Impact of financial burden, resulting from prescription co-payments, on antihypertensive medication adherence in an older publically insured population

Table 1 Eligibility criteria and co-payment levels for the General Medical Services (GMS) scheme

Weekly income thresholds by age group since Jan 1st 2014		Co-payment levied per each prescription item dispensed, maximum monthly ceiling and associated decreases in antihypertensive adherence
Age (Years)	Weekly Income (€)	Date of introduction/increase	Co-payment (€)	Ceiling (€)	Decrease in Adherence (%)
< 66	266.50	October 2010	0.50	10.00	4.8
66–69	298.00	January 2013	1.50	19.50	4.5
70+	900.00	December 2013	2.50	25.00	–

In the Republic of Ireland, publically insured patients are covered under the GMS scheme. Eligibility for the GMS is means-tested based on income, with approximately 35% of the population covered. Coverage rises to approximately 50% for the population aged between 65 and 69 years and increases to 90% for the population 70 years and over (Central Statistics Office, 2013). Weekly income eligibility thresholds are based on a couple (married/cohabiting/civil partners). Non-GMS patients include Long-term Illness scheme patients (which covers conditions such as diabetes and epilepsy, but not hypertension) who are entitled to free medication, Doctor Visit Card holders (eligibility based on higher weekly thresholds) and private patients who pay for dispensed medications up to maximum of €144 per month. GMS patients are entitled to free primary-care medical visits but pay a levy for each dispensed medications up to a ceiling per calendar month. During our study GMS patients paid €2.50 per prescription item dispensed, up to a maximum of €25 per month.

ISSN: 1471-2458