Prescribed drugs and medicines
If you live in Ireland (ordinarily resident), you can get free or subsidised approved prescribed drugs, medicines and certain medical and surgical aids and appliances.
Getting a prescription
If you need specific drugs and medicines, certain healthcare professionals can give you a prescription for them, such as a GP, a consultant, a dentist or a nurse.
A nurse must be employed by a health service provider to give you a prescription and they can only prescribe the drugs relevant to the area they work in. There are specific restrictions on certain controlled drugs.
Since April 2020, GPs and specialists can email prescriptions to pharmacists. Prescriptions are now valid for 9 months (it was previously 6 months). Pharmacists can repeat a prescription if, in their professional judgement, it is safe and appropriate to do so. This means that you may be able to repeat your prescription without visiting your GP.
Where to get prescription drugs and medicines
You can get your prescribed drugs and medicines in a retail pharmacy (chemist's shop). Most pharmacies have agreements with the Health Service Executive (HSE) to provide services under the Primary Care Reimbursement Services scheme.
GPs may give drugs and medicines directly to patients if the GP has only one practice centre and it is three miles or more from the nearest retail pharmacist. Doctors who give drugs and medicines under these arrangements are sometimes called dispensing doctors.
Hospitals and other specialist institutions may also provide drugs, medicines and aids and appliances directly.
The rules about when drugs and medicines are free or subsidised are the same regardless of who provides them.
Approved drugs and medicines
Drugs and medicines must be approved and controlled before they can be sold. The Health Products Regulatory Authority (HPRA) tests drugs and medicines for safety, quality and efficacy and provides licenses. HPRA approval does not mean that the drugs and medicines will be approved for the free and subsidised schemes. There are other factors involved in the approval process, including costs.
Free or subsidised schemes
The HSE Primary Care Reimbursement Service (PSRS) provides a list of medicines or aids provided under the medical card or Drugs Payment Scheme. These products are approved for the schemes by the HSE.
Some items that can be bought over the counter are not included in the free or subsidised schemes.
Long Term Illness Scheme
If you have a certain condition you may be able to apply for the Long Term Illness Scheme. Under the scheme, you can get free drugs, medicines and medical and surgical appliances for the treatment of that condition.
Health Amendment Act Card
If you contracted Hepatitis C directly or indirectly through the administration of blood products or transfusions, you can get drugs and medicines using the Health Amendment Act Card.
Drugs Payment Scheme
If you are not eligible for any of the schemes listed above and do not hve a medical card, you can register for the Drugs Payment Scheme which limits the monthly cost of prescription medicines.
Discretionary Hardship Scheme
If you have a medical card and are prescribed an item that is not on PCRS list, your pharmacist or Local Health Office can apply for it to be paid for by the Discretionary Hardship Scheme.
If the hardship scheme does not cover the cost of the medicine and you have to pay for it, you may want to check with your doctor to see if there is an alternative medicine. You can get more information about the scheme from your pharmacist or Local Health Office.
You can claim tax relief on medical expenses for prescribed drugs and medicines.
Generic drugs and reference pricing
Sometimes the pharmacist may give you a different brand name of the medicine you are prescribed. This is because there is a less expensive version of the brand name medicine called a generic version. The pharmacist is allowed do this if the medicines are included in the list of interchangeable drugs published by the HPRA. . The list includes all medicines which can be substituted for each other
The HPRA has published an information leaflet about generic medicines (pdf).
The HSE sets one price that it will pay for each group of the generic medicines on the approved list. This is known as the reference price.
If you have a medical card, the HSE will pay the reference price for any generic medicine. If you choose to buy the more expensive brand of the medicine, you must pay the difference between the reference price and the retail price.
If you are on the Drugs Payment Scheme, the HSE will use the reference price to calculate your monthly drugs costs. If you choose a more expensive brand of a medicine that is covered you must pay the extra cost.
If you need a particular brand of medicine for medical reasons, your doctor can write 'Do not Substitute' on the prescription. If you have a medical card, you pay the prescription charge and do not have to pay the difference between the reference price and the retail cost. If you have a Drugs Payment Scheme Card, you pay up to the monthly threshold as normal.