ESRI Research Seminar: "National and Regional GMS Community Drug Costs in Ireland to 2026: Analysis, Projections and Policy Simulations"

Venue: ESRI, Whitaker Square, Sir John Rogerson's Quay, Dublin 2

Speakers: Aisling Conway, Martin Kenneally and Alan Ó Céilleachair, Centre for Policy Studies, University College Cork.

As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on schemes such as GMS drug prescribing and to understand current and future trends in prescribing.

The first part of the presentation (by Aisling Conway and Martin Kenneally) aims to project the cost implications of future changes in population, coverage, average cost per claim and claims rate on GMS costs. Data drawn from the CSO (Regional and National Population Projections 2011 – 2026) and the PCRS (on GMS coverage, claims rates and average cost per claim) are used to make Monte Carlo age, region and gender-specific simulations of GMS prescribing costs for 2011, 2016, 2021 and 2026. Population is projected to grow by 32% by 2026 and by 96% for the ‘over 70s’. Ireland displays large regional disparities in prescribing costs: its Eastern region is estimated to grow by 3% at the expense of most other regions. Coverage, the claims rate and average claims’ cost are estimated for 2007 by age cohort, region and gender and projected to 2026. As the population of Ireland evolves over the next fifteen years to an older, more Dublin-based profile, GMS prescribing costs will continue to represent a serious challenge in funding public health services.

The second part of the presentation (by Martin Kenneally) aims to estimate semi-elasticities of GMS coverage with respect to income and income inequality by age, gender and region using CSO SILC and PCRS 2010 data and to use them to simulate the effect that recession (declining incomes) and income inequality have on GMS coverage and cost. Although GMS coverage grew 9% in 2010 average cost per cover fell by 11% reducing GMS pharmacy costs by €27m. Had average Incomes fallen identically in 2011 to 2010, other things constant, the number of 16-74 year olds covered would have risen circa 175,000 (38,000 more than in 2010) and added circa €110m to the cost of GMS medicines.

The final part of the presentation (by Alan Ó Céilleachair) aims to estimate the factors influencing prescribing levels using the PCRS 2007 Annual Report and a sample of 192,000 observations drawn from the PCRS database. Multivariate regression is used to estimate the effects gender, age category, health board region and prescribing month have in determining prescribing costs.