThe Population of Ireland is projected to grow by 32% between 2007 and 2026 and by 96% for the over 70s. The Eastern region is estimated to grow by 3% over the lifetime of the projections at the expense of most other regions. The Monte Carlo simulations project that females will be a bigger driver of GMS costs than males. Midlands region will be the most expensive of the eight old health board regions. Those aged 70 and over and children under 11 will be significant drivers of GMS costs with the impending demographic changes. Overall GMS medicines costs are projected to rise to €1.9bn by 2026.ConclusionsIreland’s population will experience rapid growth over the next decade. Population growth coupled with an aging population will result in an increase in coverage rates, thus the projected increase in overall prescribing costs. Our projections and simulations map the likely evolution of GMS cost, given existing policies and demographic trends. These costs can be contained by government policy initiatives.
Highlights
As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing
The focus of this paper is the GMS scheme which is the largest of the schemes with 36.9 per cent of the population eligible in 2011 [5]. Those who are eligible for the GMS scheme are entitled to free prescription drugs and appliances with a nominal charge per item (€0.50) introduced in budget 2011
The sample database consists of 192,000 observations extracted from the GMS population claims data
Summary
As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing. The GMS scheme covers approximately 37% of the Irish population in 2011 and entitles them, inter alia, to free prescription drugs and appliances. The annual cost of medicines under community drug schemes in Ireland increased from €564 m in 2000 to €1,961 m in 2009 before falling by an estimated 8 per cent by 2011 following a series of cost containment measures [1]. The focus of this paper is the GMS scheme which is the largest of the schemes with 36.9 per cent of the population eligible in 2011 [5] Those who are eligible for the GMS scheme (medical card holders) are entitled to free prescription drugs and appliances with a nominal charge per item (€0.50) introduced in budget 2011. Costs of medicines were approximately €1,048 million in 2007 and increased by 15.2 per cent to approximately €1,207 million in 2011
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