Pharmacy costs and claims | ||||
2013 | 2014 | 2015 | 2016 | |
Pharmacy cost (‘000) | €1,141,106 | €1,059,259 | €1,020,389 | €1,002,160 |
Number of pharmacy claims | 19,054,171 | 18,571,492 | 18,664,608 | 18,990,442 |
Average cost per claim | €60.75 | €57.78 | €55.26 | €53.29 |
Expenditure on Health Service Executive (HSE) refunded pharmacy claims under the General Medical Scheme (GMS) amounted to just over €1 billion in 2016. This is a decrease of 12% on 2013 levels, despite the number of pharmacy claims staying relatively static over the same period (a marginal fall of only 0.3% to 18.99 million claims in 2016). The decrease in pharmacy cost was largely driven by a fall in the average cost per pharmacy claim of 12.3% - from €60.75 in 2013 to €53.29 per pharmacy claim in 2016.
These payments were paid by the Primary Care Reimbursement Service (PCRS). 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.
Summary Points:
Table 1 Total number of pharmacy claims, by gender, age group and Local Health Office region, 2013-2016 | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Total | 19,054,171 | 18,571,492 | 18,664,608 | 18,990,442 |
Gender of patient | ||||
Male | 7,696,318 | 7,461,523 | 7,493,947 | 7,636,997 |
Female | 11,357,853 | 11,109,969 | 11,170,661 | 11,353,445 |
Age Group | ||||
0 - 24 years | 2,273,877 | 2,130,221 | 2,058,051 | 2,016,615 |
25 - 34 years | 1,539,249 | 1,427,909 | 1,337,689 | 1,297,209 |
35 - 44 years | 1,857,983 | 1,786,775 | 1,773,205 | 1,803,004 |
45 - 54 years | 2,068,878 | 2,027,035 | 2,070,095 | 2,159,154 |
55 - 64 years | 2,555,562 | 2,484,651 | 2,521,582 | 2,602,196 |
65 - 74 years | 3,636,260 | 3,615,195 | 3,696,992 | 3,810,426 |
75 - 84 years | 3,567,232 | 3,536,363 | 3,585,423 | 3,641,336 |
85 years and over | 1,555,130 | 1,563,343 | 1,621,571 | 1,660,502 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 4,747,701 | 4,636,432 | 4,646,964 | 4,727,016 |
Dublin North East | 3,819,943 | 3,740,917 | 3,745,689 | 3,812,861 |
West | 5,142,638 | 5,012,708 | 5,051,463 | 5,140,707 |
South | 5,343,889 | 5,181,435 | 5,220,492 | 5,309,858 |
Table 2 Pharmacy claims expenditure1, by gender, age group and Local Health Office region, 2013-2016 ('000) | ||||
€ | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Total | 1,141,106 | 1,059,259 | 1,020,389 | 1,002,160 |
Gender of patient | ||||
Male | 502,294 | 459,351 | 436,191 | 427,190 |
Female | 638,812 | 599,908 | 584,198 | 574,970 |
Age Group | ||||
0 - 24 years | 68,807 | 62,609 | 58,604 | 55,336 |
25 - 34 years | 59,068 | 52,867 | 47,056 | 43,448 |
35 - 44 years | 87,175 | 80,565 | 75,424 | 72,771 |
45 - 54 years | 121,863 | 111,241 | 105,722 | 103,926 |
55 - 64 years | 172,142 | 155,327 | 147,900 | 145,218 |
65 - 74 years | 254,053 | 234,709 | 226,793 | 225,184 |
75 - 84 years | 262,573 | 248,324 | 242,107 | 238,649 |
85 years and over | 115,422 | 113,614 | 116,780 | 117,625 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 288,770 | 268,582 | 257,814 | 252,613 |
Dublin North East | 234,782 | 218,584 | 210,503 | 206,391 |
West | 297,692 | 276,465 | 266,546 | 262,795 |
South | 319,861 | 295,627 | 285,524 | 280,359 |
1 Expenditure includes ingredient costs, fees and vat on pharmacy claims for GMS patients only and is exclusive of Stock costs, fees and vat. |
Table 3 Average costs1 of pharmacy claims, by gender, age group and Local Health Office region, 2013-2016 | ||||
€ | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Average | 60.75 | 57.78 | 55.25 | 53.29 |
Gender of patient | ||||
Male | 65.26 | 61.56 | 58.21 | 55.94 |
Female | 56.24 | 54.00 | 52.30 | 50.64 |
Age Group | ||||
0 - 24 years | 30.26 | 29.39 | 28.48 | 27.44 |
25 - 34 years | 38.38 | 37.02 | 35.18 | 33.49 |
