Pharmacist reveals new HRT scheme won’t be completely free

Just weeks ago, the Minister for Health, Stephen Donnelly, announced that legislation had been passed by the Dáil to allow for the free provision of Hormone Replacement Therapy (HRT) to women.

The ‘free’ HRT scheme is due to be rolled out in January 2025 but pharmacist Sheena Mitchell has revealed that the Free HRT Scheme won’t actually be completely free. 

While the Free Contraception Scheme, which was welcomed in 2022, is free for women and was recently expanded to include women up to the age of 35, the Free HRT Scheme will not work the same way. 

The Free Contraception Scheme covers the price of a doctor consultation, the pharmacist dispensing the medication, and the contraception products themselves, while the Free HRT Scheme will only cover the medication or medical devices that are licenced by the Government of Ireland.

This causes more of an issue when certain prescribed products, like an oestrogen patch, are in short supply, meaning an alternative patch licenced in Europe is sourced by your pharmacist and agreed with your prescribing doctor. 

Due to this product being unlicenced by the Irish Government, the patient will have to pay for the cost of it and won’t be reimbursed by the State. With HRT medicine supply issues being prominent over the past three+ years, this concern is likely to continue. 

The fee for a doctor’s consultation, and in some cases a menopause specialist, will also have to be covered by the patient. If you have never been assessed before, you will need to have an initial assessment, blood tests and a 3-month follow-up appointment, followed by 6-month follow-ups.

Another cost that will occur is for the dispensary fee from the pharmacist and the prescription tax by the State. While these are covered under the Free Contraception Scheme, they are not under the Free HRT Scheme. 

Sheena Mitchell explains, “Not only is it unfair it is also short-sighted by the Minister for Health. In fact, it would save the Government money in the long-term as replacing declining oestrogen levels in women has been scientifically and medically proven to help prevent stroke, heart disease, dementia and osteoporosis”. 

The pharmacist also revealed that the Minister for Health and his department are yet to engage with the professional healthcare services required to rollout the Free HRT Scheme.

It has been estimated that the 'Free' HRT Scheme will cost the average woman between €18 to €1,224 annually, depending on the availability of licenced HRT medication, age and menopause stage of patient, Medical Card status of patient and the pharmacy dispensing fee.

Mitchell reiterates that “a consultation with a GP or specialist menopause doctor who has trained in menopause care will charge between €60 to €250 for just an initial assessment with more follow-up visits required throughout the year. The pharmacist will charge a dispensing fee of around €15, and only the licenced HRT prescription products, if available, will actually be free”.

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