National Shared Services Primary Care Reimbursement Service STATISTICAL ANALYSIS OF CLAIMS AND PAYMENTS 2005

Transcription

1 National Shard Srvics Primary Car Rimbursmnt Srvic STATISTICAL ANALYSIS OF CLAIMS AND PAYMENTS 2005

2 Fidhmannacht na Sirbhís Sláint Sirbhísí Comhroinnt Náisiúnta Sirbhís Aisíoca Príomhchúraim Balach amach 5 an M50 An Bóthar Thuaidh Fionnghlas Bail Átha Cliath 11 Guthán: (01) Facs: (01) Ríomhphost: [email protected] Láithrán Lín: Halth Srvic Excutiv National Shard Srvics Primary Car Rimbursmnt Srvic Exit 5 M50 North Road Finglas Dublin 11 Ph: (01) Fax: (01) mail: [email protected] Wbsit:

3 National Shard Srvics Primary Car Rimbursmnt Srvic STATISTICAL ANALYSIS OF CLAIMS AND PAYMENTS 2005

4 Contnts Summary of Statistical Analysis Pag Pag Pag 5 Introduction 16 Paymnts to Dntists 24 Summary of Statistical Information - GMS Schm 6 Community Basd Srvics - Paymnt Arrangmnts 8 Summary Statmnt of Activity During th Yar 9 Th Yar Numbr of Agrmnts 11 Prsons Eligibl for Srvics 12 Paymnts to Doctors 13 Volum of Claims by Doctors 14 Paymnts to Pharmacis 15 Volum of Claims by Pharmacis 17 Volum of Claims by Dntists 18 Paymnts to Optomtrists/Ophthalmologists 19 Volum of Tratmnts by Optomtrists/ Ophthalmologists 20 Cost Pr Prson 21 Major Thraputic Classification of Drugs, Mdicins & Appliancs - GMS Schm 22 Major Thraputic Classification of Drugs, Mdicins & Appliancs - DP Schm 23 Major Thraputic Classification of Drugs, Mdicins & Appliancs - LTI Schm 25 Summary of Statistical Information - LTI/DP Schms 26 Fs and Allowancs undr Capitation Agrmnt 27 Fs and Allowancs undr F-Pr-Itm Agrmnt and Fs undr th Immunisation Schm, Halth (Amndmnt) Act 1996 and Mthadon Tratmnt Schm 28 Scal of Fs Payabl to Pharmacists 29 Scal of Fs Payabl to Dntists 30 Scal of Fs Payabl to Optomtrists/ Ophthalmologists 2

5 Contnts Dtaild Statistical Analysis Pag Tabl Pag Tabl Pag Tabl 34 1 Summary of Statistical Information GMS Summary of Statistical Information LTI/DP Numbr of Agrmnts 37 3 Paymnts to Doctors 38 4 Cost of Prscriptions 39 5 Cost of Stock Ordr Forms 40 6 Paymnts to Dntists 41 7 Paymnt pr Prson 42 8 Numbr of Doctors in Eligibl Prson Cost Catgoris 43 9 Numbr of Eligibl Prsons GMS: Numbr of Eligibl Prsons by Gndr within Ag Groups GPVC: Numbr of Eligibl Prsons by Gndr within Ag Groups Prcntag of Eligibl Prsons by Milag Allocation Siz of Panls of Doctors Paymnts to Doctors in ach Halth Srvic Excutiv Ara Numbr of Spcial Typ Consultations and Out-of-Hours Claims Paymnt to Doctors for Spcial Typ Consultations and Out-of-Hours Claims Analysis of Spcial Itms of Srvic Analysis of Spcial Itms of Srvic by Halth Srvic Excutiv Ara Visiting Rat Catgoris for Doctors on F-Pr-Itm of Srvic Cost of Mdicins by Gndr within Ag Groups GMS: Numbr of Prscription Forms and Itms Paymnt to Pharmacists in Rspct of Prscriptions GMS: Numbr of Itms on Prscription Forms DP: Numbr of Itms on Claim Forms LTI: Numbr of Itms on Claim Forms Numbr of Dispnsing Doctors and Prsons for whom thy Dispns Advanc Paymnts to Pharmacists Nots on som of th mor Commonly Prscribd Products GMS: Th Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy GMS: Th Products of th Highst Cost in th Ordr of thir Total Ingrdint Cost DP: Th Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy DP: Th Products of th Highst Cost in th Ordr of thir Total Ingrdint Cost LTI: Th Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy LTI: Th Products of th Highst Cost in th Ordr of thir Total Ingrdint Cost GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification GMS: Avrag Paymnt to Doctors in Panl Rangs GMS: Numbr of Doctors in Paymnt Rangs GMS: Numbr of Pharmacists in Dispnsing F Rangs DP: Numbr of Eligibl Prsons and Numbr and Cost of Pharmacists Claims DP: Numbr of Pharmacists in Dispnsing F/Mark-Up Rangs LTI: Numbr of Eligibl Prsons and Numbr and Cost of Pharmacists Claims LTI: Numbr of Pharmacists in Dispnsing F/Mark-Up Rangs EEA: Numbr and Cost of Pharmacists Claims DTS: Numbr of Tratmnts DTS: Numbr of Dntists in Paymnt Rangs HSE-COS: Numbr and Cost of Claims HSE-COS: Numbr of Optomtrists/ Ophthalmologists in Paymnt Rangs Invstmnt in Gnral Practic Dvlopmnt

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7 Introduction from th Dirctor of National Shard Srvics Th Halth Srvic Rform Programm is driving unprcdntd chang in our halthcar systm with th nw Halth Srvic Excutiv (HSE) in plac sinc 1st January As th singl largst rform projct undrtakn in th Stat, this programm offrs an unparallld opportunity to modrnis and improv srvic provision to our clints, stakholdrs and partnrs. By modrnising our procsss, tchnology and communication structurs w can achiv conomis of scal and striv to dlivr valu in th srvics w provid. Th formr Gnral Mdical Srvics (Paymnts) Board is now known as th Primary Car Rimbursmnt Srvic (PCRS) and is part of th HSE s National Shard Srvics Dirctorat. Th PCRS is on of six Businss Units within National Shard Srvics (NSS); othr srvics to b providd by NSS ar Financ, Human Rsourcs, Information & Communication Tchnology, Procurmnt and Lgal Srvics. Th vision for National Shard Srvics is to dlivr a customrfocusd National Shard Srvic to support halth srvic dlivry. Th cor businss of NSS PCRS is th procssing and paymnt of claims on a national basis to ky customrs including Gnral Practitionrs, Pharmacists, Dntists and Optomtrists/ Ophthalmologists for srvics thy provid to mmbrs of th public. NSS PCRS capturs larg volums of data from which it compils statistics and w provid this information to our customrs, stakholdrs and th public. During 2005 w hav workd with our customrs to improv th srvic providd by combining th appropriat tchnology, with a profssional srvic and fficint dlivry. NSS PCRS procssd mor than 56 million transactions in 2005 and xpnditur throughput amountd to 1.9 billion. Expnditur will grow to an stimatd 2.1 billion in During 2005 NSS PCRS playd an important rol in providing a rang of information to support th managmnt of th various schms, which ar bcoming incrasingly complx. This Statistical Analysis Book rflcts th many and varid Schms and Paymnt Systms in opration. Th goodwill and coopration rcivd from all of our customrs, Gnral Practitionrs, Pharmacists, Dntists, Optomtrists/Ophthalmologists and our collagus in th HSE, in a priod of major chang is vry much apprciatd. It is our aim to srv th intrsts of our customrs in a profssional and fficint mannr. Th ongoing commitmnt and ddication of our staff throughout th yar to achiv targts and rach dadlins is acknowldgd and apprciatd. As Dirctor of National Shard Srvics I look forward to furthr dvloping th businss rlationship and striving to continuously improv th srvics to our customrs. Lavrn McGuinnss Dirctor of National Shard Srvics 5

8 Community Basd Srvics Paymnt Arrangmnts Almost all paymnts for srvics providd in th community by Gnral Practitionrs, Community Pharmacis, Dntists and Optomtrists/ Ophthalmologists ar mad by th Primary Car Rimbursmnt Srvic. Paymnts in th Yar 2005 wr in xcss of 1.88bn. Estimatd paymnts by th Primary Car Rimbursmnt Srvic for 2006 ar 2.07bn. Claim data is procssd and paymnts ar mad by th Primary Car Rimbursmnt Srvic undr th following Schms/Paymnt Arrangmnts: Gnral Mdical Srvics (GMS) Prsons who ar unabl without undu hardship to arrang gnral practitionr mdical and surgical srvics for thmslvs and thir dpndants and all prsons agd 70 yars and ovr rciv a fr gnral mdical srvic. Drugs, mdicins and appliancs supplid undr th Schm ar providd through rtail pharmacis. In most cass th Doctor givs a compltd prscription form to a prson, who taks it to any pharmacy that has an agrmnt with th Halth Srvic Excutiv to dispns GMS prscription forms. In rural aras th Doctor may dispns for thos prsons who opt to hav thir mdicins dispnsd by him/hr. All GMS claims ar procssd and paid by th Primary Car Rimbursmnt Srvic. Drugs Paymnt Schm (DPS) Undr th Drugs Paymnt Schm prsons who ar ordinarily rsidnt in th Stat and who do not hav a currnt mdical card can bnfit an individual or family has now to pay no mor than 85 in a calndar month for approvd drugs, mdicins and appliancs for thmslvs or thir familis. In ordr to bnfit undr this Schm a prson must rgistr thmslvs and thir dpndants with thir Local Halth Offic. Itms currntly rimbursabl undr th Drugs Paymnt Schm ar thos listd in th GMS Cod Book. Othr itms which wr rimbursabl undr th DCS and Rfund of Drugs Schms continu, in crtain circumstancs, to b rimbursabl undr th Drugs Paymnt Schm. DPS claims ar procssd and paid by th Primary Car Rimbursmnt Srvic. Long Trm Illnss Schm (LTI) On approval by th Halth Srvic Excutiv prsons who suffr from on or mor of a schdul of illnsss ar ntitld to obtain, without charg, irrspctiv of incom, ncssary drugs/mdicins and/or appliancs undr th LTI Schm. All LTI claims ar procssd and paid by th Primary Car Rimbursmnt Srvic. Dntal Tratmnt Srvics Schm (DTSS) Undr th Dntal Tratmnt Srvics Schm GMS ligibl adults hav accss to a rang of tratmnts and clinical procdurs comprisd of Routin Tratmnts and Full Uppr and Lowr Dnturs. Routin Tratmnts ar now availabl for all ligibl prsons. Dntists may also prscrib a rang of mdicins to ligibl prsons. All claims undr th DTSS ar procssd and paid by th Primary Car Rimbursmnt Srvic. Europan Economic Ara (EEA) Rsidnts from on of th othr stats of th Europan Economic Ara, with stablishd ligibility, who rquir mrgncy gnral practitionr srvics whil on a tmporary visit to th Stat ar ntitld to rciv from a Gnral Practitionr a GMS prscription form for ncssary mdication and to hav such mdication dispnsd in a Pharmacy that has ntrd into an agrmnt with th Halth Srvic Excutiv within th Stat. Studnts, postd workrs and thir dpndants ar ntitld to full srvics on prsntation of a valid Form E128. EEA claims ar paid by th Primary Car Rimbursmnt Srvic. 6

9 High Tch Drugs (HTD) Arrangmnts ar in plac for th supply and dispnsing of High Tch mdicins through Community Pharmacis. Such mdicins ar gnrally only prscribd or initiatd in hospital and would includ itms such as anti-rjction drugs for transplant patints or mdicins usd in conjunction with chmothrapy or growth hormons. Th mdicins ar purchasd by th Halth Srvic Excutiv and supplid through Community Pharmacis for which Pharmacists ar paid a patint car f: th cost of th mdicins and patint car fs ar paid by th Primary Car Rimbursmnt Srvic. Primary Childhood Immunisation Schm A National Primary Childhood Immunisation Schm provids for immunisation of th total child population with th aim of liminating, as far as possibl, such conditions as Diphthria, Polio, Masls, Mumps, Rublla and mor rcntly Mningococcal C Mningitis. Paymnts undr this Schm to Doctors in th Midland, Mid-Wstrn, Southrn and Wstrn HSE Aras ar mad by th Primary Car Rimbursmnt Srvic. Halth (Amndmnt) Act 1996 Undr th Halth (Amndmnt) Act 1996 crtain halth srvics ar mad availabl without charg to prsons who hav contractd Hpatitis C dirctly or indirctly from th us of Human Immunoglobulin Anti D or th rcipt within th Stat of anothr blood product or blood transfusion. Gnral Practitionr srvics, pharmacutical srvics, dntal srvics and optomtric/ophthalmic srvics providd undr th Act ar paid for by th Primary Car Rimbursmnt Srvic. Mthadon Tratmnt Schm Mthadon is prscribd and dispnsd by Doctors and Pharmacists for approvd clints undr th Mthadon Tratmnt Schm capitation fs payabl to participating Doctors and Community Pharmacists and claims by pharmacis for th ingrdint cost of th Mthadon dispnsd and th associatd dispnsing fs ar procssd and paid by th Primary Car Rimbursmnt Srvic. Halth Srvic Excutiv Community Ophthalmic Srvics Schm (HSE-COS) Undr th Halth Srvic Excutiv Community Ophthalmic Srvics Schm, adult mdical card holdrs and thir dpndants ar ntitld, fr of charg, to y xaminations and ncssary spctacls/appliancs. Claims by Optomtrists/ Ophthalmologists ar paid by th Primary Car Rimbursmnt Srvic. Claims for spctacls providd undr th Childrn s Schm ar also paid by th Primary Car Rimbursmnt Srvic. Immunisations for crtain GMS Eligibl Prsons Agrmnt was rachd btwn th Dpartmnt of Halth & Childrn and th Irish Mdical Organisation on f rats to b applid to crtain immunisations for GMS ligibl prsons. Th immunisations ncompassd by th agrmnt ar: Pnumococcal, Influnza, Hpatitis B and th combind Pnumococcal/Influnza. Th Halth Srvic Excutiv facilitatd claiming for any of ths immunisations by xtnding th rang of cods for Spcial Itms of Srvic. Gnral Practitionr Visit Card (GPVC) Crtain popl in Irland who do not qualify for a mdical card may apply to th Halth Srvic Excutiv for a GP Visit Card. GP Visit Cards allow individuals and familis who qualify, to visit thir Gnral Practitionr for fr. All GP claims ar procssd and paid by th Primary Car Rimbursmnt Srvic. 7