35 - 44 years | 46.92 | 45.09 | 42.54 | 40.36 |
45 - 54 years | 58.90 | 54.88 | 51.07 | 48.13 |
55 - 64 years | 67.36 | 62.51 | 58.65 | 55.81 |
65 - 74 years | 69.87 | 64.92 | 61.35 | 59.10 |
75 - 84 years | 73.61 | 70.22 | 67.53 | 65.54 |
85 years and over | 74.22 | 72.67 | 72.02 | 70.84 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 60.82 | 57.93 | 55.48 | 53.44 |
Dublin North East | 61.46 | 58.43 | 56.20 | 54.13 |
West | 57.89 | 55.15 | 52.77 | 51.12 |
South | 59.86 | 57.06 | 54.69 | 52.80 |
1Expenditure includes ingredient costs, fees and vat on pharmacy claims for GMS patients only and is exclusive of Stock costs, fees and vat. |
Table 4 Average number of pharmacy claims per patient, by gender, age group and Local Health Office region, 2013-2016 | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Average | 17.60 | 12.13 | 12.44 | 12.72 |
Gender of patient | ||||
Male | 16.49 | 11.01 | 11.33 | 11.59 |
Female | 18.70 | 13.25 | 13.55 | 13.84 |
Age Group | ||||
0 - 24 years | 12.10 | 5.04 | 5.04 | 5.07 |
25 - 34 years | 11.66 | 8.46 | 8.57 | 8.88 |
35 - 44 years | 11.90 | 9.73 | 9.99 | 10.21 |
45 - 54 years | 16.95 | 12.42 | 12.68 | 12.89 |
55 - 64 years | 22.22 | 16.12 | 16.37 | 16.54 |
65 - 74 years | 22.80 | 18.70 | 18.94 | 19.10 |
75 - 84 years | 26.10 | 21.71 | 21.91 | 21.96 |
85 years and over | 43.79 | 24.09 | 24.39 | 24.50 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 17.64 | 12.05 | 12.31 | 12.58 |
Dublin North East | 16.60 | 11.88 | 12.19 | 12.53 |
West | 20.47 | 12.47 | 12.83 | 13.08 |
South | 15.96 | 12.49 | 12.82 | 13.05 |
Table 5 Average number of items per pharmacy claim, by gender, age group and Local Health Office region, 2013-2016 | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Total | 3.11 | 3.10 | 3.08 | 3.07 |
Gender of patient | ||||
Male | 3.19 | 3.17 | 3.13 | 3.11 |
Female | 3.02 | 3.02 | 3.02 | 3.02 |
Age Group | ||||
0 - 24 years | 1.61 | 1.60 | 1.60 | 1.60 |
25 - 34 years | 1.87 | 1.85 | 1.86 | 1.88 |
35 - 44 years | 2.22 | 2.20 | 2.19 | 2.19 |
45 - 54 years | 2.78 | 2.73 | 2.69 | 2.67 |
55 - 64 years | 3.34 | 3.29 | 3.22 | 3.19 |
65 - 74 years | 3.70 | 3.64 | 3.57 | 3.53 |
75 - 84 years | 3.98 | 3.96 | 3.91 | 3.88 |
85 years and over | 4.06 | 4.07 | 4.08 | 4.08 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 3.16 | 3.15 | 3.13 | 3.13 |
Dublin North East | 3.16 | 3.14 | 3.12 | 3.11 |
West | 2.99 | 2.97 | 2.94 | 2.94 |
South | 3.08 | 3.90 | 3.07 | 3.06 |
Table 6 Average cost1 per item per pharmacy claim, by gender, age group and Local Health Office region, 2013-2016 | ||||
€ | ||||
2013 | 2014 | 2015 | 2016 | |
State | ||||
Average | 19.53 | 18.65 | 17.97 | 17.37 |
Gender of patient | ||||
Male | 20.45 | 19.42 | 18.62 | 17.97 |
Female | 18.60 | 17.88 | 17.32 | 16.77 |
Age Group | ||||
0 - 24 years | 18.80 | 18.39 | 17.84 | 17.12 |
25 - 34 years | 20.50 | 19.97 | 18.93 | 17.82 |
35 - 44 years | 21.14 | 20.50 | 19.41 | 18.40 |
45 - 54 years | 21.20 | 20.11 | 19.00 | 18.05 |
55 - 64 years | 20.14 | 19.02 | 18.20 | 17.47 |
65 - 74 years | 18.91 | 17.86 | 17.21 | 16.72 |
75 - 84 years | 18.50 | 17.71 | 17.27 | 16.89 |
85 years and over | 18.27 | 17.84 | 17.66 | 17.37 |
Local Health Office Region | ||||
Dublin Mid-Leinster | 19.24 | 18.41 | 17.70 | 17.07 |
Dublin North East | 19.46 | 18.61 | 18.01 | 17.38 |
West | 19.38 | 18.58 | 17.92 | 17.38 |
South | 19.42 | 18.48 | 17.81 | 17.24 |
1Expenditure includes ingredient costs, fees and vat on pharmacy claims for GMS patients only and is exclusive of Stock costs, fees and vat. |
The data in this release is provided to the Central Statistics Office by the Primary Care Reimbursement Service (PCRS). The PCRS is the part of the Health Service Executive (HSE) that processes payments to all the GPs, pharmacists, dentists and other health professionals who provide free or reduced cost services to the public. The PCRS pays for this service on behalf of the HSE.
