The Primary Care Reimbursement Service (PCRS) is responsible for reimbursing pharmacists under the GMS scheme. Drugs, medicines, and appliances approved under the GMS are provided through community pharmacies. These payments are paid by the PCRS. Expenditure includes ingredient costs, fees and VAT on pharmacy claims for GMS patients.
The figures on this release are based off fully complete and processed claims for the reference year. For this reason, figures may vary from those published by the HSE. Please see Background Notes for a further description of the PCRS and GMS. Please note, care should be taken when examining trends over time in the form of expenditure and average amounts as eligibility criteria can change over time.
Expenditure on HSE funded pharmacy claims under the GMS scheme amounted to just under €1 billion in 2021, at €967.6 million. This is an increase of less than 0.05% on 2017 levels. The number of HSE funded pharmacy claims fell by 3.2%, from 18.9 million claims per year in 2019 to 18.3 million claims per year in 2021. Although the average number of items per PCRS funded pharmacy claim increased from 3.1 in 2017 to 3.4 in 2021, the average cost per item decreased from €16.53 in 2017 to €15.53 in 2021. The average cost per pharmacy claim increased by 4% between 2017 and 2021, from €50.99 to €52.85. See Table 3.1.
The total cost of a HSE funded pharmacy claims increases with age with three in five of all HSE funded pharmacy claims for patients aged 65 years and over in 2021. The cost of HSE funded pharmacy claims is highest for those aged 75-84 years at €238.1 million in 2021. In 2021, the total cost of HSE funded pharmacy claims was highest for the South Local Health Office (LHO) region at €269.9 million. Between 2017 and 2021, the total cost of HSE funded pharmacy claims increased marginally for both genders between 2017 and 2021. The total cost of HSE funded pharmacy claims decreased marginally for those aged 44 years and under between 2017 and 2021. See Table 3.2.
The trends in the average cost per HSE funded pharmacy claim are reflective of the overall HSE funded pharmacy costs by gender, with the average cost of HSE funded pharmacy claims lower for the younger age cohorts in 2021. The average cost per HSE funded pharmacy claims was highest for those aged 85 and over, at €72.80. See Figure 3.1 and Table 3.3.
The average cost of HSE funded pharmacy claims was higher for males than females across all years, in contrast to GP, dental and optical claims where the average cost of HSE funded claims were higher for females than males. However, the number of claims and total cost of claims for which pharmacies are refunded by the HSE is higher for female patients than for male patients.
| X-axis label | Average cost per claim |
|---|---|
| 0-24 | 30.08 |
| 25-34 | 32.69 |
| 35-44 | 38.18 |
| 45-54 | 45.14 |
| 55-64 | 53.5 |
| 65-74 | 57.38 |
| 75-84 | 65.77 |
| 85 years and over | 72.8 |
The average number of items per PCRS funded pharmacy claim was marginally higher for males than females in 2021, at 3.5 and 3.4 respectively. The number of items per claim was lowest for those aged 24 years and under. The number of items per claim increased progressively for the age cohorts, with an average of 4.6 items per HSE funded pharmacy claim for those aged 85 years and over. The average number of items per HSE funded pharmacy claim was similar across all LHO regions. See Table 3.4.
When analysing the total number of claims, regardless of cost, three in five (60%) of all pharmacy claims were for females with 11 million claims in comparison to 7.3 million for males. The highest number of claims in 2021 were for those aged 65 to 74 years at 3.8 million, followed by those aged 75 to 84 years at 3.6 million. Half of claims (51%) were for those aged 64 years and under. The highest number of claims in 2021 were for the South LHO region at 5.1 million.
The total number of claims decreased from 2017 to 2021, from 18.9 million claims to 18.3 million claims. A decrease in the total number of claims was seen across all demographics for the period apart from those aged 45 to 64 years and those aged 85 years and over, who saw marginal increases. See Table 3.5.
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