10 Summary Statmnt of Activity During th Yar Paymnts in th Yar wr in xcss Mor than 95% of ligibl GMS prsons Paymnts to Dntists undr th DTS totalld of 1,881.3m. availd of GP, Pharmacutical, Dntal or 54.46m. Claim data is procssd and paymnts ar mad by th PCRS undr th following Schms: Gnral Mdical Srvics (GMS); Drugs Paymnt (DP); Long Trm Illnss (LTI); Dntal Tratmnt Srvics (DTS); Europan Economic Ara (EEA); High Tch Drugs (HTD); Primary Childhood Immunisation; Halth (Amndmnt) Act 1996; Mthadon Tratmnt; Halth Srvic Excutiv Community Ophthalmic srvics providd by mor than 5,612 Doctors, Pharmacists, Dntists and Optomtrists/Ophthalmologists. Mor than 50.5m prscription itms wr paid for by th PCRS an incras of ovr 3.3m itms on Fs and allowancs paid to Doctors totalld m. Paymnts to Pharmacis totalld 1,198.14m; GMS m; DP m; LTI m; Paymnts to Optomtrists/Ophthalmologists undr th HSE-COS totalld 17m. Paymnts to Wholsalrs undr th HTD Schm totalld m. Administration costs in th accounting priod of 2005 wr 17.01m. Claims procssd ar in rspct of srvics providd in th community and availd of by almost 51.3% of th population. Ophthalmic Srvics (HSE-COS). EEA 1.88m; At yar nd thr wr mor than 2.73m prsons rgistrd as bing ligibl to bnfit undr th Gnral Mdical Srvics, Drugs Paymnt, Long Trm Illnss, Dntal Tratmnt and Halth Srvic Excutiv Community Ophthalmic Srvics Schms. Patint Car Fs undr th HTD Schm 8.73m; Th Halth (Amndmnt) Act 1996, Mthadon Tratmnt Schm and DTS prscriptions 8.86m. 8

11 Th Yar 2005 Total of Paymnts for th yar 1,881.3m Doctors Fs m Allowancs m Pharmacists Fs and Mark-Up m Drugs and Mdicins m Dntists Optomtrists/Ophthalmologists High Tch Drugs Schm Paymnt to Wholsalrs Patint Car Fs paid to Pharmacists Invstmnt in Gnral Practic Dvlopmnt Administration 54.46m 17.00m m 8.73m 11.93m 17.01m Fs to Doctors includ an amount of 4.80m in rspct of th Primary Childhood Immunisation Schm, 0.23m in rspct of th Halth (Amndmnt) Act 1996, 4.08m in rspct of th Mthadon Tratmnt Schm. Allowancs paid to Doctors includ an amount of 6.25m paid as suprannuation to Rtird District Mdical Officrs and thir dpndants. Paymnts to Pharmacists includ an amount of 1.48m in rspct of drugs/mdicins dispnsd undr th Halth (Amndmnt) Act 1996, an amount of 6.78m in rspct of th cost of Mthadon dispnsd undr th Mthadon Tratmnt Schm and an amount of 0.6m in rspct of DTS prscriptions. Paymnts to Dntists includ an amount of 55,922 in rspct of tratmnts undr th Halth (Amndmnt) Act Paymnts to Optomtrists/Ophthalmologists includ an amount of 44,541 in rspct of tratmnts undr th Halth (Amndmnt) Act Th corrsponding figurs for 2004 ar- Total of Paymnts 1,652.83m. Doctors Fs m and Doctors Allowancs 96.59m. Pharmacists Fs and Mark-Up m, Drugs and Mdicins m. Paymnts to Dntists undr th DTS Schm wr 52.49m. Paymnts to Optomtrists/ Ophthalmologists 17.44m. Invstmnt in Gnral Practic Dvlopmnt was 15.79m. High Tch Drugs Schm Paymnt to Wholsalrs m, Patint Car Fs 6.8m. Administration 15.50m. 9

12 Numbr of Agrmnts 2,257 Doctors 1,430 Pharmacists 1,394 Dntists 531 Optomtrists Th numbr of agrmnts btwn Halth Srvic Excutiv and Gnral Practitionrs for th provision of srvics to GMS prsons rflcts th policy position agrd btwn th Dpartmnt of Halth & Childrn and th Irish Mdical Organisation on ntry to th GMS. In Dcmbr 2005 thr wr 2,257 such agrmnts. Numbr of Agrmnts as at 31st Dcmbr 2005 Halth Srvic Excutiv Doctors Pharmacists Dntists Optomtrists East Coast Ara South Wstrn Ara Northrn Ara Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn Wstrn National *2,257 #1,430 +1, Corrsponding Figurs for ,210,, * 239 GPs who do not hold GMS agrmnts and who wr rgistrd as providing srvics undr th Primary Childhood Immunisation Schm, th Halth (Amndmnt) Act 1996, Hartwatch, Palliativ Car and th Mthadon Tratmnt Schm at yar nd ar includd abov. # 11 Pharmacis who do not hold GMS agrmnts and who wr rgistrd as providing srvics undr non GMS Schms at yar nd ar includd abov Dntists who ar mploys of th Halth Srvic Excutiv and who provid srvics undr th Dntal Tratmnt Srvics Schm ar includd abov. 10

13 Prsons Eligibl for Srvics GMS 1,155,727 GPVC 5,079 DP 1,478,650 LTI 99,280 Prsons who ar unabl without undu hardship to arrang Gnral Practitionr mdical and surgical srvics plus dntal and optomtric srvics for thmslvs and thir dpndants ar providd with such srvics fr of charg undr th GMS Schm. An ligibl prson is ntitld to slct a Doctor of his/hr choic, from among thos Doctors who hav ntrd into agrmnts with th Halth Srvic Excutiv. Drugs, mdicins and appliancs prscribd by participating Doctors for thir GMS patints ar providd through Community Pharmacis. Dntal and ophthalmic srvics ar providd by Dntists and Optomtrists/Ophthalmologists who hav contractd with th Halth Srvic Excutiv. GMS prscription forms may b dispnsd in any Pharmacy that has an agrmnt with th Halth Srvic Excutiv to dispns GMS prscription forms. In rural aras, whr a Doctor has a cntr of practic thr mils or mor from th narst rtail Pharmacy participating in th Schm, th Doctor dispnss for thos prsons srvd from th cntr who opt to hav thir mdicins dispnsd by him/hr. Th numbr of ligibl GMS prsons at yar nd includd 53,808 prsons who wr ntitld and had optd to hav thir mdicins dispnsd by thir GPs. Undr th trms of th Drugs Paymnt Schm prsons who do not hav a mdical card may apply for a Drugs Paymnt Schm card on an individual or on a family unit basis. Prscribd mdicins, which ar rimbursabl undr th GMS, costing in xcss of a spcifid amount pr month, currntly 85 pr family, is claimd by th Pharmacy and is paid by th Primary Car Rimbursmnt Srvic. On approval by th Halth Srvic Excutiv prsons who suffr from on or mor of a schdul of illnsss ar ntitld to obtain, without charg, irrspctiv of incom, ncssary drugs/mdicins and/or appliancs undr th LTI Schm. Th Primary Car Rimbursmnt Srvic maks paymnts on bhalf of th Halth Srvic Excutiv for LTI claims submittd by Pharmacis. Numbr of Eligibl Prsons as at 31st Dcmbr 2005 Halth Srvic Excutiv Eastrn Aras GMS 9,647 GPVC 767 DP 508,193 LTI 52,044 Midland 70, ,933 5,410 Mid-Wstrn 00, ,566 7,001 North Eastrn 99, ,931 7,888 North Wstrn 98, ,325 5,492 South Eastrn 9, ,560 9,936 Southrn 73,586, ,023 6,852 Wstrn, ,119 4,657 National 1,155,727 5,079 1,478,650 99,280 % of Population 29.50% 0.13% 36.57% 2.46% Corrsponding Figurs for 2004,148,914 -,469,251 93,504 GMS - Gnral Mdical Srvics Schm. GPVC - GP Visit Card Schm. DP - Drugs Paymnt Schm. LTI - Long Trm Illnss Schm. 11

14 Paymnts to Doctors Fs m Allowancs m Paymnts to Gnral Practitionrs ar catgorisd as fs and/or allowancs. For th majority of GPs who oprat undr th 1989 agrmnt th principl f is th capitation pr prson which is wightd for gndr, ag and distanc from Doctor s cntr of practic capitation fs totalld 206,098,590 in 2005 an incras of 48,731,232 ovr Fs totalling 1,803,460 wr paid to 17 GPs who continu to provid srvics undr th F-Pr-Itm of srvic agrmnts. Apart from Out-of-Hours fs and fs for a rang of spcial srvics th cost of srvics providd in normal hours by GPs for GMS prsons, including th prscribing of ncssary mdicins, is ncompassd by th capitation f. All GMS prsons can avail of full GP srvics and in many cass thy can bnfit from spcialist clinics providd by GPs for issus such as Womn s Halth, Family Planning and Asthma. In addition to a capitation f an outsid normal hours f is payabl for non routin consultations whn an ligibl GMS prson is sn by thir Total of Paymnts to Doctors by Halth Srvic Excutiv GP or anothr GP acting on his/hr bhalf from 5pm in th vning to 9am on th following morning (Monday to Friday) and all hours on Saturdays, Sundays and Bank Holidays. Th numbr of Out-of-Hours claims incrasd to 576,885 in 2005 compard with 547,001 in 2004 and th cost of such claims incrasd to 33,506,917 from 24,354,181 in Spcial fs ar payabl for a rang of 18 srvics such as xcisions, suturing, vaccinations, cathtrization, family planning tc. th most frqunt claimd spcial srvic in 2005 was Influnza Vaccination (299,094) followd by Excisions (68,152) and E.C.G tratmnts (49,929) thr was a total of mor than 580,722 spcial srvics providd in 2005 spcial fs totalling 18,499,824 wr paid in Annual and Study Lav togthr with locum, nursing and scrtarial support plus othr practic support paymnts account for most of th 122,697,221 allowancs paid in th yar. Th total paid in 2004 was 96,591,919. Halth Srvic Excutiv 2005 East Coast Ara 30,440,924 South Wstrn Ara 47,155,710 Northrn Ara 40,616,965 Midland 26,355,837 Mid-Wstrn 35,695,113 North Eastrn 34,873,408 North Wstrn 32,650,491 South Eastrn 49,932,757 Southrn 65,986,796 Wstrn 50,317,307 National 414,025,306 Corrsponding Figur for ,499,398 Th total of paymnts to Doctors includs paymnts of: 4,804,366 undr th Primary Childhood Immunisation Schm; 227,523 to Doctors who providd srvics undr th Halth (Amndmnt) Act 1996; Hartwatch 1,841,690; Trainrs/Train Grants 1,808,360 and 4,080,640 undr th Mthadon Tratmnt Schm. Th abov figurs includ th arrars paid rsulting from th implmntation of th 2005 LRC Agrmnt. 12

15 Volum of Claims by Doctors National Numbr of Claims 2005 F-Pr-Itm 101,608 Spcial Typ 196,443 Spcial Srvic 580,722 Out-of-Hours 576,885 Numbr of Claims in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv F-Pr-Itm Spcial Typ Spcial Srvic Out-of-Hours East Coast Ara 8,769 7,809 23,779 South Wstrn Ara 24,016 7,984 54,537 55,608 Northrn Ara 25,15 4,139 47,415 43,763 Midland 8,425 9,559 7,730 Mid-Wstrn 9,674 21,619 46,479 41,837 North Eastrn 9,678 45,768 9,254 North Wstrn 2,864 53,271 47,054 South Eastrn 0,19 7,578 78,693 81,075 Southrn 2,574 44,545 96,256 41,694 Wstrn 0,842 80,935 95,091 National 101, , , ,885 Corrsponding figurs for ,462 86, , ,001 A majority of Doctors ar paid an annual capitation f for ach ligibl prson th rat of paymnt is dtrmind by th ag/gndr of th prson and distanc btwn ach prson s rsidnc and th cntr of practic of thir Doctor-of-Choic. A minority of Doctors (17) who hav continud to provid srvics undr th F-Pr-Itm of Srvic agrmnt ar paid a f for ach Doctor/Patint contact. A Spcial Typ Consultation (STC) f is payabl whn a GMS ligibl prson is unabl to contact thir rgistrd Doctor and is sn as an mrgncy cas by anothr. Gnral Practitionrs qualify for paymnt of spcial fs for th spcial itms of srvic sparatly idntifid undr th Capitation agrmnt and th F-Pr-Itm agrmnt. 13

16 Paymnts to Pharmacis GMS m DP m LTI m EEA 1.88m A GMS prson who is providd with a proprly compltd GMS prscription form by his/hr GP can choos to hav such prscription forms dispnsd in any of th Pharmacis who hav ntrd into agrmnts with th Halth Srvic Excutiv for th provision of srvics undr Sction 59 of th Halth Act, In 2005 thr wr 13.2m prscription forms containing 37m prscription itms dispnsd at a cost of ovr 816,303,561 i.. an avrag cost of pr dispnsd itm. Mor than 95% of all ligibl GMS prsons wr prscribd for in th yar. Th avrag cost of mdicins pr GMS prson in 2005 was Paymnts mad to Pharmacis undr th GMS and DTS Schms ar inclusiv of th ingrdint cost of mdicins, dispnsing fs and VAT. Undr DP, LTI and EEA Schms Pharmacis ar rimbursd th ingrdint cost of itms dispnsd; dispnsing fs and VAT; a markup of up to 50% on th ingrdint cost of itms dispnsd is also paid. Th cost of th High Tch Drugs Schm was m at yar nd thr wr 31,510 prsons rgistrd undr this Schm Patint Car Fs totalld 8.7m and paymnts for drugs and mdicins totalld m. In th yar th Primary Car Rimbursmnt Srvic procssd claims valud at 318.6m on drugs acting on th cardiovascular systm (GMS m, DP 97.72m, LTI 20.20m). Th scond highst cost catgory was drugs acting on th nrvous systm m (GMS m, DP 58.16m, LTI 14.01m). Th third highst amount paid was for drugs acting on th alimntary tract and mtabolism systm m (GMS m, DP 57.83m, LTI 28.38m). Total of Paymnts to Pharmacis by Halth Srvic Excutiv Halth Srvic Excutiv GMS DP LTI *EEA East Coast Ara 59,006,019 23,341,2 2,114,274 64,303 South Wstrn Ara 94,743,861 41,200,688 7,784,470 2,307 Northrn Ara 91,389,300 5,915,992 5,162,437 62,192 Midland 57,193,332 4,105,133 5,940,055 77,502 Mid-Wstrn 76,358,730 20,726,149 6,557,278 84,670 North Eastrn 72,217,128 20,564,876 8,928,228 9,683 North Wstrn 53,715,449 8,422,499 5,534, ,913 South Eastrn 02,863,194 23,996,49 0,267, ,992 Southrn,061,175 7,371,322,597, ,790 Wstrn 90,894,435 8,841,555 6,660,14 8,257 National 831,442, ,485, ,546,643 1,879,609 Corrsponding Figurs for ,318, ,958,894 85,551,069 1,791,527 * EEA Paymnt to Pharmacis to covr th cost of GMS prscriptions dispnsd for rsidnts from th Europan Economic Ara. Pharmacis wr also paid in rspct of th drugs/mdicins dispnsd undr: Halth (Amndmnt) Act ,483,077; Mthadon Tratmnt Schm 6,780,362; DTS Schm 598,687 and Patint Car Fs totalling 8,726,632 undr th High Tch Drugs Schm. (Paymnts to Wholsalrs undr th High Tch Drugs Schm amountd to 168,757,201). In 2005 Th National Matrnity Hospital was paid 496,813 and Th Rotunda Hospital was paid 1,700,415 in rspct of Frtility Tratmnt. Ths figurs ar not includd in th abov tabl. 14

