Pharmacoeconomics: Open Access

Irish GMS Cost Projections and Its Implications between 2016 and 2026

Abstract

Conway Lenihan A and Woods N

Introduction: Ireland had one of the highest pharmaceutical spends per capita in the EU in 2012. The General Medical Services (GMS) scheme is the largest community drug scheme in Ireland with approximately 40% of the population eligible for free drugs and appliances in 2012. The total cost of GMS prescriptions increased by 414% between 1998 and 2012. This paper projects Irish GMS cost from 2016 to 2026 and examines the implications of the estimated impact on GMS expenditure.

Method: Central Statistics Office (CSO) population projections (2013) and HSE-PCRS GMS population prescription data (2012) were used to develop four variables; population, GMS coverage, average cost per claimant and claims rate. A Monte Carlo Simulation (MCS) model simulated the effect of these four variables on GMS costs, by health board region, age cohort and sex.

Results: Irish population is projected to grow by approximately 10% between 2012 and 2026. The over 70s population is estimated to grow by 64% with the proportion of males growing by 72%. GMS expenditure is estimated to increase by 64%, from €1.1 billion in 2016 to €1.8 billion by 2026. Age is a key driver of GMS expenditure, specifically those aged under 11 and over 70. The MCS results project that males, the Mid-Western and South- Eastern regions are driving GMS costs in the under 11s. Females, Midlands and Southern regions are driving GMS costs in the over 70s.

Conclusion: Population growth coupled with an aging population will impact future GMS costs. Targeted GMS policy changes such as co-payment charges, reference pricing, and generic substitution can help to contain future GMS expenditure.