Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health ServiceTable 6.2: Pharmacy Costs (¤ )Medical CardDrugs Payment SchemeAverage Pharmacy CostNet Pharmacy Costper Cardholder (¤ ) per Claimant (¤ )Source: GMS (Payments) Board, Annual Report 2001Figure 6.2:Average Pharmacy Costs in GMS and DPS SchemesAverage Cost (£ )10005000GMSDPSIt should, however, be noted that there are legitimate reasons for variations across the twoschemes:●●●DPS claimants tend to be, by definition, heavy users of drugs and pharmaceuticals – onlythose using drugs costing in excess of ¤ 70 per month can claim under the scheme.Medical cardholders, on the other hand, are largely determined by reference to meansrather than health status. The medical card population, therefore, will contain bothhealthy and sick people and, as such, can be expected to have a lower average cost.Different cost structures exist; pharmacists receive a 50% mark-up on prescriptionsunder the Drugs Payment Scheme compared to a flat-fee arrangement under the medicalcard scheme.The medical card and Drugs Payment Schemes do not share a common approved drugslist.Nonetheless, we are concerned to learn that the significant cost variations across the variousdrugs schemes and between health board regions (see Figures 6.3 and 6.4 below), and thereasons behind those variations, do not appear to be the subject of ongoing systematic analysisand review.82