17 Volum of Claims by Pharmacis National Numbr of Itms 2005 GMS prscription forms procssd for paymnt in th yar totalld 13.2m th total of prscribd itms was mor than 37m ths accountd for approximatly 74% of all itms paid for by th Primary Car Rimbursmnt Srvic in Approximatly 38.83% of GMS forms containd a singl itm; mor than 20.15% containd 2 itms th avrag numbr of itms pr form Numbr of Itms in ach Halth Srvic Excutiv Ara was 2.83 ( ). 15 GMS 37.43m DP 10.58m LTI 1.93m EEA 0.08m HTD 0.21m Othr 0.33m GMS dispnsd itms paid for by th Primary Car Rimbursmnt Srvic in 2005 incrasd by mor than 2,397,521 th incras in th numbr of DP itms was mor than 649,055 th ovrall incras in th numbr of pharmacy claims procssd by th Primary Car Rimbursmnt Srvic in th yar was mor than 3.3m. Halth Srvic Excutiv GMS DP LTI EEA HTD *Othr East Coast Ara 2,700,203 1,035, ,736 3,119 16,732 32,657 South Wstrn Ara 4,417,734 1,627, ,906 4,742 27, ,193 Northrn Ara 4,066,787 1,471, ,019 2,773 22,813 85,562 Midland 2,531, , ,245 3,394 13,074 9,616 Mid-Wstrn,508, , ,286 8,146 16,058 14,861 North Eastrn,256, , ,743 4,953 19,647 14,984 North Wstrn 2,367, , ,485 11,233 15,219 6,636 South Eastrn 4,629,133 1,122, ,637 9,881 22,375 17,548 Southrn 6,080,556 1,622, ,390 19,021 28,842 22,868 Wstrn,869, , ,664 14,703 24,057 13,194 National 37,427,774 10,581,689 1,929,111 81, , ,119 Corrsponding Figurs for ,030,253 9,932,634 1,674,707 80, , ,625 * This group includs: 48,975 claim itms in rspct of th Halth (Amndmnt) Act 1996; 203,385 itms undr th Mthadon Tratmnt Schm and 75,759 prscription itms undr th DTS Schm. GMS Gnral Mdical Srvics Schm. DP Drugs Paymnt Schm. LTI Long Trm Illnss Schm. EEA Europan Economic Ara. HTD High Tch Drugs Schm. Othr Mthadon Tratmnt Schm, Halth (Amndmnt) Act 1996 and Dntal Tratmnt Srvics Schm.

18 Paymnts to Dntists Abov th lin 35.63m Dntists wr paid a total of 54,402,901 in 2005, in rspct of tratmnts providd for mor than 242,865 GMS prsons undr th DTS Schm. Th following tratmnts wr availabl to all ligibl GMS prsons. Blow th lin 18.77m Blow th Lin tratmnts prior Halth Srvic Excutiv approval for a spcific cours of tratmnt undr this catgory is rquird. Full dntur tratmnt is availabl, with prior Halth Srvic Excutiv approval, to all dntulous GMS prsons ovr 16 yars. ROUTINE: Routin tratmnts ar catgorisd as ithr Abov th Lin or Blow th Lin : Abov th Lin tratmnts ar uncomplicatd procdurs viz. Amalgam; Extractions; Blow th Lin tratmnts ar advancd procdurs viz. Protractd Priodontal; Prosthtics. Paymnts to Dntists in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv 2005 Eastrn Aras 14,472,331 Midland 3,001,007 Mid-Wstrn 4,787,246 North Eastrn 4,448,018 North Wstrn 3,808,938 South Eastrn 6,774,939 Southrn 9,689,962 Wstrn 7,420,460 National 54,402,901 Corrsponding Figur for ,432,828 Dntists wr also paid a total of 55,922 in 2005 in rspct of tratmnts undr th Halth (Amndmnt) Act

19 Volum of Claims by Dntists National Volum of Tratmnts 2005 Abov th Lin 962,936 Blow th Lin 106,466 Volum of Tratmnts by Dntists in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv + Abov th Lin + Blow th Lin No. of prsons tratd undr DTS Eastrn Aras 264,154 26,094 63,982 Midland 51,924 6,728,614 Mid-Wstrn 82,458 0,833 22,236 North Eastrn 77,217 9,795 20,410 North Wstrn 75,373 5,329 18,387 South Eastrn 5,584 4,822 29,713 Southrn 178,104 7,445 44,929 Wstrn 118,122 5,420 29,594 National 962, , ,865 Corrsponding Figurs for ,665 04, ,828 ROUTINE Routin tratmnts ar catgorisd as ithr Abov th Lin or Blow th Lin : Abov th Lin (ATL) tratmnts ar uncomplicatd procdurs; Blow th Lin (BTL) tratmnts ar advancd procdurs. + Th most frquntly usd ATL srvic was Amalgam Rstoration, which was usd by 94,187 patints followd by Oral Examination. In th BTL catgory th most frquntly usd srvic was Prosthtics followd by Radiographs and Protractd Priodontal. 17

20 Paymnts to Optomtrists/Ophthalmologists Undr th Halth Srvic Excutiv Community Ophthalmic Srvics Schm, Optomtric/Ophthalmic srvics ar providd to adult mdical cardholdrs, which includ fr y xaminations and ncssary spctacls/appliancs. Paymnts in rspct of spctacls providd undr th Childrn s Schm ar also mad by th Primary Car Rimbursmnt Srvic on bhalf of th majority of Halth Srvic Excutiv Aras. Paymnts in rspct of y xaminations and ncssary spctacls/ appliancs ar providd undr th Tnagr s Schm for ligibl mdical card holdrs on bhalf of crtain Halth Srvic Excutiv Aras. In th 12-month priod to th nd of Dcmbr 2005 claims wr rcivd on bhalf of ligibl prsons for 175,093 tratmnts costing 15,833,940. Ey xaminations by Optomtrists/Ophthalmologists totalld 168,400 - complt spctacls (distanc, rading and bi-focals) providd undr th Schm totalld 249,133. Th balanc of tratmnts includd rplacmnt lnss and frams, tintd lnss, prisms and contact lnss. A brakdown of tratmnts and paymnts in ach Halth Srvic Excutiv ara is shown hrundr. Paymnts to Optomtrists/Ophthalmologists in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv 2005 Eastrn Aras 4,771,686 Midland 1,075,739 Mid-Wstrn 1,409,210 North Eastrn 1,225,170 North Wstrn 1,283,706 South Eastrn 2,198,744 Southrn 2,438,926 Wstrn 1,430,759 National 15,833,940 Corrsponding Figur for ,273,620 Opticians wr also paid in rspct of: Halth (Amndmnt) Act ,541; Optical srvics for Tnagrs 83,210; Optical srvics for Childrn 1,038,

21 Volum of Tratmnts by Optomtrists/Ophthalmologists National Volum of Tratmnts 2005 Ey Exams 168,400 Appliancs 249,133 Volum of Tratmnts by Optomtrists/Ophthalmologists in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv Ey Exams Appliancs Volum of No. of Prsons Tratmnts Tratd Eastrn Aras Midland Mid-Wstrn North Eastrn North Wstrn 50,666 0,337 4,044,366 4,902 72,555 5,804 23,474 20,054 20,490 23,221 GMS 1, ,14 LTI 1, ,518 DP ,420 DTS ,392 HSE-COS ,030,349 5,648,503 5,100 South Eastrn 23,26 6,118 59,379 24,695 Southrn 26,348 7,722 64,070 26,744 Wstrn 5,476 22,916 8,392 6,024 National 168, , , ,093 Corrsponding Figurs for , , ,184 73,155 C % N % A % R % V % Othr % 19

22 Cost pr Prson National 2005 GMS 1, LTI 1, DP DTS HSE-COS Cost pr Prson in ach Halth Srvic Excutiv Ara GMS LTI dp DTS hs-cos Halth Srvic Doctor Pharmacy Total Pharmacy Nt Cost Pr Prson Pr Adult Excutiv Cost Cost Cost Cost Pr Claimant Tratd Tratd C % Eastrn Aras , , N % Midland , , A % Mid-Wstrn , , R % North Eastrn , , V % North Wstrn , Othr % South Eastrn , , Southrn , , Wstrn , , National , , Corrsponding Figurs for , C % N % Th Doctor cost abov dos not includ suprannuation paid to rtird DMOs. A % Th abov tabl shows th actual cost pr prson in rspct of thos who availd of srvics undr ach Schm in Mdical and pharmacutical srvics dlivrd to GMS prsons incrasd in cost from in 2004 R to - 61, % in 2005 an incras of pr prson - th cost of mdical srvics pr prson incrasd in cost from in 2004 to in 2005 an incras of V 31.29% % as did th cost pr prson of pharmacutical srvics in 2004 to in 2005 an incras of 8.27%. Othr % 20

23 A % R % V % Othr % Major Thraputic Classification of Drugs, Mdicins and Appliancs - Gnral Mdical Srvics Schm National 2005 C % N % A % R % V % Othr % Major Thraputic Classification m % A Alimntary Tract and Mtabolism B Blood and Blood Forming Organs C Cardiovascular Systm V % D Drmatologicals A % 2.03 G Gnito Urinary Systm and Sx Hormons C % H Systmic Hormonal Prps. xcl. Sx Hormons and Insulins N % J Anti-infctivs for Systmic Us Othr % 3.74 L Antinoplastic and Immunomodulating Agnts M Musculo-Skltal Systm N Nrvous Systm P Antiparasitic Products, Inscticids and Rpllnts R Rspiratory Systm S Snsory Organs V Clinical Nutritional Products Diagnostic Products Ostomy Appliancs Urinary Appliancs Ndls/Syrings/Lancts Othr Thraputic Products Drssings Miscllanous Total m 100% 21

24 HSE-COS Major Thraputic Classification of Drugs, Mdicins and Appliancs - Drugs Paymnt Schm National 2005 C % N % A % R % V % Othr % Major Thraputic Classification m % A Alimntary Tract and Mtabolism B Blood and Blood Forming Organs C Cardiovascular Systm D Drmatologicals C % G Gnito Urinary Systm and Sx Hormons N % A % H Systmic Hormonal Prps. xcl. Sx Hormons and Insulins R % J Anti-infctivs for Systmic Us V % L Antinoplastic and Immunomodulating Agnts Othr % M Musculo-Skltal Systm N Nrvous Systm P Antiparasitic Products, Inscticids and Rpllnts R Rspiratory Systm S Snsory Organs V Clinical Nutritional Products V % Ostomy Appliancs Urinary Appliancs A % Diagnostic Products C % Drssings Ndls/Syrings/Lancts N % Othr Thraputic Products Othr % Miscllanous Total m 100% Not: Th abov costs ar inclusiv of th monthly paymnt of 85 payabl to th Pharmacy by th individual or family. 22

25 V % Othr % Major Thraputic Classification of Drugs, Mdicins and Appliancs Long Trm Illnss Schm National 2005 V % A % C % N % Othr % Major Thraputic Classification m % A Alimntary Tract and Mtabolism B Blood and Blood Forming Organs C Cardiovascular Systm D Drmatologicals G Gnito Urinary Systm and Sx Hormons H Systmic Hormonal Prps. xcl. Sx Hormons and Insulins J Anti-infctivs for Systmic Us L Antinoplastic and Immunomodulating Agnts M Musculo-Skltal Systm N Nrvous Systm P Antiparasitic Products, Inscticids and Rpllnts R Rspiratory Systm S Snsory Organs V Diagnostic Products Clinical Nutritional Products Ndls/Syrings/Lancts/Swabs Urinary Appliancs Nutritional/Ancillary Dvics Drssings Ostomy Appliancs Othr Thraputic Products Miscllanous Total m 100% 23

26 Summary of Statistical Information rlating to th GMS Schm for ach of th fiv yars Numbr of Eligibl Prsons in Dcmbr 1,155,727 1,148,914 1,158,143 1,168,745 1,199,454 Doctors (000 s) (000 s) (000 s) (000 s) (000 s) Total Paymnts 403, , , , ,863 Doctors Paymnt pr Prson Pharmacis (000 s) (000 s) (000 s) (000 s) (000 s) Total Cost of Prscriptions 816, , , , ,464 Ingrdint Cost 653, , , , ,497 Dispnsing F 147, , , ,827 85,413 VAT 15,193 13,702 11,873 9,778 7,554 Numbr of Forms 13,227 12,794 12,243 11,551 10,454 Numbr of Itms 37,428 35,030 32,241 29,500 25,521 Cost pr Form Cost pr Itm Ingrdint Cost pr Itm Itms pr Form (000 s) (000 s) (000 s) (000 s) (000 s) Total Cost of Stock Ordrs 15,139 15,413 14,096 13,018 11,555 Ingrdint Cost 11,714 11,944 10,904 10,059 8,945 Pharmacy Fs 2,927 2,986 2,726 2,515 2,222 VAT (000 s) (000 s) (000 s) (000 s) (000 s) Ovrall Cost of Mdicins 831, , , , ,019 *Pharmacy Paymnt pr Prson Ovrall Paymnts 1,234,514 1,069, , , ,882 *Ovrall Paymnt pr Prson 1, Doctors paymnt pr prson is xclusiv of suprannuation paid to rtird DMOs. *Sinc 2003 ths figurs ar basd on th actual numbr of prsons who availd of srvics. 24

27 Summary of Statistical Information rlating to th LTI/DP Schms for ach of th fiv yars LTI Schm Numbr of Eligibl Prsons in Dcmbr 99,280 93,504 97,184 92,745 87,988 *Numbr of Claimants 53,006 50,526 48,053 (000 s) (000 s) (000 s) (000 s) (000 s) Numbr of Itms 1,929 1,675 1,464 1,280 1,157 Total Cost 100,547 85,551 73,348 61,636 52,081 Cost pr Itm *Cost pr Claimant 1, , , DP Schm Numbr of Eligibl Prsons in Dcmbr 1,478,650 1,469,251 1,396,813 1,319,395 1,156,836 *Numbr of Claimants 526, , ,411 (000 s) (000 s) (000 s) (000 s) (000 s) Numbr of Itms 10,582 9,933 9,311 9,063 8,985 Gross Cost 388, , , , ,187 Nt Cost 244, , , , ,617 Gross Cost pr Itm *Nt Cost pr Claimant *Sinc 2003 ths figurs ar basd on th actual numbr of prsons who availd of srvics undr ach Schm. 25

