Expenditure on Health Service Executive (HSE) refunded pharmacy claims under the General Medical Scheme (GMS) amounted to just over €1 billion in 2016. This is a decrease of 12% on 2013 levels, despite the number of pharmacy claims staying relatively static over the same period (a marginal fall of only 0.3% to 18.99 million claims in 2016). The decrease in pharmacy cost was largely driven by a fall in the average cost per pharmacy claim of 12.3% - from €60.75 in 2013 to €53.29 per pharmacy claim in 2016.

These payments were paid by the Primary Care Reimbursement Service (PCRS). Please see background notes for a further description of the PCRS and GMS. Please note, care should be taken when examining trends over time in the form of expenditure and average amounts as eligibility criteria can change over time. 

Summary Points:

• The average cost per pharmacy claim is higher for male patients than for female patients. In 2016, the overall average cost of a claim was €55.94 for male patients and €50.64 for female patients. However, the number of claims for which pharmacies are refunded is higher for female patients than for male patients. See Table 1 and 3.
• The average cost of a pharmacy claim increases with age, and is highest in the 85 years and over age group.  The average cost of claims decreased between the years 2013-2016 for both genders and for all age groups. See Table 3.
• The average number of pharmacy claims was higher for female patients (13.84) than for male patients (11.59) in 2016. See Table 4. 
• The average number of items per pharmacy claim has stayed steady at just over 3 items per pharmacy claim (marginally decreasing from 3.1 items in 2013 to 3.06 items per claim in 2016).  The average number of items per claim increases with age and is highest in the 85 years and over age group at 4.08 number of items per claim, compared to 1.6 number of items for the youngest age group of 0-24 years. See Table 5.
• The average cost per item has seen a decrease between 2013 and 2016. The average cost per item was €17.37 per item in 2016, compared to €19.53 in 2013. See Table 6.