As the IPU and the Department of Health commence talks on the future of pharmacy fees, Deputy David Cullinane (Waterford, Sinn Féin) asked the Minister for Health about “the cost of increasing pharmacy fees by 10 per cent; and the cost of reversing all FEMPI cuts to pharmacy fees”.
In her response, Minister for Health, Jennifer Carroll MacNeill TD, outlined the background to the issue, referencing the Financial Emergency Measures in the Public Interest (FEMPI) legislation. She said, “the current pharmacy fee structure was put in place by the Public Service Pay and Pensions Act 2017, which came into effect from 1 January 2020 . . . since then, the overall spend on fees paid to community pharmacists under the community drug schemes has continued to rise year-on-year.”
Minister Carroll MacNeill said, “a 10 per cent increase on the pharmacy fees paid in 2024 would cost an additional €52 million at minimum”. She concluded by noting that “the State has recently entered into contract negotiations with the Irish Pharmacy Union, under the agreed Framework of Engagement, published on 23 May 2025”.
As attention continues to focus on the evolving role of pharmacy in delivering frontline healthcare, a series of parliamentary questions addressed the scope of services provided in community settings.
Deputy Barry Henegan (Dublin Bay North, Independent) asked the Minister for Health, “to outline her plans to further enhance the ability of community pharmacists to administer vaccinations in the community”.
In her reply, Minister Carroll MacNeill recognised the “crucial role” that pharmacists play in delivering healthcare across Ireland and told Deputy Heneghan that “since 2011, pharmacists have been empowered to administer the seasonal influenza vaccine, with legislation subsequently amended to include the pneumococcal, shingles, and COVID-19 vaccines”.
Concluding her response, the Minister said she is “a huge advocate for the reform and expansion of pharmacy services” and highlighted the work of the Expert Taskforce to Support the Expansion of the Role of Pharmacy, expressing a clear ambition for pharmacists to have an expanded role in healthcare delivery.
Barry Ward (Dún Laoghaire, Fine Gael) asked the Minister for Health whether she was aware of “the concerns of pharmacists regarding the prohibitive cost of the shingles vaccine, despite it being recommended by the National Immunisation Advisory Committee,” and if the Department had engaged with the manufacturer to reduce the price.
The Minister explained that the vaccine “is licensed in Europe for the prevention of shingles and its most common complication, post-herpetic neuralgia,” and that “NIAC recommends the vaccine for adults aged 65 and older, and for adults aged 18–49 who are at increased risk of shingles”.
While HIQA carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine, published in July 2024, the Minister said the HTA “found that adding the shingles vaccine to the routine immunisation schedule would not be cost effective and would be associated with a substantial budget impact”.
Separately, in response to questions from Roderic O’Gorman (Dublin West, Green Party) on RSV immunisation for the 2026–2027 season and beyond, the Minister confirmed that a Health Technology Assessment on RSV immunisation for infants and adults is currently being undertaken by HIQA.
The rapid HTA published in August 2024 estimated that “offering the vaccine to everyone aged 65 years and older was estimated to cost €146 million” with potential HSE cost savings from reduced hospitalisations projected at only “between €0.9 million and €1.2 million.”
The Minister added that “HIQA has now progressed to undertaking a full HTA on RSV immunisation for infants and adults.
She also confirmed that her Department had asked the HSE to tender for enhanced flu vaccines for older adults. However, “neither of the enhanced vaccines for older people met the criteria set out in the HTA for net monetary benefit compared to standard flu vaccine,” and “the introduction of an enhanced vaccine for the older age groups can be reconsidered when cost effectiveness is more favourable”.
Deputy John Clendennen (Offaly, Fine Gael) asked the Minister for Health “for an update on the progress of the introduction of the common conditions services by community pharmacists.”
In response, the Minister outlined the work of the Community Pharmacy Expansion Implementation Oversight Group (IOG), which was “established to implement recommendations from the Expert Taskforce to Support the Expansion of the Role of Pharmacy”. She noted that the IOG is “made up of stakeholders from the PSI, IPU, HPRA, and HSE while chaired by the Department of Health”, and explained that it also includes practising pharmacists and a patient advocate.
The Minister confirmed that the IOG meets monthly and directed those seeking further detail to the Department’s dedicated webpage.
Deputy John Clendennen (Offaly, Fine Gael) asked the Minister for Health, “for an update on the percentage of pharmacies that have now opted in to providing free hormone replacement therapy to patients with a valid prescription” and “if all pharmacies participating in the free HRT scheme are listed on the pharmacy finder database.”
The Minister referred the question to the HSE for a response.
A further question on the HRT scheme came from Deputy Pa Daly (Kerry, Sinn Féin), who asked, “if all dispensing pharmacies are obligated to take part in the free hormone replacement therapy scheme once it is implemented” and “if the refund of the costs incurred for hormone replacement therapy will be introduced”.
The Minister replied that “the HRT arrangement will commence on 1 June 2025, with the full support of the IPU, with pharmacies having until 1 June to sign up,” and noted that the HSE is developing a “pharmacy finder” to help women locate participating pharmacies. She added that “reimbursement support will only commence from 1 June 2025, and the measure as planned will now involve no costs for the prescribed HRT product at the point of dispensing in participating pharmacies”.
Conor Sheehan (Limerick City, Labour) asked the Minister for Health, “when she intends to publish and implement guidelines from the pharmacy regulator on pharmacy charges; and if she will make a statement on the matter”.
In response, Minister Carroll MacNeill emphasised that, “transparency in pricing for patients and members of the public is desirable and empowers individuals to make informed decisions about their care”, noting that the PSI Council has previously published information on pricing transparency, available on its website.
She added that, “in April 2025 I requested the PSI to consider the development of appropriate guidelines so that patients have an improved understanding of the fees that they pay in respect of the products they are dispensed and the services they use in pharmacies”.
The Minister confirmed that “the PSI is scheduled to consider proposed draft guidance on Pricing Transparency at its upcoming meeting on the 26 June 2025, with a view to subsequently issuing this for public consultation prior to formal approval at the next subsequent meeting”.
Brian Harrison
Managing Director, MKC Communications
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