28 Fs and Allowancs undr Capitation Agrmnt as at 31st Dcmbr 2005 Up to 3 Mils 3-5 Mils 5-7 Mils 7-10 Mils Ovr 10 Mils Ags Mal Fmal Mal Fmal Mal Fmal Mal Fmal Mal Fmal Undr 5 yars and ovr Abov rats inclusiv of supplmntary Out-of-Hours F. Th Capitation rat is 594 pr annum for prsons agd 70 yars and ovr in th community issud with a mdical card for th first tim rgardlss of incom. A Capitation rat of 861 pr annum will apply to anyon agd 70 yars and ovr in a privat nursing hom (approvd by th Halth Srvic Excutiv) for continuous priods in xcss of fiv wks. Out-of-Hours Paymnt Surgry Domiciliary Up to 3 mils mils mils mils Ovr 10 mils Additional F *Spcial Itms of Srvic (i) to (ix) (x) and (xi) (xii) (xiii) (xiv) (xv) and (xvi) (xvii) (xviii) Milag Tmporary Rsidnts Surgry Domiciliary Up to 3 mils mils mils mils Ovr 10 mils Rural Dispnsing F F for Scond Mdical Opinion Practic Paymnts for Rural Aras Rural Practic Allowanc Pr Annum 18, Practic Support Allowanc for Practic Scrtary up to a maximum Pr Annum of 24, Allowanc for Practic Nurs up to a maximum Pr Annum of 38, Contributions to Locum Expnss (Subjct to th conditions of th Agrmnt) Annual Lav Sick Lav Study Lav Matrnity Lav Patrnity Lav Up to a maximum of 1, pr wk Up to a maximum of pr day Contributions to Mdical Indmnity Insuranc Calculation of contribution is rlatd to GMS panl numbrs and nt prmium. Asylum Skrs A on off suprannuabl rgistration f of pr rlvant patint will b paid to Doctors in rspct of ach such patint on thir GMS Schm panls. * Spcial Itms of Srvic. (i) Excisions/Cryothrapy/ Diathrmy of Skin Lsions. (ii) Suturing of Cuts and Lacrations. (iii) Draining of Hydrocls. (iv) Tratmnt and Plugging of Dntal and Nasal Hamorrhags. (v) Rcognisd Vin Tratmnt. (vi) ECG Tsts and thir Intrprtation. (vii) Instruction in th fitting of a Diaphragm. (viii) Rmoval of Adhrnt Forign Bodis from th Conjunctival Surfac of th Ey. (ix) Rmoval of Lodgd or Impactd Forign Bodis from th Ear, Nos and Throat. (x) Nbulisr Tratmnt in th cas of Acut Asthmatic Attack. (xi) Bladdr Cathtrization. (xii) Attndanc at cas confrncs (in cass whr such ar convnd by th HSE). (xiii) Advic and Fitting of a Diaphragm. (xiv) Counslling and Fitting of an IUCD. (xv) Pnumococcal Vaccination. (xvi) Influnza Vaccination. (xvii) Pnumococcal/Influnza Vaccination. (xviii) Hpatitis B Vaccination. 26

29 Fs and Allowancs undr th F-Pr-Itm Agrmnt and Fs undr th Immunisation Schm, Halth (Amndmnt) Act 1996 and Mthadon Tratmnt Schm as at 31st Dcmbr 2005 Surgry Consultations Day Normal Hours Lat Outsid Normal Hours othr than (Night) Night Midnight to 8.00 a.m Domiciliary Consultations Day Lat Night Normal Hours Urban Up to 3 mils mils mils mils Ovr 10 mils Outsid Normal Hours Urban Up to 3 mils mils mils mils Ovr 10 mils Midnight to 8.00 a.m. Urban Up to 3 mils mils mils mils Ovr 10 mils Emrgncy F/EEA F (Additional to Standard F) Dispnsing F Rural Practitionr s Allowanc Pr Annum 7, Locum and Practic Expns Allowanc Pr Annum 1, Sssional Rat - Homs for th Agd Pr 3 Hour Sssion * Spcial Itms of Srvic (i) to (vii) (viii) and (ix) (x) (xi) Immunisation Fs (i) Rgistration of child with a GP (ii) Complt cours of immunisation against PT/DT; Hib; Polio and MMR (iii) 95% uptak bonus Halth (Amndmnt) Act 1996 Surgry F Domiciliary F Mthadon Tratmnt Schm Lvl 1 Contractor Lvl 2 Contractor * Spcial Itms of Srvic. (i) Excisions/Cryothrapy/ Diathrmy of Skin Lsions. (ii) Suturing of Cuts and Lacrations. (iii) Draining of Hydrocls. (iv) Tratmnt and Plugging of Dntal and Nasal Hamorrhags. (v) Rcognisd Vin Tratmnt. (vi) ECG Tsts and thir Intrprtation. (vii) Instruction in th fitting of a Diaphragm. (viii) Pnumococcal Vaccination. (ix) Influnza Vaccination. (x) Pnumococcal/Influnza Vaccination. (xi) Hpatitis B Vaccination. 27

30 Scal of Fs Payabl to Participating Pharmacists as at 31st Dcmbr 2005 GMS Schm Standard F-Pr-Itm (Not 1) 3.26 Extmporanous F 6.28 Extmporanous dispnsing and compounding of - Powdrs Ointmnts and Crams 2.56 Controlld Drugs 5.07 Non-Dispnsing - xrcis of profssional judgmnt.14 Phasd Dispnsing - ach part of phasd dispnsing.14 Urgnt/Lat Dispnsing Additional f for Urgnt/Lat dispnsing othr than btwn midnight and 8.00 a.m. (Not 2) 8.81 Additional f for Urgnt/Lat dispnsing btwn midnight and 8.00 a.m Not 1 Not 2 Not 3 Not basic f and 0.48 allowanc for containrs, obsolscnc tc. Urgnt f prscriptions ar thos so spcifid by th prscribr and ncssarily dispnsd outsid normal hours. Lat f prscriptions ar thos which, though not markd urgnt, ar in xcptional circumstancs ncssarily dispnsd outsid normal hours by th Pharmacist, having rgard to th prson s rquirmnts. A Standard F-Pr-Itm is also payabl on prscription forms issud by Dntists undr th DTS Schm. A F-Pr-Itm of 4.21 is also payabl on prscription forms in rspct of prsons agd 70 yars and ovr issud with a mdical card for th first tim rgardlss of incom. Supplis to Dispnsing Doctors Pharmacis supplying Dispnsing Doctors ar rimbursd on th basis of th basic trad pric with th addition of 25% on cost. DP/LTI/EEA Schms and Halth (Amndmnt) Act 1996 Rimbursmnt of ingrdint cost plus 50% mark-up on ingrdint cost plus Standard F (Not 1) 20% mark-up on Incontinnc Products and Drssings undr DP Schm Extmporanously dispnsd prparations ar rimbursd at currnt privat prscription rats. In th cas of th Drugs Paymnt Schm th PCRS maks paymnts to Pharmacis in rspct of authorisd Patints whos monthly costs of prscribd drugs and mdicins ar in xcss of th spcifid monthly amount (currntly 85) payabl to th Pharmacy by an individual or family. Not 1 Th standard f is an all inclusiv f which includs containr and brokn bulk allowanc. High Tch Mdicins Schm Patint Car F: pr month. Mthadon Tratmnt Schm Patint Car F: Up to a Maximum of pr month. E 28

31 Scal of Fs Payabl undr th Dntal Tratmnt Srvics Schm as at 31st Dcmbr 2005 Tratmnt Typ Routin E Oral Examination Prophylaxis Rstoration (Amalgam) Rstoration (Composit) 6 antrior tth only Exodontics (Extraction undr local anasthtic) 5.72 Surgical Extraction - Maximum 3 units: F payabl for ach 15 minut unit Maximum st Stag Endodontic Tratmnt (Antrior tth only) Dntur Rpairs 1st Itm of Rpair Each Subsqunt Itm Maximum Apicctomy/Amputation of Roots Endodontics (Antrior tth only) Protractd Priodontal Tratmnt Radiographs *Dntist Estimat *Dntist Estimat *Dntist Estimat 1 Film or mor Films.83 Panoramic 7.46 Miscllanous Prosthtics (.g. Abcss, Hamorrhag, Drssings tc.) Full Uppr or Lowr Dntur (Othr than Edntulous Prsons) Partial Uppr or Lowr Acrylic Dntur Complt Uppr or Lowr Rlin 2.29 Complt Uppr and Lowr Rlin Full Uppr and Lowr Dntur (Edntulous Prsons Only) * Dntist Estimats ar subjct to agrmnt btwn a Dntist and th Halth Srvic Excutiv Ara. 29

32 Scal of Fs Payabl undr th Halth Srvic Excutiv Community Ophthalmic Srvics Schm As as 31st Dcmbr 2005 E E Examinations Ey Examination Ophthalmic Optician Ey Examination Ophthalmologist/ Ophthalmic Mdical Practitionr Mdical Ey Examination by Ophthalmologist Ey Examination for Contact Lnss (Grant) (H) Ey Examination Ophthalmic (Dilation) Appliancs Singl Vision Complt Appliancs Spctacls Distanc Spctacls - Rading Spctacls - Uncollctd Contact Lnss (Pair) Contact Lnss Standard or Disposabl pr pair (Grant) (H) Singl Vision Spctacls - with Glass Lnss Distanc (H) Singl Vision Spctacls - with Glass Lnss Rading (H) Singl Vision Spctacls - with Plastic Lnss Distanc (H) Singl Vision Spctacls - with Plastic Lnss Rading (H) Singl Vision Lnss to Own Fram Rplacmnt Distanc Lns (1) to own fram 6.02 Rplacmnt Distanc Lnss (2) to own fram 2.04 Rplacmnt Rading Lns (1) to own fram 6.02 Rplacmnt Rading Lnss (2) to own fram 2.04 Singl Vision Lnss to Non-Standard Fram Singl Vision Lns (1) (Glass) Distanc Singl Vision Lnss (2) (Glass) Distanc Singl Vision Lns (1) (Glass) Rading Singl Vision Lnss (2) (Glass) Rading Singl Vision Lns (1) (Plastic) Distanc (H) (H) (H) (H) (H) Singl Vision Lnss (2) (Plastic) Distanc Singl Vision Lns (1) (Plastic) Rading Singl Vision Lnss (2) (Plastic) Rading (H) (H) (H) Additional Spcification for Lnss to All Spctacl Typs Spcial grant towards additional spcification for lns (1) applis to all spctacl typs (H) Spcial grant towards additional spcification for lnss (2) applis to all spctacl typs (H) Othr Itms - Singl Vision Lnticular Lns (1 Surfac).50 Lnticular Lnss (2 Surfacs) Lnticular Lnss (3 Surfacs) 4.50 Lnticular Lnss (4 Surfacs) Tintd Lns (1) 7.30 Tintd Lnss (2) 4.59 Tintd Lnss (3) Tintd Lnss (4) Prism (1) 6.23 Prisms (2) 2.45 Prisms (3) 8.68 Prisms (4) Prisms (5).14 Prisms (6) 7.36 Prisms (7) Prisms (8) Dioptric powrs highr than 8.00 (1) Lns 6.15 Dioptric powrs highr than 8.00 (2) Lnss 2.29 Dioptric powrs highr than 8.00 (3) Lnss 8.44 Dioptric powrs highr than 8.00 (4) Lnss Anti-Rflctiv Coating on Plastic Lns (1) 8.05 (H) (H) Dnots fs payabl in rspct of srvics undr th Halth (Amndmnt) Act 1996 only. 30

33 Scal of Fs Payabl undr th Halth Srvic Excutiv Community Ophthalmic Srvics Schm continud As as 31st Dcmbr 2005 E E Anti-Rflctiv Coating on Plastic Lnss (2) 6.09 (H) Dioptric powrs highr than 6.00 (Plastic) (1) Lns Dioptric powrs highr than 6.00 (Plastic) (2) Lnss Dioptric powrs highr than 6.00 (Plastic) (3) Lnss Dioptric powrs highr than 6.00 (Plastic) (4) Lnss Plastic Lns (1) for childrn as prscribd 4.52 Plastic Lnss (2) for childrn as prscribd 9.03 Plastic Lns (1) Adult 4.52 (H) Plastic Lnss (2) Adult 9.03 (H) Rpairs Rplacmnt Fram to own lnss.83 Rplacmnt Front to own lnss 5.83 Rplacmnt Sid (1) to own fram 2.45 Rplacmnt Sids (2) to own fram 4.90 Complt Nw Frams (H) Bifocals Spctacls Bifocal Complt Fusd Bifocal Spctacls (H) Varifocals Spctacls - Glass or Plastic (H) Bifocal Lnss Rplacmnt Bifocal Lns (1) to own fram 6.31 Rplacmnt Bifocal Lnss (2) to own fram Bifocal Lns (1) to Non-Standard Frams (H) Bifocal Lnss (2) to Non-Standard Frams (H) Varifocal Lns (1) (Grant) (H) Varifocal Lnss (2) (Grant) (H) Othr Itms - Bifocals Sphr ovr 6.00 and up to 9.00 xtra charg (1) Lns 4.15 Sphr ovr 6.00 and up to 9.00 xtra charg (2) Lnss 8.30 Sphr ovr 9.00 xtra charg (1) Lns 9.22 Sphr ovr 9.00 xtra charg (2) Lnss 8.44 Tintd Lns (1) 8.07 Tintd Lnss (2) 6.13 Prism (1) 8.63 Prisms (2) 7.25 (H) Dnots fs payabl in rspct of srvics undr th Halth (Amndmnt) Act 1996 only. 31

34 32

35 DETAILED STATISTICAL ANALYSIS OF CLAIMS AND PAYMENTS

36 Tabl 1 GMS: Summary of Statistical Information for ach of th Fiv Yars Yar ndd Dcmbr: Yar ndd Dcmbr: Numbr of Eligibl 1,155,727 1,148,914 1,158,143 1,168,745 1,199,454 Numbr of Doctor Contracts 2,257 2,210 2,181 2,134 1,863 Prsons in Dcmbr Numbr of Pharmacist Contracts 1,430 1,333 1,292 1,249 1,203 DOCTORS (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) Total Paymnts 8403, , , , ,863 Total Cost of Stock Ordrs 815, , , , ,555 Ingrdint Cost 811, , , ,059 88,945 Doctors Paymnt Pharmacy Fs 82,927 82,986 82,726 82,515 82,222 pr Prson VAT PHARMACIES Total Cost of 8816, , , , ,464 Ovrall Cost of Mdicins 8831, , , , ,019 Prscriptions Ingrdint Cost 8653, , , , ,497 *Pharmacy Paymnt Dispnsing F 8147, , , , ,413 pr Prson VAT 815, , ,873 89,778 87,554 Numbr of Forms 13,227 12,794 12,243 11,551 10,454 Numbr of Itms 37,428 35,030 32,241 29,500 25,521 Ovrall Paymnts 81,234,514 81,069, , , ,882 Cost pr Form *Ovrall Paymnt 81, pr Prson Cost pr Itm Ingrdint Cost pr Itm Itms pr Form Not: Doctors paymnt pr prson is xclusiv of suprannuation paid to rtird DMOs. *Sinc 2003 ths figurs ar basd on th actual numbr of prsons who availd of srvics. 34

37 Tabl 1.1 LTI/DP: Summary of Statistical Information for ach of th Fiv Yars Yar ndd Dcmbr: Yar ndd Dcmbr: LTI Schm DP Schm Numbr of Eligibl Numbr of Eligibl Prsons Prsons in Dcmbr 99,280 93,504 97,184 92,745 87,988 in Dcmbr,478,650 1,469,251 1,396,813 1,319,395 1,156,836 *Numbr of Claimants 53,006 50,526 48,053 *Numbr of Claimants 526, , ,411 (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) (000 s) Numbr of Itms,929 1,675 1,464 1,280 1,157 Numbr of Itms 0,582 9,933 9,311 9,063 8,985 Total Cost 8100, , , , ,081 Gross Cost 8388, , , , ,187 Cost pr Itm Nt Cost 8244, , , , ,617 *Cost pr Claimant 81, , , Gross Cost pr Itm *Nt Cost pr Claimant *Sinc 2003 ths figurs ar basd on th actual numbr of prsons who availd of srvics undr ach Schm. 35

