New State-Funded HRT Scheme Faces Backlash from Pharmacists

Yesterday, Minister for Health Jennifer Carroll MacNeill announced the long awaited launch of a State-funded Hormone Replacement Therapy (HRT) scheme, set to commence from June 1st. While the announcement has been welcomed in political circles and by many women’s health advocates, community pharmacists across Ireland are raising serious concerns-with some warning that they may not participate in the scheme at all.

What Does the New Scheme Offer?

The newly announced plan provides free access to HRT products and medications for women experiencing menopause and perimenopause. Under the scheme:

• The Department of Health will cover the full dispensing fee (previously borne by patients, often up to €10).
• Pharmacies who opt into the scheme will receive a €5 dispensing fee per HRT product.
• A €1,000 one-off grant is being offered to each participating pharmacy, with an earlier alternative offer of €3,000 during negotiations.

Despite these provisions, pharmacy bodies are not on board.

Pharmacists Push Back: “Not Viable, Not Sustainable”

Tom Murray, President of the Irish Pharmacy Union (IPU), spoke on RTÉ’s Morning Ireland today, stating:

“I don’t see pharmacists signing up to the scheme… The €5 fee no longer reflects the cost of delivering safe, regulated and professional care.”

According to the IPU, the break-even point for dispensing HRT medication is €6.50, based on independent economic advice. Pharmacists argue that joining the scheme at the current rate would mean transferring private-paying patients into a public model at a financial loss.

Murray also emphasised the IPU’s willingness to work with the Minister to find a resolution:

“We are six weeks out. We’re happy to continue consultation to resolve this… but if women present a prescription from June, as it currently stands, we will be asking for payment.”

What This Means for Pharmacists and Locums

From a pharmacy operations standpoint, this dispute shines a spotlight on the recurring challenge of State schemes falling short of commercial viability. Pharmacists are already navigating tight margins, increased regulatory burdens, and staffing pressures. Adding another scheme that offers inadequate reimbursement only exacerbates these pressures.

For locum pharmacists, the implications could be particularly pronounced:

• Increased strain on community pharmacies could lead to budget tightening, affecting staffing levels and shift availability.
• Pharmacists may find themselves dealing with frustrated patients who expect free medication but are met with requests for payment due to the pharmacy opting out of the scheme.
• If the scheme proceeds without full buy-in, it could lead to fragmented care delivery, uneven access, and administrative headaches for locums floating between participating and non-participating pharmacies.

Where Do We Go From Here?

While political support for the scheme is strong, with backing from both Sinn Féin and the Social Democrats, the implementation hangs in the balance.

Sinn Féin’s David Cullinane called the scheme a “welcome step” but stressed that pharmacist participation is crucial for it to work. Meanwhile, TD Pádraig Rice echoed concerns over the Government’s handling of negotiations and called for retrospective reimbursement for women who incurred HRT costs since January 2025, the scheme’s original start date.

A Call for Sustainable Solutions

At Clarity Locums, we see firsthand the challenges facing Ireland’s pharmacy sector from staffing shortages to underfunded schemes, and this latest development highlights a familiar tension: policy ambition vs. operational reality.

As the June 1st deadline approaches, it’s imperative that meaningful dialogue resumes between the Department of Health and the IPU to ensure this scheme doesn’t become yet another well-intentioned policy undermined by financial impracticality.