This release is categorised as a CSO Frontier Series output. Particular care must be taken when interpreting the statistics in this release as it may use new methods which are under development and/or data sources which may be incomplete, for example new administrative data sources.
The General Medical Services (GMS) Scheme provides access to free or low-cost healthcare services for eligible individuals, primarily through medical cards and GP visit cards. Medical cards are the focus of the analysis in this release. Being "active" on the scheme refers to people who were reimbursed for at least one prescribed item.
Almost one in ten (9%) people active on the GMS Scheme in 2023 had prescriptions reimbursed for 20 or more medications over the year. This corresponds to approximately 128,000 people.
More than a quarter (26%) of people active on the GMS Scheme had one or more prescriptions reimbursed for antidepressants in 2023 (350,200 people). This increased from 21% in 2018 (293,200 people).
The largest year-on-year increases in the number of people being reimbursed for prescriptions for antidepressants were seen from 2019 to 2020 (+11,300 people) and 2020 to 2021 (+17,000 people).
The number of people aged under 18 active on the GMS Scheme decreased by 10.2% between 2018 and 2023 (27,200 fewer people). The number of people aged 65 years or older reimbursed for prescription(s) went up by 11.1% (or 48,200 people).
More than a quarter of the population (26%) or 1.35 million people were active on the GMS Scheme in 2022.
A higher percentage of females (29%) were active on the GMS Scheme in 2022 compared with males (23%).
The statistical release Analysis of Prescriptions Dispensed under the General Medical Services (GMS) Scheme, 2018 - 2023 is designed to provide greater insights in terms of people’s health and the medications that they are prescribed. Medications are classified according to Anatomical Therapeutic Chemical (ATC) codes. ATC codes are a globally adopted method of classifying medications into categories based on various levels, from Level 1 (the anatomical target) to Level 5 (the distinct chemical compound). See the Background Notes for further information on ATC codes. The new Health Service Executive (HSE) Health Regions are included where possible in the PxStat Tables supporting this release and provide additional scope for exploration.
People being reimbursed for an item on the GMS Scheme as a percentage of the population was highest amongst groups aged 70+ in 2022, with 71% availing of the service (See Figure 1).
There was a fall of 5,500 people in the number of people active on the GMS Scheme between 2018 and 2023 (See Table 1). The 65+ age group had significant rises in the number of people being active (+11.1%, or 48,200 people). By contrast, the age group under 18, saw a reduction of 10.2% (27,200 people) in the number of active people between 2018 and 2023.
Between the genders, females were more likely to be active on the GMS Scheme in 2022 across all age groups, with the largest differences being evident in the 25-49 years age group (See Table 2), at 22% for females and 13% for males.
Most anatomical groups saw increases in the number of people receiving medications from both 2018 to 2023 and 2022 to 2023 (See Table 3).
In absolute terms, the largest five-year changes were seen in the Alimentary Tract & Metabolism (+91,700), Cardiovascular System (+81,700 people), and Blood & Blood Forming Organs (+52,000 people) categories. Alimentary Tract & Metabolism refers to the digestive system and how the body uses food for energy and growth.
In terms of percentage change, Antineoplastic & Immunomodulating Agents (L) saw the largest five-year change, with a 19.8% increase. These are medicines that treat cancer or problems with the immune system. In absolute terms, this equates to a 7,700 increase, from 38,800 to 46,500 people. This increase was in part driven by the increasing availability and use of treatments for such conditions in primary care.
With declines of 3.8% and 2.2% respectively, Dermatologicals (D) and Anti-infectives for Systemic Use (J) were the only categories to see reductions over the five years (-16,200 and -18,800 people in absolute terms). Dermatologicals are treatments used on the skin to help with conditions like rashes, acne, infections, eczema, and psoriasis. Anti-infectives are medicines used to treat infections caused by germs like bacteria, viruses, fungi, or parasites.
The largest absolute changes over the period 2022 to 2023 were for the Alimentary Tract & Metabolism (+29,400 people), Anti-infectives for Systemic Use (+27,300 people) and Cardiovascular System (+26,900 people) categories.
In terms of one-year percentage changes between 2022 and 2023, Antiparasitic Products, Insecticides & Repellents (P), which are treatments to protect against or get rid of harmful bugs and parasites, saw the largest increase in usage at 11.2% (7,000 prescribed people). Genito Urinary System & Sex Hormones (G) was the only category to see a fall, of 3.6% (11,000 prescribed people). These are treatments which affect the organs involved in urination, reproduction, and sex hormones. They are used for cases such as urinary problems, contraception, menopause symptoms, hormone imbalances, fertility issues, or in transgender healthcare.
