1. Out of pocket or out of control: A qualitative analysis of healthcare professional stakeholder involvement in pharmaceutical policy change in Ireland
- Author
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Valerie Walshe, Mark Mulcahy, Sarah-Jo Sinnott, Gary L. O'Brien, Stephen Byrne, and Bridget O’ Flynn
- Subjects
Attitude of Health Personnel ,education ,Pharmacist ,General medical services ,Framework analysis ,Pharmacists ,Nonprobability sampling ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,General Practitioners ,Humans ,030212 general & internal medicine ,Medical prescription ,health care economics and organizations ,Health policy ,Pharmaceutical policy ,Co-payment ,030503 health policy & services ,Health Policy ,Stakeholder ,Primary care ,Drug and Narcotic Control ,Business ,Community pharmacy ,0305 other medical science ,Delivery of Health Care ,Ireland ,Qualitative research - Abstract
Background Mandatory co-payments attached to prescription medicines on the Irish public health insurance [General Medical Services (GMS)] scheme have undergone multiple iterations since their introduction in October 2010. To date, whilst patients’ opinions on said co-payments have been evaluated, the perspectives of community pharmacists and general practitioners (GPs) have not. Objective To explore the involvement and perceptions of community pharmacists and GPs on this pharmaceutical policy change. Methods A qualitative study using purposive sampling alongside snowballing recruitment was used. Nineteen interviews were conducted in a Southern region of Ireland. Data were analysed using the Framework Approach. Results Three major themes emerged: 1) the withered tax-collecting pharmacist; 2) concerns and prescribing patterns of physicians; and 3) the co-payment system – impact and sustainability. Both community pharmacists and GPs accepted the theoretical concept of a co-payment on the GMS scheme as it prevents moral hazard. However, there were multiple references to the burden that the current method of co-payment collection places on community pharmacists in terms of direct financial loss and reductions in workplace productivity. GPs independently suggested that a co-payment system may inhibit moral hazard by GMS patients in the utilisation of GP services. It was unclear to participants what evidence is guiding the GMS co-payment fee changes. Conclusion Interviewees accepted the rationale for the co-payment system, but reform is warranted.
- Published
- 2020
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