Representatives from the HSE PCRS and the IPU Contract Unit met on 12 December 2024 for the Joint Operational Group (JOG), a forum to allow for engagement between the IPU and the PCRS on an operational basis. At this meeting, the following items were discussed:

• Discretionary Hardship Arrangement payment delays: The IPU delegation outlined that it contacted Local Health Offices (LHOs) on pharmacies’ behalf regarding payment delays and in most cases, pharmacies had received full or partial outstanding payments. The IPU will continue to support all members with this issue by engaging directly with the LHOs;
• Three quote requests for Discretionary Hardship Arrangement applications: The IPU noted that pharmacies are occasionally being asked to provide three quotes when submitting a Discretionary Hardship Arrangement application. The PCRS delegation clarified that this has always been standard practice and advised pharmacies to confirm contact with three wholesalers. They acknowledged that some wholesalers might not provide a quote and confirmed that they are satisfied as long as the pharmacy has made an effort to obtain three quotes;
• Dental Prescribable List review: The IPU delegation inquired whether there are plans to introduce a replacement painkiller, such as Solpadeine, to the Dental Prescribable List to address the gap created by the discontinuation of GMS-coded Maxilief as a prescribable item. The PCRS delegation will review and provide an update. Additionally, the IPU raised the issue of pharmacies receiving dental prescriptions for patients under 16 years of age and suggested that these be considered for coverage under the DTSS contract. PCRS delegation confirmed that there was no plan in place for this;
• Timeline for all High Tech medications to move to the High Tech Hub: The PCRS advised that they cannot provide a completion date for moving all High Tech medications to the High Tech Hub due to resourcing constraints. Oncology medications will not be added all at once but may be included individually if classified as Best Value Medicines. The PCRS will keep the IPU updated on progress;and
• Telmisartan shortage and EMPs: The IPU delegation inquired whether an EMP for Telmisartan could be reimbursed under the 777- code due to the current shortage. The PCRS delegation clarified that EMPs for Telmisartan would not be reimbursed as clinical alternatives are available. The IPU highlighted that this situation requires patients to revisit their prescriber for an alternative prescription and that some GPs are hesitant to switch medications without clinical guidance, resulting in patients having to pay for the EMP themselves. The PCRS delegation stated that currently there are no plans to issue clinical guidance but committed to consulting with the HPRA on this matter.