38 Tabl 2 Numbr of Agrmnts Halth Srvic Excutiv Doctors Pharmacists Dntists Optomtrists East Coast Ara South Wstrn Ara Northrn Ara Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn Wstrn National 2,257 2,210 1,430 1,333 1,394 1, Not: (i) Whr Doctors hav panls numbrs drawn from mor than on HSE Ara, th Ara whrin th majority of such prsons rsid is dmd to b th Doctors HSE Ara. (ii) 239 Doctors who do not hav agrmnts undr th GMS Schm and who provid srvics undr th Primary Childhood Immunisation Schm, th Halth (Amndmnt) Act 1996, Hartwatch, Palliativ Car and th Mthadon Tratmnt Schm ar includd in th abov. (iii) 198 Dntists ( ) who ar mploys of th Halth Srvic Excutiv and who provid srvics undr th Dntal Tratmnt Srvics Schm ar includd abov. (iv) 11 Pharmacis who do not hold GMS agrmnts and who wr rgistrd as providing srvics undr th non GMS Schms at yar nd ar includd abov. (v) Abov figurs rlat to th position as at 31st Dcmbr

39 Tabl 3 GMS: Paymnts to Doctors FEES - Itm of Srvic Contract,803,460,210,542 - Capitation 206,098,590 57,367,358 - Spcial Claims/Srvics 4,634,854 23,249,824 - Out-of-Hours,506,917 24,354,181 - Dispnsing 2,753,426,833,355 - Asylum Skrs,484,255,643,102 - GP Visit Cards 92,365 - ALLOWANCES - Annual Lav 8,508,173 6,751,482 - Locum and Practic Expnss,215 6,357 - Sick Lav,514,79,372,059 - Matrnity Lav 532,758 7,411 - Rural Practic 4,974,708 2,929,286 - Scrtarial/Nursing 59,418,733 42,693,313 - Study Lav,560,225,253,182 - Mdical Indmnity Insuranc,919,026 2,167,783 - Rostring/Out-of-Hours 6,548,291 6,528,544 - Practic Dvlopmnt 4,365,469 4,352,325 - Practic Support Grant 2,668,681 2,671,547 - IMO Agrmnts: On-in-On rotas 634, ,869 Third yar Trains 281, ,599 Trainr Grants 891, ,160 SALARIES - Formr District Mdical Officrs,807,437 2,016,679 - Bnfits to rtird DMOs and thir dpndants 6,249,438 5,779,920 SUPERANNUATION FUND - Contribution 20,807,914 6,095,403 TOTAL 403,071, ,250,280 Not: Th abov figurs includ th arrars paid rsulting from th implmntation of th 2005 LRC Agrmnt. 37

40 Tabl 4 GMS: Cost of Prscriptions Halth Srvic Excutiv 2005 Ingrdint Cost Dispnsing F VAT Total East Coast Ara 46,496,561 41,523,478 11,161,953 13,181,871 1,114, ,926 58,772,807 55,704,275 South Wstrn Ara 75,433,230 68,750,063 17,289,034 18,645,657 1,864,426 1,733,029 94,586,690 89,128,749 Northrn Ara 73,247,610 65,107,099 16,370,106 18,003,517 1,689,822 1,520,182 91,307,538 84,630,798 Midland 45,478,996 40,415,464 10,096,069 9,544,860 1,047, ,892 56,622,978 50,888,216 Mid-Wstrn 60,153,877 53,304,434 13,661,854 13,210,452 1,391,282 1,222,566 75,207,013 67,737,452 North Eastrn 56,533,835 51,308,799 12,814,200 12,604,709 1,308,787 1,192,968 70,656,822 65,106,476 North Wstrn 40,948,981 37,088,659 9,140,657 8,520, , ,708 51,034,241 46,475,501 South Eastrn 79,072,272 70,542,710 18,258,235 17,594,976 1,945,504 1,755,670 99,276,011 89,893,356 Southrn 106,311,334 95,150,593 23,813,500 23,466,655 2,368,159 2,144, ,492, ,761,971 Wstrn 69,573,817 61,930,977 15,254,274 14,308,567 1,518,377 1,339,508 86,346,468 77,579,052 National 653,250, ,122, ,859, ,081,398 15,193,166 13,702, ,303, ,905,846 Not: Cost of mdicins supplid by pharmacis to Dispnsing Doctors is givn in Tabl 5. 38

41 Tabl 5 GMS: Cost of Stock Ordr Forms Halth Srvic Excutiv 2005 Ingrdint Cost *Pharmacy F VAT Total East Coast Ara 160, ,065 40,223 38,519 32,108 32, , ,377 South Wstrn Ara 104, ,410 26,004 30,608 27,133 27, , ,411 Northrn Ara 54,250 36,913 13,568 9,236 13,944 9,315 81,762 55,464 Midland 437, , , ,982 22,913 23, , ,045 Mid-Wstrn 883, , , ,937 47,686 44,114 1,151,717 1,108,736 North Eastrn 1,206,281 1,054, , ,677 52,459 53,674 1,560,306 1,372,070 North Wstrn 2,098,402 2,111, , ,985 58,823 59,388 2,681,208 2,699,304 South Eastrn 2,797,152 2,923, , ,771 90,747 92,631 3,587,183 3,746,518 Southrn 407, , , ,384 58,310 52, , ,585 Wstrn 3,564,090 3,579, , ,833 93,772 87,523 4,547,967 4,561,718 National 11,714,162 11,943,684 2,927,005 2,985, , ,612 15,139,062 15,412,228 Not: (i) Stock Ordr Forms ar providd by HSE Aras for us by Dispnsing Doctors to obtain Mdicins and Appliancs from rtail pharmacis for dispnsing to prsons who ar ntitld to b dispnsd to. (ii) *Pharmacis ar rimbursd for stock ordr itms on th basis of th basic trad pric, with th addition of 25% on cost. (iii) Th abov figurs includ ndls, syrings and drssings which ar availabl for Doctors us. 39

42 Tabl 6 DTS: Paymnts to Dntists Halth Srvic Excutiv 2005 Abov th Lin Blow th Lin Total Eastrn Aras 9,899,747 9,925,433 4,572,584 4,447,763 14,472,331 14,373,197 Midland 1,874,345 1,713,905 1,126,662 1,012,263 3,001,007 2,726,168 Mid-Wstrn 3,023,569 2,897,091 1,763,677 1,558,725 4,787,246 4,455,816 North Eastrn 2,840,442 2,765,727 1,607,576 1,469,489 4,448,018 4,235,216 North Wstrn 2,698,869 2,425,977 1,110, ,895 3,808,938 3,384,872 South Eastrn 4,221,062 3,999,529 2,553,877 2,442,847 6,774,939 6,442,376 Southrn 6,593,095 6,554,936 3,096,867 2,900,032 9,689,962 9,454,969 Wstrn 4,477,946 4,623,983 2,942,514 2,736,230 7,420,460 7,360,214 National 35,629,075 34,906,581 18,773,826 17,526,244 54,402,901 52,432,828 Not: Dntists wr also paid a total 55,922 in 2005 ( 55,587 in 2004) in rspct of fs undr Halth (Amndmnt) Act

43 Tabl 7 GMS: Paymnt pr Prson Halth Srvic Excutiv Doctors Pharmacis Total Doctors Pharmacis Total Eastrn Aras , Midland , , Mid-Wstrn , North Eastrn , North Wstrn South Eastrn , Southrn , Wstrn , National , Not: Th paymnt pr prson is inclusiv of total paymnts to Doctors (Tabl 3) xcluding suprannuation bnfits to rtird DMOs and thir dpndants and total paymnts to pharmacis (Tabls 4 and 5) in rspct of th actual cost pr prson who availd of srvics. 41

44 Tabl 8 GMS: Numbr of Doctors in Eligibl Prson Cost Catgoris 2005 (2004 in brackts) Numbr of Doctors with an annual cost pr ligibl prson of:- Halth Srvic Excutiv Up to &Ovr Eastrn Aras 17 (5) 8 (3) 3 (5) 15 (15) 10 (22) 12 (10) 16 (19) 10 (15) 11 (21) 493 (469) Midland 1 (-) - 1 (-) - 1 (-) - - (2) 1 (2) 1 (4) 96 (96) Mid-Wstrn 3 (-) 3 (-) - 1 (1) 1 (-) 2 (3) 1 (4) 2 (4) 7 (8) 147 (138) North Eastrn 4 (2) 2 (1) 2 (1) 1 (1) 3 (-) 1 (1) 2 (10) 5 (6) 2 (-) 133 (117) North Wstrn 2 (2) 2 (-) - 2 (4) 2 (1) 4 (4) 1 (14) 6 (8) 9 (11) 100 (76) South Eastrn 2 (1) 1 (-) - 2 (-) - (1) 1 (4) 4 (2) 2 (3) 4 (4) 194 (188) Southrn 2 (1) - (1) - (1) 1 (-) 1 (1) 4 (4) 4 (2) 2 (5) 5 (16) 303 (287) Wstrn 5 (1) 2 (-) - (1) - (2) 3 (3) 4 (1) 1 (8) 3 (4) 7 (9) 202 (193) National 36 (12) 18 (5) 6 (8) 22 (23) 21 (28) 28 (27) 29 (61) 31 (47) 46 (73) 1,668 (1,564) Not: (i) Doctors not in th GMS Schm for th full yar hav bn xcludd from this tabl. (ii) Th annual cost pr ligibl prson is th total paymnt for th Doctor and th total prscribing/dispnsing costs in rspct of th numbr of prsons on th panl as at Dcmbr (iii) Doctors paymnt is xclusiv of suprannuation paid to rtird DMOs. 42

45 Tabl 9 Halth Srvic Excutiv EASTERN AREAS GMS: Numbr of Eligibl Prsons Numbr of prsons (including dpndants) Numbr of prsons (including dpndants) and % of population* ligibl in and % of population* ligibl in Halth Srvic Dcmbr 2005 Dcmbr 2004 Excutiv Dcmbr 2005 Dcmbr 2004 No. % No. % No. % No. % NORTH WESTERN Dublin 274, , Dongal 68, , Kildar 37, , Litrim 11, , Wicklow 27, , Sligo 19, , TOTAL 339, , TOTAL 98, , MIDLAND SOUTH EASTERN Laois 16, , Carlow 15, , Longford 12, , Kilknny 19, , Offaly 19, , Tipprary S.R. 28, , Wstmath 20, , Watrford 35, , TOTAL 70, , Wxford 40, , TOTAL 139, , MID-WESTERN Clar 31, , SOUTHERN Limrick 49, , Cork 132, , Tipprary N.R. 19, , Krry 41, , TOTAL 100, , TOTAL 173, , NORTH EASTERN WESTERN Cavan 18, , Galway 65, , Louth 35, , Mayo 47, , Math 29, , Roscommon 20, , Monaghan 16, , TOTAL 133, , TOTAL 99, , National 1,155, ,148, Not: (i) *Th population figurs for ach county ar takn from th Cnsus of Population Th most rcnt Official C.S.O. stimat of national population as at April 2005 is 4,130,700. (ii) As at Dcmbr ,079 popl on GP Visit Only Cards ar xcludd. 43

46 Tabl 9.1 GMS: Numbr of Eligibl Prsons by Gndr within Ag Groups Ag Classification Halth Srvic Excutiv As at Dcmbr 2005 Undr 5 Yars 5-11 Yars Yars Yars Yars Yars Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras 13,434 13,992 27,426 16,177 17,205 33,382 8,271 8,573 16,844 15,502 9,525 25,027 20,849 11,126 31,975 16,981 12,477 29,458 Midland 2,373 2,447 4,820 3,266 3,466 6,732 1,876 1,942 3,818 3,647 2,449 6,096 3,597 2,070 5,667 3,510 2,574 6,084 Mid-Wstrn 3,062 3,025 6,087 4,257 4,504 8,761 2,498 2,575 5,073 5,135 3,766 8,901 5,075 3,285 8,360 4,800 3,912 8,712 North Eastrn 3,090 3,348 6,438 4,553 4,784 9,337 2,552 2,623 5,175 5,567 3,720 9,287 5,166 3,087 8,253 4,856 3,795 8,651 North Wstrn 2,873 3,116 5,989 4,578 4,925 9,503 2,674 2,914 5,588 6,074 4,442 10,516 5,031 3,351 8,382 5,318 4,427 9,745 South Eastrn 4,262 4,612 8,874 5,857 6,401 12,258 3,405 3,569 6,974 7,740 5,292 13,032 7,221 4,373 11,594 6,990 5,351 12,341 Southrn 4,879 5,337 10,216 6,809 7,355 14,164 3,932 4,124 8,056 8,131 5,523 13,654 8,756 5,510 14,266 8,574 6,611 15,185 Wstrn 3,531 3,752 7,283 5,551 5,844 11,395 3,509 3,521 7,030 6,822 5,167 11,989 6,148 3,939 10,087 6,374 5,363 11,737 National 37,504 39,629 77,133 51,048 54, ,532 28,717 29,841 58,558 58,618 39,884 98,502 61,843 36,741 98,584 57,403 44, ,913 % of Eligibl Prsons 3.25% 3.43% 6.67% 4.42% 4.71% 9.13% 2.48% 2.58% 5.07% 5.07% 3.45% 8.52% 5.35% 3.18% 8.53% 4.97% 3.85% 8.82% 44

47 Tabl 9.1 GMS: Numbr of Eligibl Prsons by Gndr within Ag Groups continud Ag Classification Halth Srvic Excutiv As at Dcmbr Yars Yars Yars Yars 75 Yars and Ovr All Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras 14,130 11,124 25,254 16,286 12,819 29,105 10,435 7,313 17,748 20,628 16,988 37,616 41,945 23,868 65, , , ,648 Midland 3,305 2,859 6,164 4,089 3,248 7,337 2,236 1,786 4,022 3,502 3,389 6,891 7,432 5,060 12,492 38,833 31,290 70,123 Mid-Wstrn 4,796 4,239 9,035 5,891 5,100 10,991 3,241 2,759 6,000 5,307 4,984 10,291 11,164 7,313 18,477 55,226 45, ,688 North Eastrn 4,621 4,087 8,708 5,721 4,788 10,509 3,136 2,470 5,606 4,979 4,593 9,572 10,937 7,093 18,030 55,178 44,388 99,566 North Wstrn 5,176 4,909 10,085 5,712 5,531 11,243 2,859 2,632 5,491 3,671 3,700 7,371 8,861 6,141 15,002 52,827 46,088 98,915 South Eastrn 6,783 5,948 12,731 8,375 7,232 15,607 4,718 4,028 8,746 7,114 6,564 13,678 14,192 9,593 23,785 76,657 62, ,620 Southrn 8,536 7,591 16,127 10,519 8,816 19,335 6,165 5,053 11,218 9,710 8,701 18,411 20,044 12,910 32,954 96,055 77, ,586 Wstrn 6,885 6,522 13,407 7,820 7,588 15,408 4,306 3,885 8,191 6,193 6,195 12,388 14,647 10,020 24,667 71,786 61, ,582 National 54,232 47, ,511 64,413 55, ,535 37,096 29,926 67,022 61,104 55, , ,222 81, , , ,528 1,155,728 % of Eligibl Prsons 4.69% 4.09% 8.78% 5.57% 4.77% 10.34% 3.21% 2.59% 5.80% 5.29% 4.77% 10.06% 11.18% 7.09% 18.28% 55.48% 44.52% % 45

