Table 1: GMS Scheme fees  

	GMS Scheme Dispensing Fee per Item	GMS MOSS Fee per Item	Total
For the first 1,667 items per month	€5.60	€0.35	€5.95
For the next 833 items per month	€4.50	€0.35	€4.85
For each other item dispensed per month	€4.10	€0.35	€4.45

 

Service fees

Funding arrangements for medicines optimisation have been revised with the Community Pharmacy Agreement 2025 (CPA25) and applied more broadly across GMS activity. These payment arrangements are designed to ensure that pharmacies are appropriately supported and remunerated for providing medicines optimisation services, particularly for patients with greater support needs.  

GMS Medicines Optimisation Support Service Fee

A GMS MOSS fee of €0.35 is paid for every GMS item dispensed, including those under the Hospital Emergency Scheme and GMS Dental Treatment Service Scheme. This means pharmacies receive an uplift across all GMS dispensing, in addition to increased CPA25 dispensing fees (€5.60/€4.50/€4.10), and it is not limited to specific patients or services.   While most GMS patients will not require additional medicines optimisation support, the universal €0.35 fee is intended to support pharmacies in delivering this additional support to those who do. The MOSS fee of €0.35 will be automatically applied by the PCRS to all tiered-fee GMS items at the point of claim payment, so no action is required from pharmacies to claim this fee.  

Monthly Enhanced Medicine Optimisation Support Fee

A monthly Enhanced Medicines Optimisation Support Fee of €32.50 will be paid where a patient is prescribed and dispensed medication(s) on the PCRS approved list of medications more frequently than once weekly (for example, daily, twice weekly). This list includes medications such as psychotropics, gabapentinoids, antiepileptics and opioids. The list is available on the Medicines Optimisation Hub at ipu.ie or on the PCRS Online Services.   The monthly Enhanced Medicines Optimisation Support fee of €32.50 can be claimed by submitting phased claims in the normal manner for eligible patients. The PCRS will pay the fee automatically where the claiming requirements are met. There is no requirement to seek prior approval. One fee will be paid per patient per month, regardless of the number of items dispensed to the patient.   Additionally, pharmacies may continue to use the phased dispensing functionality within their PMR system to track dispensings for patients outside this cohort. In such cases, a standard dispensing fee (€5.60/€4.50/€4.10) will be paid.   The Enhanced Medicines Optimisation Support Fee of €32.50 will not be paid where medicines are supplied weekly or where a patient is not on at least one of the medications on the PCRS approved list.  

Eligibility for the GMS Medicines Optimisation Support Service

The medicines optimisation process begins by establishing whether the patient requires medicines optimisation support, whether they hold GMS eligibility and whether they are eligible for the MOSS.   The new fees will support the provision of medicines optimisation supports to people in the following two categories where clinically appropriate: 1. GMS patients who were in receipt of phased dispensing or monitored dosage systems (MDS) free of charge in August 2025: Existing GMS patients who were receiving phased dispensing or MDS (blister packs) free of charge in August 2025 should continue to receive these services free of charge. Maintaining current arrangements, with no additional changes for these patients, will ensure continuity of care and avoid disruption for those already established on these supports; and 2. GMS patients in the eligible cohorts: For GMS patients who do not fall into category 1 above, eligibility for MOSS depends on whether the patient falls within defined cohorts. Where a patient falls within the defined cohorts below and requires additional medicines optimisation support, the appropriate supports will be provided to the patients without additional charge:

• Patients who are on high-risk medicines and are at risk of misuse and/or abuse of those medicines;
• Patients with physical impairment affecting the ability to use conventional packaging (who do not have carers that could support them to use original packs);
• Patients diagnosed with cognitive impairment or dementia who have carers to support them (including home care) by prompting them to take their medications at the appropriate intervals;
• Patients with an intellectual disability; or
• Patients who, for social inclusion reasons, including homeless or marginalised people, are unable to appropriately manage their medication.

 

Residential care exception

For patients in residential care, MDS will not be provided free of charge under the agreement and so may be provided privately.  

Other groups

Where a GMS patient was not receiving phased or MDS free of charge in August 2025 and does not fall into one of the eligible cohorts above, appropriate supports may still be provided but these would be delivered on a private basis.   Similarly, where a patient does not hold GMS eligibility, supports may still be provided on a private basis.  

Flowchart

A flowchart published on the Medicines Optimisation Hub on the IPU website can help you determine which patients fall under the MOSS.  

Types of supports available under the GMS Medicines Optimisation Support Service

Supporting patients to use their medicines safely and effectively through a personalised approach helps improve adherence and ensures they achieve the best possible outcomes from their treatment. If a GMS patient meets the eligibility criteria for the MOSS, pharmacies can provide certain supports free of charge to help patients manage their medicines safely and effectively. After assessing eligibility, the pharmacy team will discuss the service with the patient, and may, where appropriate, liaise with the prescriber or other healthcare professionals to confirm the patient’s needs. Supports should be individualised, proportionate, and based on the patient’s ability to manage medicines safely. Under the MOSS, there are a range of medicines optimisation supports that a pharmacist can offer, including:

• Further patient counselling to support understanding, identify techniques for self-management, and monitor and support adherence;
• Medicine reminder charts;
• ‘Know, Check, Ask’ My Medicines List;
• Winged bottle caps/easy open lids;
• Labelling modifications such as large print labels and advice on talking labels;
• Advice on the use of dosette boxes;
• Advice on the use of tablet splitters;
• Advice on the use of digital medication reminders;
• Instalment dispensing; or
• MDS/blister packs.

  In-line with the available evidence and international practice, MDS should remain a last-resort option due to the recognised risks involved and the potential impact on patient autonomy and empowerment. Where no other support is considered appropriate and MDS is being considered, an IPU Patient Assessment for Medicines Compliance Support tool is available in the Medicines Optimisation section of the IPU website to assist in determining its suitability for the patient. In practice, when a patient is experiencing difficulty managing their medicines, the pharmacist should begin by engaging directly with the patient to understand their specific challenges. Using professional judgement, the pharmacist can assess the level of support required and determine the most appropriate intervention, whether that involves changes to dispensing arrangements, adherence supports or other tailored measures. The chosen approach and rationale for it should then be documented clearly.  

Record keeping

Pharmacies must retain copies of prescriptions and collection records relating to claims for the €32.50 Enhanced Medicines Optimisation Support fee, as these may be requested by the PCRS for verification purposes. An instalment dispensing collection record form is available on the IPU website within the Medicines Optimisation Hub to support you in this.  

Resources for pharmacy teams

Further information and resources for pharmacy teams on medicines optimisation in general, as well as the GMS Medicines Optimisation Support Service, are available on the Medicine Optimisation Hub at ipu.ie > Medicines Optimisation:

• An FAQ document;
• A flowchart to help you determine which patients fall under the MOSS;
• PCRS Circular 016/26 in relation to the MOSS;
• The addendum to the Community Pharmacy Agreement 2025 outlining the changes and the eligible cohorts;
• The webinar slides from the MOSS webinar in April;
• The IPU Patient Assessment for Medicines Compliance Support;
• An Instalment Dispensing Collection Record Form to record collections of medications where the Enhanced Medicines Optimisation Support fee of €32.50 is claimed;
• A template letter to assist you in writing a letter to a prescriber to outline that you do not recommend MDS for a particular patient; and
• A poster to inform patients of the service.

If you require any further support in implementing the service, please contact us directly at contract@ipu.ie.