It should be noted that the top five increases are based on ATC Level 3 categories that are reported on in the PxStat tables. Some categories were excluded due to Statistical Disclosure Control concerns.
It should be noted that the top five decreases are based on ATC Level 3 categories that are reported on in the PxStat tables. Some categories were excluded due to Statistical Disclosure Control concerns.
Polypharmacy is the use of multiple medications by a single individual, often five or more, which can increase the risk of negative health outcomes. It is receiving increasing focus from the health research community because it is important to understand to improve patient safety, support better treatment outcomes, and reduce unnecessary or inappropriate medicine use, especially in older or vulnerable populations. The number of people who received 20 or more medications over the year in 2023 as a percentage of active persons was 9% (See Figure 2 and Table 6), with this rising as people got older from 0% in the Under 18 cohort to 30% in the 90+ cohort, showing more medications were received as people aged. At the other end, 10% received only one medication over the year, with this decreasing as one got older, from 27% in the Under 18 cohort to 1% in the 90+ cohort.
Quite often, people were taking different types of medications (ATC Level 1), as evidenced by Table 7, which is an indication of how many people were managing two or more conditions in 2023. Excluding the Various category, the highest co-prescribed ATC Level 1 categories were Antineoplastic & Immunomodulating Agents (L) and Alimentary Tract & Metabolism (A), with 88% of those receiving an item from ATC L also receiving an item from ATC A (See Table 7). The lowest co-prescribed categories were Anti-Infectives for Systemic Use (J) and L, with 3.8% of those receiving an item from J also receiving an item from L in 2023.
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Statistician's Comment
The Central Statistics Office (CSO) has today (21 January 2026) published Analysis of Prescriptions Dispensed under the General Medical Services (GMS) Scheme, 2018 – 2023.
Commenting on the release, Tomás Kelly, Statistician, said: “The purpose of this release is to provide detailed statistical information on prescribing patterns for those availing of medical cards in Ireland from 2018 to 2023.
This release and the associated PxStat Tables present insights on the people who availed of the General Medical Services (GMS) Scheme in Ireland to help with Public Health analysis. The GMS Scheme provides access to free or low-cost healthcare services for eligible individuals, primarily through medical cards and GP visit cards. Prescriptions reimbursed under the medical card were the focus of this analysis. The Drugs Payment Scheme and the Long-Term Illness Scheme are not included in this analysis. Being "active" on the GMS Scheme refers to a person being reimbursed for at least one prescribed item over the course of the year.
From reviewing prescriptions that were reimbursed from 2018 to 2023, data was explored by Year, Age, Sex, Anatomical Therapeutic Chemical (ATC) code and Health Service Executive (HSE) Health Region. ATC codes are used to classify drugs and other medical products, and the system, which is maintained by the World Health Organisation (WHO), is widely used in pharmacology, research, and health statistics (See Background Notes).
Overall Results
In 2022, more than a quarter of the population (26%) or 1.35 million people were active on the GMS Scheme, with a higher percentage of females (29%) being active compared with males (23%). Activity also varied by age, with 71% of people aged 70 or over being active on the scheme and 18% of people aged 25 to 49 years being active.
There was an overall decline in the number of active people between 2018 and 2023, with 5,500 fewer people availing of the scheme in 2023, however, changes over the years varied with age. Those aged under 18 had 10.2% fewer people active in 2023 compared with 2018, while people aged 65 and over had 11.1% more active people in 2023.
Approximately 9% of people active on the GMS Scheme in 2023 had prescriptions reimbursed for 20 or more medications over the year. This varied significantly with age, with 30% of those aged 90+ receiving 20 or more medications, compared with 0% of under 18-year-olds.
An estimated 26% of people active on the GMS Scheme had one or more prescriptions reimbursed for antidepressants over the year in 2023 or 350,200 people. This was an increase from 21% in 2018 or 293,200 people. It should be noted that antidepressants are not only used for treating depression and can be used for treating social anxiety, post-traumatic stress disorder, and eating disorders, among other conditions.
The largest year-on-year increases in the number of people being reimbursed for prescriptions for antidepressants were seen from 2019 to 2020 (+11,300 people) and 2020 to 2021 (+17,000 people).
Trends in many different categories of medications between 2016 and 2023 can be explored further using our PxStat Tables.
A video tutorial on using the data from this release in R is available in the Videos section, as well as a promotional video.”