48 Tabl 9.2 GPVC: Numbr of Eligibl Prsons by Gndr within Ag Groups Ag Classification Halth Srvic Excutiv As at Dcmbr 2005 Undr 5 Yars 5-11 Yars Yars Yars Yars Yars Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn Wstrn National % of Eligibl Prsons 5.57% 5.59% 11.16% 7.23% 7.82% 15.04% 4.57% 3.88% 8.45% 5.00% 3.45% 8.45% 7.97% 3.98% 11.95% 9.45% 7.58% 17.03% 46

49 Tabl 9.2 GPVC: Numbr of Eligibl Prsons by Gndr within Ag Groups continud Ag Classification Halth Srvic Excutiv As at Dcmbr Yars Yars Yars All Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn ,245 Wstrn National ,760 2,319 5,079 % of Eligibl Prsons 6.42% 5.12% 11.54% 6.30% 5.69% 11.99% 1.83% 2.56% 4.39% 54.34% 45.66% % 47

50 Tabl 9.3 GMS: Prcntag of Eligibl Prsons by Milag Allocation Milag Classification Halth Srvic Excutiv As at Dcmbr 2005 Up to 3 Mils 3-5 Mils 5-7 Mils 7-10 Mils Ovr 10 Mils Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn Wstrn National

51 Tabl 10 GMS: Siz of Panls of Doctors As at Dcmbr 2005 (2004 in brackts) Halth Srvic Excutiv Numbr of Doctors with panls of:- Up to ,000 1,001-1,500 1,501-2,000 2,001-2,500 East Coast Ara 59 (62) 49 (47) 61 (60) 3 (3) - - South Wstrn Ara 64 (64) 47 (43) 81 (85) 42 (40) 4 (3) 3 (2) Northrn Ara 35 (33) 42 (44) 71 (68) 28 (28) 10 (10) 1 (1) Midland 13 (14) 22 (17) 47 (49) 21 (21) - - Mid-Wstrn 37 (32) 33 (30) 77 (78) 18 (17) 4 (4) - North Eastrn 24 (30) 30 (26) 81 (80) 19 (20) 1 (1) - North Wstrn 17 (16) 21 (20) 47 (51) 36 (33) 7 (6) - South Eastrn 26 (27) 39 (38) 113 (110) 28 (26) 5 (5) - Southrn 75 (73) 79 (79) 136 (137) 30 (30) 2 (2) 1 (1) Wstrn 44 (48) 55 (53) 101 (92) 29 (33) 1 (2) - National 394 (399) 417 (397) 815 (810) 254 (251) 34 (33) 5 (4) 49

52 Tabl 11 GMS: Paymnts to Doctors in ach Halth Srvic Excutiv Ara Halth Srvic Excutiv East Coast Ara 29,687,792 21,954,859 South Wstrn Ara 45,029,291 34,487,150 Northrn Ara 39,192,489 29,725,829 Midland 25,206,856 19,026,820 Mid-Wstrn 34,223,427 26,008,407 North Eastrn 34,409,257 27,906,452 North Wstrn 32,470,288 24,414,071 South Eastrn 49,715,964 36,950,000 Southrn 63,954,440 48,283,554 Wstrn 49,181,284 37,493,138 National 403,071, ,250,280 Not: Th abov figurs includ th arrars paid rsulting from th implmntation of th 2005 LRC Agrmnt. 50

53 Tabl 12 GMS: Numbr of Spcial Typ Consultations and Out-of-Hours Claims Halth Srvic Excutiv No. of Tmporary Rsidnt Claims No. of EEA Visitor Claims No. of Emrgncy Claims Scond Mdical Opinion Claims No. of Out-of- Hours Claims Total No. of Claims East Coast Ara 3,329 3,056 2,850 2,954 2,588 1, ,779 23,598 32,548 31,486 South Wstrn Ara 7,959 6,992 4,470 4,449 5,542 5, ,608 50,956 73,592 68,195 Northrn Ara 6,545 5,944 2,263 2,249 5,331 4, ,763 43,001 57,902 55,772 Midland 8,326 9,595 2,188 2,170 7,908 7, ,730 35,479 56,155 54,652 Mid-Wstrn 13,248 10,682 5,197 5,374 3,035 2, ,837 41,192 63,456 60,192 North Eastrn* 5,202 4,623 3,031 2,963 1,442 1, ,254 10,227 18,932 19,334 North Wstrn 3,226 3,232 7,933 7,880 1,673 1, ,054 44,955 59,918 57,987 South Eastrn 8,041 7,373 5,902 6,208 3,629 3, ,075 75,595 98,653 92,223 Southrn 24,196 21,921 13,631 12,920 5,666 5,281 1, , , , ,631 Wstrn 15,043 14,917 10,330 10,484 5,440 5, ,091 90, , ,989 National 95,115 88,335 57,795 57,651 42,254 39,548 1, , , , ,461 * HSE North Eastrn Ara figurs do not includ statistics from North East Doc. 51

54 Tabl 12.1 GMS: Paymnt to Doctors for Spcial Typ Consultations and Out-of-Hours Claims Halth Srvic Excutiv Cost of Tmporary Rsidnt Claims Cost of EEA Visitor Claims Cost of Emrgncy Claims Cost of Scond Mdical Opinion Claims Cost of Out-of-Hours Claims Total Cost of Claims East Coast Ara 139, , , , ,338 71, , ,872 1,295,298 1,204,223 South Wstrn Ara 319, , , , , , ,276,275 1,997,762 2,994,791 2,659,701 Northrn Ara 254, ,901 87,002 84, , , ,698,684 1,620,341 2,244,665 2,096,183 Midland 329, ,231 83,722 81, , , ,540,667 1,406,485 2,260,384 2,132,495 Mid-Wstrn 515, , , , , ,813 3,659 1,882 1,707,605 1,641,688 2,543,987 2,357,864 North Eastrn * 212, , , ,655 57,383 57, , , , ,322 North Wstrn 125, , , ,003 65,668 71, ,933,638 1,778,438 2,430,535 2,268,896 South Eastrn 310, , , , , , ,261,288 2,945,111 3,937,982 3,569,379 Southrn 1,005, , , , , ,751 26,931 19,749 5,740,039 5,175,512 7,520,085 6,778,783 Wstrn 594, , , , , , ,898,543 3,568,567 5,103,547 4,727,190 National 3,807,060 3,424,473 2,219,021 2,158,099 1,660,792 1,504,853 32,822 23,023 23,370,850 21,434,587 31,090,545 28,545,036 * HSE North Eastrn Ara figurs do not includ statistics from North East Doc. 52

55 Tabl 13 GMS: Analysis of Spcial Itms of Srvic Typ of Srvic Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 68,152 64,032 1,635,049 1,490,956 (ii) Suturing: Cuts and Lacrations 27,574 26, , ,170 (iii) Hydrocls: Draining of 1,005 1,108 24,216 25,788 (iv) Hamorrhags: Dntal/Nasal 1,587 1,463 38,320 34,074 (v) Vins: Rcognisd tratmnt 2,714 2,108 65,519 49,138 (vi) ECG: Tsts and intrprtation 49,929 45,943 1,198,888 1,070,369 (vii) Diaphragm: Instruction in th fitting of ,454 17,094 (viii) Ey: Rmoval of Adhrnt forign body 7,929 7, , ,873 (ix) Ear/Nos/Throat: Rmoval of forign body 18,378 16, , ,152 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 47,775 42,127 1,726,807 1,472,167 (xi) Bladdr: Cathtrization 5,473 5, , ,881 (xii) Cas Confrnc: Convnd by HSE ,163 8,610 (xiii) Diaphragm: Advic and fitting of ,443 17,419 (xiv) IUCD: Counslling and fitting of 4,914 4, , ,669 (xv) Pnumococcal: Vaccination 20,337 11, , ,098 (xvi) Influnza: Vaccination 299, ,476 9,989,318 9,372,468 (xvii) Pnumococcal/Influnza: Vaccination 23,885 11,900 1,204, ,802 (xviii) Hpatitis B: Vaccination ,123 31,047 National 580, ,803 18,499,824 16,119,775 53

56 Tabl 13.1 GMS: Analysis of Spcial Itms of Srvic by HSE Ara Typ of Srvic East Coast Ara South Wstrn Ara Numbr of Claims Cost of Claims Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 3,790 91,089 7, ,158 (ii) Suturing: Cuts and Lacrations ,604 1,834 44,086 (iii) Hydrocls: Draining of ,233 (iv) Hamorrhags: Dntal/Nasal ,060 (v) Vins: Rcognisd tratmnt ,001 (vi) ECG: Tsts and intrprtation 2,520 60,628 3,235 77,810 (vii) Diaphragm: Instruction in th fitting of 56 1, ,678 (viii) Ey: Rmoval of Adhrnt forign body 177 4, ,702 (ix) Ear/Nos/Throat: Rmoval of forign body ,257 1,991 47,646 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 1,077 38,903 3, ,944 (xi) Bladdr: Cathtrization 148 5, ,246 (xii) Cas Confrnc: Convnd by HSE (xiii) Diaphragm: Advic and fitting of 37 1, ,658 (xiv) IUCD: Counslling and fitting of , ,479 (xv) Pnumococcal: Vaccination 1,687 58,345 2,016 69,150 (xvi) Influnza: Vaccination 24, ,026 30,429 1,019,213 (xvii) Pnumococcal/Influnza: Vaccination 2, ,686 2, ,788 (xviii) Hpatitis B: Vaccination ,557 Total 37,809 1,253,046 54,537 1,758,295 54

57 Tabl 13.1 GMS: Analysis of Spcial Itms of Srvic by HSE Ara continud Typ of Srvic Mid-Wstrn North Eastrn Numbr of Claims Cost of Claims Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 4,148 99,282 4, ,434 (ii) Suturing: Cuts and Lacrations 1,913 46,113 1,686 40,350 (iii) Hydrocls: Draining of 81 1, ,740 (iv) Hamorrhags: Dntal/Nasal 95 2, ,178 (v) Vins: Rcognisd tratmnt , ,985 (vi) ECG: Tsts and intrprtation 3,529 84,985 3,550 84,956 (vii) Diaphragm: Instruction in th fitting of ,872 (viii) Ey: Rmoval of Adhrnt forign body 407 9, ,706 (ix) Ear/Nos/Throat: Rmoval of forign body ,114 1,368 32,917 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 2,402 87,212 3, ,944 (xi) Bladdr: Cathtrization , ,857 (xii) Cas Confrnc: Convnd by HSE (xiii) Diaphragm: Advic and fitting of 35 1, ,305 (xiv) IUCD: Counslling and fitting of , ,785 (xv) Pnumococcal: Vaccination 1,962 67,142 1,662 56,565 (xvi) Influnza: Vaccination 27, ,363 25, ,172 (xvii) Pnumococcal/Influnza: Vaccination 2, ,248 2, ,299 (xviii) Hpatitis B: Vaccination 25 3, ,328 Total 46,479 1,501,888 45,768 1,487,802 55

58 Tabl 13.1 GMS: Analysis of Spcial Itms of Srvic by HSE Ara continud Typ of Srvic Northrn Ara Midland Numbr of Claims Cost of Claims Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 4,086 97,844 3,526 84,247 (ii) Suturing: Cuts and Lacrations 1,456 35,004 2,329 56,102 (iii) Hydrocls: Draining of (iv) Hamorrhags: Dntal/Nasal 137 3, ,430 (v) Vins: Rcognisd tratmnt (vi) ECG: Tsts and intrprtation 1,649 39,750 4, ,727 (vii) Diaphragm: Instruction in th fitting of (viii) Ey: Rmoval of Adhrnt forign body , ,960 (ix) Ear/Nos/Throat: Rmoval of forign body 1,321 31,792 1,397 33,525 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 1,320 47,954 5, ,908 (xi) Bladdr: Cathtrization 64 2, ,125 (xii) Cas Confrnc: Convnd by HSE (xiii) Diaphragm: Advic and fitting of 32 1, (xiv) IUCD: Counslling and fitting of , ,934 (xv) Pnumococcal: Vaccination 1,817 62,438 1,548 54,320 (xvi) Influnza: Vaccination 31,327 1,049,128 18, ,474 (xvii) Pnumococcal/Influnza: Vaccination 2, ,801 1,285 65,462 (xviii) Hpatitis B: Vaccination 26 3, ,655 Total 47,415 1,573,059 39,559 1,258,236 56

59 Tabl 13.1 GMS: Analysis of Spcial Itms of Srvic by HSE Ara continud Typ of Srvic North Wstrn South Eastrn Numbr of Claims Cost of Claims Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 7, ,696 8, ,589 (ii) Suturing: Cuts and Lacrations 3,004 71,944 5, ,876 (iii) Hydrocls: Draining of 130 3, ,837 (iv) Hamorrhags: Dntal/Nasal 139 3, ,922 (v) Vins: Rcognisd tratmnt ,688 (vi) ECG: Tsts and intrprtation 7, ,881 7, ,846 (vii) Diaphragm: Instruction in th fitting of 43 1, (viii) Ey: Rmoval of Adhrnt forign body 1,000 23, ,984 (ix) Ear/Nos/Throat: Rmoval of forign body 2,381 57,051 2,126 51,231 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 6, ,847 8, ,106 (xi) Bladdr: Cathtrization , ,382 (xii) Cas Confrnc: Convnd by HSE ,142 (xiii) Diaphragm: Advic and fitting of 51 2, ,722 (xiv) IUCD: Counslling and fitting of , ,837 (xv) Pnumococcal: Vaccination 1,470 51,279 2,403 82,916 (xvi) Influnza: Vaccination 20, ,970 38,485 1,279,281 (xvii) Pnumococcal/Influnza: Vaccination 1,727 86,140 2, ,332 (xviii) Hpatitis B: Vaccination 27 3, ,687 Total 53,271 1,637,261 78,693 2,485,122 57

60 Tabl 13.1 GMS: Analysis of Spcial Itms of Srvic by HSE Ara continud Typ of Srvic Southrn Wstrn Numbr of Claims Cost of Claims Numbr of Claims Cost of Claims (i) Excisions/Cryothrapy/Diathrmy: Skin Lsions 12, ,019 12, ,692 (ii) Suturing: Cuts and Lacrations 5, ,647 4, ,410 (iii) Hydrocls: Draining of 156 3, ,241 (iv) Hamorrhags: Dntal/Nasal 151 3, ,247 (v) Vins: Rcognisd tratmnt , ,252 (vi) ECG: Tsts and intrprtation 7, ,061 8, ,243 (vii) Diaphragm: Instruction in th fitting of 164 3, ,329 (viii) Ey: Rmoval of Adhrnt forign body 2,442 58,542 1,118 26,881 (ix) Ear/Nos/Throat: Rmoval of forign body 3,605 86,686 2,546 61,230 (x) Nbulisr: Tratmnt in th cas of acut asthmatic attack 7, ,132 8, ,857 (xi) Bladdr: Cathtrization ,263 1,151 41,527 (xii) Cas Confrnc: Convnd by HSE 46 2, ,284 (xiii) Diaphragm: Advic and fitting of 105 4, ,358 (xiv) IUCD: Counslling and fitting of , ,060 (xv) Pnumococcal: Vaccination 2,795 96,166 2, ,326 (xvi) Influnza: Vaccination 47,650 1,584,661 35,865 1,196,032 (xvii) Pnumococcal/Influnza: Vaccination 3, ,729 2, ,291 (xviii) Hpatitis B: Vaccination , ,092 Total 96,256 3,042,763 80,935 2,502,352 58

