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Branded medicines only reimbursed at price of generic
Patients who refuse generic versions of their medication where one exists are now reimbursed less under new rules aimed at saving the state €100 million per year.
Typically, generic versions of medicines cost 30-40% less than branded counterparts.
The rest of the cost will be paid by any patient who insists on branded options without medical justification.
Pharmacists were already expected to encourage patients to accept a generic, except where a doctor specified on the prescription that they should not by noting “NS” on the prescription for “non-substitutable”.
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One exception to the rule will be drugs said to have a “narrow therapeutic margin”, meaning there is only a narrow difference between a beneficial dose and a toxic one, and where the patient is doing well on the branded medicine.
These include Levothyrox, a thyroid deficiency medicine which was subject to controversy, legal battles and even manslaughter charges in recent years after thousands of patients claimed that a new formula did not work.
Another exception is for children under six, where the branded medicine has a more suitable format (eg. a syrup rather than a pill).
Finally, branded medicines (formally referred to as the princeps) can be fully reimbursed if the patient is allergic to an additive in the generic