Under the GMS, people who are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants may be granted a medical card and receive free general medical services. All GMS claims are processed and paid by the PCRS. In most cases the GP gives a completed prescription form to an eligible person, who takes it to any Pharmacy that has an agreement with the Health Service Executive to dispense drugs, medicines and appliances on presentation of GMS prescription forms.
The figures derived in this release refer to claims that were carried out in the corresponding year. Expenditure includes ingredient costs, fees and vat on pharmacy claims for GMS patients only and is exclusive of Stock costs, fees and vat. Please note average figures were calculated from actual figures not rounded figures.
Definitions:
Medical card: With a medical card issued by the HSE, one can receive certain health services free of charge. To qualify for medical card, an individual’s weekly income must be below a certain figure. If an individual does not qualify for a medical card, they may qualify for a GP visit card.
Total expenditure includes ingredient costs, fees and vat on pharmacy claims for GMS patients only, and is exclusive of Stock costs, fees and vat.
Regions
The regions consist of the local health offices and are constructed as follows;
Local Health Offices |
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Dublin Mid-Leinster |
Dublin South |
Dublin North East |
Dublin North West |
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Dublin South East |
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Dublin North Central |
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Dublin South City |
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Dublin North City |
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Dublin South West |
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Cavan / Monaghan |
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Dublin West |
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Louth |
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Kildare / West Wicklow |
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Meath |
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Wicklow |
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Laois / Offaly |
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Longford / Westmeath |
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West |
Galway |
South |
South Lee Cork |
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Mayo |
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North Lee Cork |
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Roscommon |
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West Cork |
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Donegal |
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Kerry |
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Sligo / Leitrim |
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North Cork |
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Clare |
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Carlow / Kilkenny |
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North Tipperary / East Limerick |
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Waterford |
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Limerick |
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South Tipperary |
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Wexford |
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