61 Tabl 14 GMS: Visiting Rat Catgoris for Doctors on F-Pr-Itm of Srvic NATIONAL 2005 (2004 in brackts) Doctors with panls of:- Visiting Rat:-* and Ovr (-) - - (1) - (1) 1 (-) 1 (2) (1) 1 (-) - (2) - (1) 1 (-) (1) - - (1) (-) - (1) 1,000-1,499-1 (-) (1) Ovr 1, (1) (1) - TOTAL 2 (1) 2 (1) 1 (2) 1 (1) - (3) 3 (2) 3 (4) Not: (i) Th ovrall visiting rat in 2005 of th Doctors who continud on a F-Pr-Itm of srvic contract was (Surgry: 9.50 Domiciliary: 1.06), ( Total: Surgry: 9.82 Domiciliary: 0.95). (ii) Only Doctors with panls of 100 prsons or ovr ar includd in th abov tabl. (iii) *Visiting Rat is th total numbr of consultations dividd by th total numbr of prsons on panl. 59

62 Tabl 15 GMS: Cost of Mdicins by Gndr within Ag Groups Halth Srvic Excutiv Ag Classification Undr 5 Yars 5-11 Yars Yars Yars Yars Yars Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras Midland Mid-Wstrn North Eastrn North Wstrn South Eastrn Southrn Wstrn National % of National Avrag 12.80% 14.05% 13.44% 9.55% 11.03% 10.31% 10.68% 11.77% 11.23% 32.77% 31.77% 32.36% 45.97% 55.69% 49.59% 65.21% 67.73% 66.31% 60

63 Tabl 15 GMS: Cost of Mdicins by Gndr within Ag Groups continud Halth Srvic Excutiv Ag Classification Yars Yars Yars Yars 75 Yars & Ovr Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Fmal Mal Total Eastrn Aras , , , , , , , , , , , , Midland , , , , , , , , , , , , Mid-Wstrn , , , , , , , , , , , , North Eastrn , , , , , , , , , North Wstrn , , , , , , South Eastrn , , , , , , , , , , , , Southrn , , , , , , , , , , , , Wstrn , , , , , , , , National , , , , , , , , , , , , % of National Avrag % 99.20% % % % % % % % % % % % % % % 97.06% % 61

64 Tabl 16 GMS: Numbr of Prscription Forms and Itms Halth Srvic Excutiv Numbr of Forms Numbr of Itms Itms pr Form East Coast Ara 911, ,458 2,700,203 2,512, South Wstrn Ara 1,546,259 1,520,809 4,417,734 4,183, Northrn Ara 1,394,802 1,350,966 4,066,787 3,799, Midland 875, ,797 2,531,618 2,343, Mid-Wstrn 1,221,813 1,170,705 3,508,363 3,249, North Eastrn 1,144,399 1,128,888 3,256,141 3,086, North Wstrn 924, ,130 2,367,623 2,230, South Eastrn 1,654,962 1,594,818 4,629,133 4,310, Southrn 2,150,993 2,079,929 6,080,556 5,707, Wstrn 1,403,790 1,350,367 3,869,616 3,606, National 13,227,483 12,793,867 37,427,774 35,030,

65 Tabl 16.1 GMS: Paymnt to Pharmacists in Rspct of Prscriptions Halth Srvic Excutiv Cost Cost pr Form Cost pr Itm Ingrdint Cost pr Itm East Coast Ara 58,772,807 55,704, South Wstrn Ara 94,586,690 89,128, Northrn Ara 91,307,538 84,630, Midland 56,622,978 50,888, Mid-Wstrn 75,207,013 67,737, North Eastrn 70,656,822 65,106, North Wstrn 51,034,241 46,475, South Eastrn 99,276,011 89,893, Southrn 132,492, ,761, Wstrn 86,346,468 77,579, National 816,303, ,905,

66 Tabl 16.2 GMS: Numbr of Itms on Prscription Forms Prscription forms having: No. of Forms % of Total No. of Forms % of Total On Itm 5,141, ,082, Two Itms 2,668, ,638, Thr Itms 1,555, ,527, Four Itms 1,074, ,036, Fiv Itms 849, , Six Itms 743, , Svn Itms 794, , Eight or mor Itms 413, ,

67 Tabl 16.3 DP: Numbr of Itms on Claim Forms Claim forms having: No. of Forms % of Total No. of Forms % of Total On Itm 1,859, ,798, Two Itms 908, , Thr Itms 543, , Four Itms 354, , Fiv Itms 230, , Six Itms 143, , Svn Itms 88, , Eight or mor Itms 133, ,

68 Tabl 16.4 LTI: Numbr of Itms on Claim Forms Claim forms having: No. of Forms % of Total No. of Forms % of Total On Itm 279, , Two Itms 142, , Thr Itms 90, , Four Itms 67, , Fiv Itms 50, , Six Itms 35, , Svn Itms 22, , Eight or mor Itms 25, ,

69 Tabl 17 GMS: Numbr of Dispnsing Doctors* and Prsons for whom thy Dispns Halth Srvic Excutiv No. of Doctors No. of Prsons No. of Doctors No. of Prsons Eastrn Aras Midland 11 4, ,929 Mid-Wstrn 10 2, ,956 North Eastrn 6 1, ,587 North Wstrn 35 16, ,556 South Eastrn 24 8, ,936 Southrn 11 1, ,408 Wstrn 37 17, ,362 National , ,338 * In rural aras whr a Doctor has a cntr of practic 3 mils or mor from th narst rtail pharmacy th Doctor dispnss for prsons srvd from that cntr who opt to b dispnsd to. Th Doctor is paid a dispnsing f for ach such prson. A Doctor s mdicin rquirmnts ar obtaind on a Stock Ordr from a rtail pharmacy - th stock ordrd is approvd in advanc by a HSE Ara. 67

70 Tabl 18 GMS: Advanc Paymnts to Pharmacists Halth Srvic Excutiv Amount Advancd to Pharmacists as at 31st Dcmbr: Eastrn Aras 3,946,702 4,479,652 Midland 917, ,356 Mid-Wstrn 1,204,348 1,299,459 North Eastrn 1,636,093 1,760,065 North Wstrn 1,252,343 1,304,286 South Eastrn 1,972,536 2,054,350 Southrn 2,260,880 2,471,057 Wstrn 1,980,845 2,128,443 National 115,171, ,487,668 68

71 Tabl 19 GMS: Nots on Som of th Mor Commonly Prscribd Products AMOXICILLIN AMOXICILLIN AND ENZYME INHIBITOR Amoxicillin, alon or potntiatd by an inhibitor of bactrial nzyms is a broad spctrum Pnicillin antibiotic indicatd for th tratmnt of a wid rang of infctions. BECLOMETASONE Bclomtason is a potnt stroid having an anti-inflammatory action within th lungs. It is usd mainly by inhalation for th tratmnt of bronchial asthma. SALBUTAMOL Salbutamol is a bta-adrnrgic stimulant usd mainly in th tratmnt of chronic asthma and chronic bronchitis. AMLODIPINE Amlodipin is a calcium - channl blockr (similar to nifdipin) with priphral and coronary vasodilator proprtis. It is givn by mouth in th managmnt of hyprtnsion and of angina pctoris. DICLOFENAC Diclofnac is a Non-Stroidal Antiinflammatory Drug (NSAID) mainly usd to trat pain and inflammation associatd with muscular conditions and rhumatoid arthritis. ACETYLSALICYLIC ACID - ASPIRIN Actylsalicylic Acid - Aspirin has anti-inflammatory and additionally analgsic and antipyrtic (body tmpratur lowring) action. Actylsalicylic Acid - Aspirin also has action against thrombosis or clot formation by inhibition of platlt cll aggrgrtion in th blood. ATORVASTATIN AND PRAVASTATIN Atorvastatin and Pravastatin ar indicatd, in combination with ditary masurs, for lowring cholstrol lvls. ATENOLOL Atnolol is a bta blockr. Mmbrs of this class of drugs ar usd in th tratmnt of hyprtnsion, angina pctoris and cardiac arrythmias. FUROSEMIDE FUROSEMIDE WITH POTASSIUM SPARING DIURETICS Th diurtic Furosmid, alon or in combination with potassium - sparing diurtics, is usd to trat hyprtnsion. OMEPRAZOLE LANSOPRAZOLE Omprazol and Lansoprazol ar proton pump inhibitors which prvnt scrtion of gastric acid. Thy ar usd in th tratmnt of rflux osophagitis and pptic ulcration. 69

72 Tabl 19.1 GMS: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 1 Actylsalicylic Acid - Aspirin (Antithrombotic) 1,929, ,309, Atorvastatin 971, ,471, Lvothyroxin Sodium 586, ,259, Pravastatin 582, ,213, Salbutamol (Inhald) 581, ,257, Atnolol 574, ,055, Amoxicillin and Enzym Inhibitor 521, ,850, Furosmid 519, , Amlodipin 512, ,501, Warfarin 502, ,284, Ramipril 494, ,065, Omprazol 482, ,661, Calcium, Combinations 463, ,786, Bisoprolol 452, ,618, Diclofnac (Systmic) 414, ,930, Diazpam 413, , Paractamol 411, , Lansoprazol 404, ,652, Clinical Nutritional Products 389, ,762, Prdnisolon (Systmic) 387, , Bndrofluazid 386, , Dxtropropoxyphn Combs. xcl. Psycholptics 352, , Amoxicillin 350, ,679, Zopiclon 322, ,289, Nimsulid 321, ,472, Esomprazol 319, ,289, Digoxin 309, , Mtformin 305, , Paractamol Combs. xcl. Psycholptics 288, ,874, Prindopril 287, ,752, Alprazolam 283, ,120, Clopidogrl 282, ,364, Diagnostic Products 275, ,846, Pantoprazol 270, ,156, Bndroflumthazid and Potassium 269, ,

73 Tabl 19.1 GMS: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 36 Alndronic Acid 268, ,508, Lactulos 264, ,503, Bclomtason (Inhald) 262, ,079, Salmtrol and othr drugs for obstructiv airway disass 253, ,927, Salbutamol and othr drugs for obstructiv airway disass 252, ,917, Carbocistin 250, ,311, Furosmid and Potassium-Sparing Agnts 246, ,257, Doxazosin 244, ,585, Isosorbid Mononitrat 242, ,312, Lisinopril 241, ,832, Alginic Acid 241, ,290, Citalopram 233, ,162, Tmazpam 227, , Gliclazid 224, ,303, Zolpidm 223, ,531, Tramadol 221, ,323, Artificial Tars and othr indiffrnt prparations 210, , Diclofnac (Topical) 207, ,241, Vnlafaxin 197, ,553, Folic Acid 197, , Dompridon 188, ,022, Frrous Fumarat 187, , Clarithromycin 178, ,495, Flurazpam 173, ,189, Ibuprofn 158, , Mfnamic Acid 152, , Mtoprolol 151, , Glycryl Trinitrat 149, ,625, Escitalopram 146, ,308, Cfaclor 140, ,158, Allopurinol 138, , Rabprazol 137, ,235, Olanzapin 137, ,133, Toltrodin 136, ,350, Btamthason (Topical) 135, ,

74 Tabl 19.1 GMS: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 71 Simvastatin 135, ,786, Actylsalicylic Acid - Aspirin (Anti-inflammatory) 135, , Flucloxacillin 131, ,164, Risdronic acid 130, ,757, Fluoxtin 127, ,712, Paroxtin 127, ,945, Rispridon 126, ,992, Carbamazpin 125, , Btahistin 125, ,926, Rosuvastatin 124, ,649, Diltiazm 122, ,797, Tiotropium Bromid 121, ,088, Ndls/Syrings/Lancts 121, ,539, Latanoprost 120, ,915, Tamsulosin 118, ,615, Bromazpam 116, , Losartan 114, ,146, Amitriptylin 114, , Captopril 114, ,066, Nifdipin 114, ,478, Prochlorprazin 112, , Sodium Valproat 112, ,225, Ranitidin 109, ,693, Glucosamin 108, ,487, Ispaghula (Psylla Sds) 107, , Lvonorgstrl and Estrogn (Fixd Combination Contracptivs) 106, , Drosprinon and Estrogn 106, , Codin Combs. xcl. Psycholptics 105, , Srtralin 104, ,016, Dothipin 103, , Total 26,789, % 451,229, % 72

75 Tabl 19.2 GMS: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 1 Atorvastatin 36,471, , Clinical Nutritional Products 28,762, , Pravastatin 24,213, , Omprazol 23,661, , Salmtrol and othr drugs for obstructiv airway disass 17,927, , Olanzapin 16,133, , Lansoprazol 15,652, , Clopidogrl 15,364, , Esomprazol 13,289, , Diagnostic Products 10,846, , Amlodipin 10,501, , Alndronic Acid 9,508, , Pantoprazol 9,156, , Ostomy Appliancs 8,701, , Vnlafaxin 8,553, , Donpzil 8,534, , Ramipril 8,065, , Rispridon 7,992, , Doxazosin 7,585, , Salbutamol and othr drugs for obstructiv airway disass 6,917, , Toltrodin 6,350, , Citalopram 6,162, , Tiotropium Bromid 6,088, , Prindopril 5,752, , Nimsulid 5,472, , Budsonid (Inhald) 5,328, , Bclomtason (Inhald) 5,079, , Srtralin 5,016, , Diclofnac (Systmic) 4,930, , Amoxicillin and Enzym Inhibitor 4,850, , Simvastatin 4,786, , Risdronic Acid 4,757, , Bisoprolol 4,618, , Formotrol and othr drugs for obstructiv airway disass 4,414, , Actylsalicylic Acid - Aspirin (Antithrombotic) 4,309, ,929,

76 Tabl 19.2 GMS: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 36 Escitalopram 4,308, , Rabprazol 4,235, , Paroxtin 3,945, , Lamotrigin 3,904, , Lisinopril 3,832, , Gabapntin 3,796, , Fntanyl 3,793, , Calcium, Combinations 3,786, , Fluoxtin 3,712, , Rosuvastatin 3,649, , Tamsulosin 3,615, , Clarithromycin 3,495, , Glucosamin 3,487, , Tramadol 3,323, , Isosorbid Mononitrat 3,312, , Qutiapin 3,303, , Zopiclon 3,289, , Salbutamol (Inhald) 3,257, , Losartan 3,146, , Nicotin (Rplacmnt Thrapy) 3,060, , Atnolol 3,055, , Urinary Appliancs 3,004, , Fluticason (Inhald) 2,982, , Latanoprost 2,915, , Anastrazol 2,751, , Ranitidin 2,693, , Mirtazapin 2,639, , Valsartan 2,448, , Prgabalin 2,319, , Gliclazid 2,303, , Sildnafil 2,219, , Ondanstron 2,194, , Clcoxib (Anti-inflammatory) 2,129, , Orlistat 2,128, , Montlukast 2,122, ,

