Reform of HSE online prescribing process for GPs planned

Major reform of the HSE online prescribing system for GPs is planned following growing concern at the huge increase in online prescribing approval processes.

The number of drugs requiring online HSE pre-approval before they can be prescribed by GPs has increased dramatically in recent years.

However, under reform plans, so-called ‘pre-approval’ drugs would be reduced, thereby decreasing the volume of online work required by GPs.

The majority of novel oral anticoagulants (NOACs), which currently require HSE pre-approval before they are prescribed by GPs, would be removed from the process, it is understood.

Pre-approval for the Versatis (lidocaine) patches, to which prescribing restrictions were attached in 2017 after a huge rise in costs, will remain in place. 

The Medical Independent (MI) understands that HSE spending on the lidocaine 5 per cent medicated plaster has fallen from €3 million to €250,000 per month since the restrictions were introduced.  Limited evidence to support its use, enormous costs, and the HSE’s ongoing difficulty in affording essential medicines prompted the controls. 

The HSE now only reimburses the product for its licensed indication, which is neuropathic pain associated with post-herpetic neuralgia.

The new changes would form part of a prescribing incentive scheme, which has been developed by Prof Michael Barry, Clinical Director of the National Centre for Pharmacoeconomics.

Proposals for the scheme have been submitted to the HSE, but have yet to be endorsed, it is understood.

The scheme would work on a similar premise to the previous incentivised prescribing scheme in general practice some years ago. Under this scheme, GPs were rewarded with funding to invest in their practices for positive and cost-effective prescribing practices.

NAGP President Dr Maitiú Ó Tuathail told MI the Association would fully support such a scheme and that representatives planned to meet with the HSE to advocate for its introduction. He said the development would be a “win/win” for patients and GPs.