Dáil Éireann Debate, Wednesday - 17 December 2025
371. Deputy Conor Sheehan asked the Minister for Health if she will intervene to ensure that patients are not charged for blister packs of medications prepared by pharmacists; and if she will make a statement on the matter. [72621/25]
View answer374. Deputy Michael Cahill asked the Minister for Health if she will introduce a scheme to cover the costs associated with blister packs, as the majority of senior citizens simply cannot afford this payment and are already struggling with the cost-of-living crisis; and if she will make a statement on the matter. [72677/25]
View answer391. Deputy Colm Burke asked the Minister for Health if the HSE will provide State funding for the preparation of blister packs in pharmacies to ensure that elderly and vulnerable patients who depend heavily on this service for their health are not impacted financially; and if she will make a statement on the matter. [72796/25]
View answer398. Deputy Danny Healy-Rae asked the Minister for Health to provide an update on a matter regarding blister packaging (details supplied); and if she will make a statement on the matter. [72860/25]
View answer410. Deputy Brendan Smith asked the Minister for Health if she will ensure that funding for blister packing services will continue as this has been an important support for many people in ill health, as outlined in correspondence from persons who rely on this service to sort their medicine (details supplied); and if she will make a statement on the matter. [73036/25]
View answerI propose to take Questions Nos. 371, 374, 391, 398 and 410 together.
Monitored Dosage Systems, known as “blister packs” or compliance aids, are systems that enable the individual medicine doses for any medication to be organised according to the prescribed dose schedule. These are ordinarily provided once a month and packaged to indicate when medication should be taken.
The State has never agreed to fund this and there has never been a fee associated with monitored dosage systems under the Pharmacy contract. This has always been the case and has been repeated in several HSE circulars to pharmacists.
I recognise that for certain patients, or their carers, the use of blister packs to simplify adherence with their dosage schedule can be helpful and they rely heavily on the provision of these products.
However, it is important to recognise that phased dispensing and blister packing are not the same thing. The State funds phased dispensing for medical card holders. It does not, however, fund Monitored Dosage Systems.
The community pharmacy contract has supported phased dispensing since 1996 for patient safety reasons and will continue to do so. Phased dispensing requires the patient to present to the pharmacy on multiple occasions in the month (e.g., each week) when it would be unsafe for the patient to receive the totality of their medication in one supply occasion, or if the shelf life of the medicine requires it. Community pharmacies receive additional fees for this service – which has only ever been in place for medical card holders.
The changes agreed under the Community Pharmacy Agreement – now paused until later in quarter 1 2026 – will introduce improved controls to align phased dispensing to specified high risk drugs, where a patient safety concern may exist. This will ensure that patients on high-risk medicines, such as anti-psychotics or opioids, are appropriately targeted with support.
Psychotropic medications represent a class of medication that are high risk, have a high dependency potential, and carry a significant risk of misuse. They are often prescribed in the management of conditions where cognitive or functional impairments justify closer monitoring through phased supply.
The State has not imposed a new charge on blister packs. This remains a private service provided by pharmacies. It is also understood that different approaches are taken by community pharmacies in respect of funding the use of Monitored Dosage Systems for medical card holders.
• Some have been blister packing their patient’s medicines for free,
• Some have been charging the patient privately for providing that service, and,
• Some have submitted claims for phased dispensing to the HSE when in reality they were using Monitored Dosage Systems. The State has never agreed to this last practice, and it is inappropriate claiming to do so.
It remains open to pharmacies to charge patients or not for the use of Monitored Dosage Systems as a private service, as many currently do. It is important where a pharmacy charges a fee for any professional service, that they provide updated information to patients in line with the new Pricing Transparency Guidelines, which came into effect on 1st December.
In addition, community pharmacies can, and do, use a variety of means to assist their patients including:
• counselling,
• reminder charts,
• the “Know Check Ask system” with the HSE, and
• tools like picture or large-print labels and alarms.
All of these are aimed at improving understanding and adherence to medication. This remains a key part of the service and support that pharmacies provide to patients. There is no change in that regard.
The HSE Health App ‘My medicines list’ provides a secure place for patients to record a list of their medicines, which can be useful for pharmacy or hospital visits. It also allows people to see a list of their medicines received through the Drugs Payment Scheme or Medical Card Scheme. Keeping a list can help patients know their medicines. It can also help when patients are discussing their medicines with a healthcare professional.
These measures can assist older people, people with disabilities, and people with multiple conditions, to ensure that they manage their medicines safely. Patients should talk to their pharmacist directly about the best way to manage their medicines.