77 Tabl 19.2 GMS: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 71 Captopril 2,066, , Candsartan 1,952, , Btahistin 1,926, , Insulin (Human), Comb. Intrmdiat/Fast Acting 1,924, , Msalazin 1,908, , Paractamol Combs. xcl. Psycholptics 1,874, , Rosiglitazon 1,860, , Insulin Glargin 1,815, , Diltiazm 1,797, , Lvtiractam 1,728, , Alfuzosin 1,688, , Amoxicillin 1,679, , Glycryl Trinitrat 1,625, , Ciprofloxacin 1,592, , Etoricoxib 1,573, , Trbinafin (Systmic) 1,573, , Oxycodon 1,563, , Othr Osmotically Acting Laxativs 1,562, , Ndls/Syrings/Lancts 1,539, , Zolpidm 1,531, , Tlmisartan 1,518, , Lactulos 1,503, , Nifdipin 1,478, , Svlamr 1,463, , Carbocistin 1,311, , Valsartan and Diurtics 1,293, , Alginic Acid 1,290, , Warfarin 1,284, , Calcipotriol, combinations 1,276, , Lvothyroxin Sodium 1,259, , Total 524,388, % 21,142, % 75

78 Tabl 19.3 DP: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 1 Actylsalicylic Acid - Aspirin (Antithrombotic) 494, ,154, Atorvastatin 424, ,104, Salbutamol (Inhald) 237, ,215, Pravastatin 200, ,864, Lvothyroxin Sodium 197, , Atnolol 175, , Amoxicillin and Enzym Inhibitor 173, ,664, Omprazol 167, ,267, Diclofnac (Systmic) 165, ,006, Bisoprolol 148, ,590, Esomprazol 146, ,505, Amlodipin 144, ,020, Calcium, Combinations 144, ,289, Salmtrol and othr drugs for obstructiv airway disass 144, ,989, Ramipril 125, ,128, Prdnisolon (Systmic) 124, , Lansoprazol 117, ,925, Nimsulid 114, ,900, Vnlafaxin 98, ,626, Clarithromycin 94, ,001, Clinical Nutritional Products 91, ,832, Bndrofluazid 89, , Warfarin 86, , Bclomtason (Inhald) 82, ,573, Alndronic Acid 81, ,900, Clopidogrl 78, ,324, Paractamol Combs. xcl. Psycholptics 78, , Alprazolam 77, , Prindopril 77, ,667, Doxazosin 76, ,449, Zopiclon 76, , Pantoprazol 76, ,755, Rosuvastatin 74, ,232, Amoxicillin 72, , Citalopram 72, ,184,

79 Tabl 19.3 DP: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 36 Diazpam 66, , Lisinopril 64, ,108, Zolpidm 62, , Escitalopram 61, ,018, Bndroflumthazid and Potassium 58, , Formotrol and othr drugs for obstructiv airway disass 57, ,364, Dxtropropoxyphn Combs. xcl. Psycholptics 56, , Folic Acid 54, , Tramadol 53, , Alginic Acid 51, , Simvastatin 51, ,953, Glucosamin 50, ,655, Fluoxtin 48, ,684, Allopurinol 48, , Srtralin 48, ,502, Paroxtin 48, ,601, Carbocistin 47, , Montlukast 47, ,894, Dompridon 47, , Mfnamic Acid 46, , Risdronic Acid 45, ,644, Trbinafin (Systmic) 45, ,729, Furosmid 44, , Cfaclor 44, , Losartan 43, ,239, Fluticason (Nasal) 43, , Estradiol 43, , Valsartan 42, ,052, Diclofnac (Topical) 42, , Mtoprolol 40, , Btamthason (Topical) 39, , Artificial Tars and othr indiffrnt prparations 39, , Drosprinon and Estrogn 38, , Paractamol 38, , Ctirizin 37, ,

80 Tabl 19.3 DP: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 71 Salbutamol and othr drugs for obstructiv airway disass 36, , Momtason 36, , Fluticason (Inhald) 36, ,529, Lithium 35, , Candsartan 35, , Olanzapin 34, ,346, Bromazpam 34, , Msalazin 33, ,437, Ostomy Appliancs 33, ,834, Raloxifn 32, , Flucloxacillin 32, , Amitriptylin 31, , Mthotrxat 31, , Nbivolol 31, , Dsloratadin 30, , Diltiazm 29, , Cyprotron and Estrogn 29, , Rabprazol 28, , Sildnafil 28, , Actylsalicylic Acid - Aspirin (Anti-inflammatory) 28, , Atnolol and othr Diurtics 28, , Lvonorgstrl and Estrogn (Fixd Combination Contracptivs) 27, , Tlmisartan 27, , Fluconazol 27, , Budsonid (Inhald) 27, ,203, Valsartan and Diurtics 27, , Dothipin 26, , Antifungal Combs. (Topical) 26, , Minocyclin 26, , Ranitidin 25, , Total 7,454, % 160,374, % 78

81 Tabl 19.4 DP: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 1 Atorvastatin 17,104, , Salmtrol and othr drugs for obstructiv airway disass 9,989, , Omprazol 9,267, , Pravastatin 8,864, , Esomprazol 6,505, , Follitropin Bta 5,345, , Lansoprazol 4,925, , Vnlafaxin 4,626, , Clopidogrl 4,324, , Clinical Nutritional Products 3,832, , Formotrol and othr drugs for obstructiv airway disass 3,364, , Olanzapin 3,346, , Amlodipin 3,020, , Alndronic Acid 2,900, , Ostomy Appliancs 2,834, , Pantoprazol 2,755, , Trbinafin (Systmic) 2,729, , Srtralin 2,502, , Doxazosin 2,449, , Msalazin 2,437, , Rosuvastatin 2,232, , Citalopram 2,184, , Ramipril 2,128, , Escitalopram 2,018, , Diclofnac (Systmic) 2,006, , Clarithromycin 2,001, , Simvastatin 1,953, , Nimsulid 1,900, , Montlukast 1,894, , Fluoxtin 1,684, , Calcipotriol, combinations 1,681, , Orlistat 1,677, , Prindopril 1,667, , Amoxicillin and Enzym Inhibitor 1,664, , Glucosamin 1,655, ,

82 Tabl 19.4 DP: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 36 Risdronic acid 1,644, , Paroxtin 1,601, , Bisoprolol 1,590, , Bclomtason (Inhald) 1,573, , IUCD with Progstogn 1,555, , Fluticason (Inhald) 1,529, , Calcium Combinations 1,289, , Tiotropium Bromid 1,242, , Losartan 1,239, , Salbutamol (Inhald) 1,215, , Gabapntin 1,209, , Budsonid (Inhald) 1,203, , Actylsalicylic Acid - Aspirin (Antithrombotic) 1,154, , Isotrtinoin 1,120, , Lisinopril 1,108, , Azathioprin 1,058, , Valsartan 1,052, , Toltrodin 1,049, , Rispridon 1,043, , Prgabalin 1,030, , Anastrazol 1,023, , Sibutramin 1,021, , Raloxifn 983, , Atnolol 983, , Sildnafil 977, , Sumatriptan 975, , Tacrolimus (Topical) 934, , Rabprazol 930, , Famciclovir 920, , Eztimib 885, , Clcoxib (Anti-inflammatory) 879, , Tramadol 858, , Zopiclon 850, , Candsartan 820, , Lamotrigin 813, ,

83 Tabl 19.4 DP: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 71 Urinary Appliancs 801, , Etoricoxib 786, , Ondanstron 782, , Qutiapin 775, , Ranitidin 748, , Calcipotriol 713, , Fluticason (Nasal) 708, , Tadalafil 706, , Tlmisartan 703, , Valsartan and Diurtics 679, , Fntanyl 671, , Salbutamol and othr drugs for obstructiv airway disass 646, , Tamsulosin 643, , Zolmitriptan 618, , Ciprofloxacin 593, , Momtason 574, , Fluconazol 564, , Acyclovir (Systmic) 563, , Minocyclin 563, , Mirtazapin 556, , Paractamol Combs. xcl. Psycholptics 527, , Captopril 508, , Valaciclovir 497, , Tinzaparin 481, , Nbivolol 468, , Zolpidm 462, , Candsartan and Diurtics 460, , Diltiazm 457, , Salmtrol 454, , Diagnostic Products 452, , Total 189,031, % 6,132, % 81

84 Tabl 19.5 LTI: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 1 Diagnostic Products 222, ,801, Mtformin 146, , Actylsalicylic Acid - Aspirin (Antithrombotic) 145, , Atorvastatin 100, ,955, Ndls/Syrings/Lancts 99, ,399, Gliclazid 85, , Ramipril 54, , Insulin Aspart 50, ,008, Carbamazpin 44, , Sodium Valproat 43, , Pravastatin 36, ,591, Insulin Glargin 33, ,567, Lamotrigin 33, ,392, Prindopril 31, , Amlodipin 30, , Clinical Nutritional Products 28, ,131, Phnytoin 24, , Insulin (Human), Comb. Intrmdiat/Fast Acting 23, ,215, Atnolol 22, , Lisinopril 21, , Rosiglitazon 19, ,065, Insulin (Human), Intrmdiat Acting 19, , Insulin (Human), Fast Acting 18, , Doxazosin 18, , Bisoprolol 18, , Glimpirid 14, , Insulin Dtmir 14, ,104, Rosuvastatin 11, , Lvtiractam 11, ,165, Lvothyroxin Sodium 10, , Phnobarbiton 10, , Losartan 10, , Clopidogrl 10, , Furosmid 9, , Bndrofluazid 9, ,

85 Tabl 19.5 LTI: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 36 Insulin Lispro 9, , Simvastatin 8, , Folic Acid 8, , Pancratic Enzyms 8, , Valsartan 7, , Glibnclamid 7, , Candsartan 6, , Glucagon 6, , Lvodopa and Dcarboxylas Inhibitor 6, , Mtformin and Rosiglitazon 6, , Injction Swabs 5, , Topiramat 5, , Mtoprolol 5, , Captopril 5, , Nbivolol 5, , Warfarin 5, , Bndroflumthazid and Potassium 5, , Gabapntin 5, , Enalapril 5, , Urinary Appliancs 4, , Actylsalicylic Acid - Aspirin (Anti-inflammatory) 4, , Quinapril 4, , Omprazol 4, , Diltiazm 4, , Sildnafil 4, , Irbsartan 4, , Slgilin 4, , Tlmisartan 4, , Salbutamol (Inhald) 4, , Indapamid 4, , Evning Primros Oil (Naudicll) 4, , Vitamin A and D in Combination 3, , Baclofn 3, , Amoxicillin and Enzym Inhibitor 3, , Lisinopril and Diurtics 3, ,

86 Tabl 19.5 LTI: Th Top 100 Most Commonly Prscribd Products in th Ordr of thir Prscribing Frquncy continud Nam Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total 71 Pramipxol 3, , Isosorbid Mononitrat 3, , Nifdipin 3, , Diazpam 3, , Insulin Infusion Sts 3, , Tadalafil 2, , Clobazam 2, , Prindopril and Diurtics 2, , Valsartan and Diurtics 2, , Lansoprazol 2, , Atnolol and othr Diurtics 2, , Digoxin 2, , Toltrodin 2, , Flucloxacillin 2, , Colistin (Parntral) 2, , Paractamol 2, , Ropinirol 2, , Clonazpam 2, , Furosmid and Potassium-Sparing Agnts 2, , Fnofibrat 2, , Insulin (Human), Long Acting 2, , Eprosartan 2, , Olmsartan 2, , Drssings 2, , Calcium, Combinations 2, , Glycryl Trinitrat 2, , Oxcarbazpin 2, , Sodium Chlorid 2, , Primidon 2, , Esomprazol 2, , Total 1,750, % 51,672, % 84

87 Tabl 19.6 LTI:Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 1 Diagnostic Products 10,801, , Atorvastatin 3,955, , Clinical Nutritional Products 3,131, , Insulin Aspart 3,008, , Insulin Glargin 2,567, , Lamotrigin 2,392, , Pravastatin 1,591, , Ndls/Syrings/Lancts 1,399, , Insulin (Human), Comb. Intrmdiat/Fast Acting 1,215, , Lvtiractam 1,165, , Insulin Dtmir 1,104, , Rosiglitazon 1,065, , Gliclazid 963, , Ramipril 940, , Pancratic Enzyms 888, , Insulin (Human), Fast Acting 836, , Insulin (Human), Intrmdiat Acting 787, , Prindopril 741, , Amlodipin 659, , Doxazosin 642, , Pramipxol 598, , Apomorphin 577, Clopidogrl 559, , Sodium Valproat 548, , Insulin Lispro 524, , Mtformin 505, , Urinary Appliancs 482, , Topiramat 473, , Insulin Infusion Sts 424, , Carbamazpin 402, , Lisinopril 378, , Gabapntin 355, , Simvastatin 347, , Actylsalicylic Acid - Aspirin (Antithrombotic) 340, , Rosuvastatin 336, ,

88 Tabl 19.6 LTI:Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 36 Mtformin and Rosiglitazon 331, , Colistin (Parntral) 323, , Nutritional/Ancillary Dvics 309, , Losartan 300, , Ropinirol 271, , Omprazol 239, , Bisoprolol 199, , Glucagon 198, , Valsartan 195, , Mtamftamin 176, , Candsartan 159, , Glimpirid 158, , Slgilin 146, , Tizanidin 146, , Azithromycin 140, , Atnolol 134, , Sildnafil 133, , Lvodopa and Dcarboxylas Inhibitor 130, , Orlistat 129, , Prgabalin 126, , Dsmoprssin 118, , Toltrodin 117, , Lansoprazol 116, , Captopril 115, , Ostomy Appliancs 111, , Irbsartan 111, , Evning Primros Oil (Naudicll) 109, , Tlmisartan 107, , Insulin (Human), Fast Acting Combinations 96, , Entacapon 91, Enalapril 90, , Salmtrol and othr drugs for obstructiv airway disass 88, , Tadalafil 87, , Esomprazol 86, , Mropnm 82,

89 Tabl 19.6 LTI: Th Top 100 Products of Highst Cost in th Ordr of thir Total Ingrdint Cost continud Nam Ingrdint Cost E % of Schm Total Prscribing Frquncy % of Schm Total 71 Nbivolol 80, , Lvocarnitin 79, Ciprofloxacin 78, , Eztimib 74, , Quinapril 73, , Vitamin A and D in Combination 72, , Prindopril and Diurtics 72, , Phnytoin 71, , Valsartan and Diurtics 69, , Cabrgolin 69, Lisinopril and Diurtics 69, , Drssings 69, , Baclofn 68, , Alimntary Tract/Mtabolism, Various Products 67, Diltiazm 66, , Oxcarbazpin 65, , Rispridon 64, , Cftazidim 64, Rpaglinid 62, , Modafinil 62, Glibnclamid 62, , Flucloxacillin 62, , Vigabatrin 60, Gmfibrozil 59, , I.V. Administration 57, Insulin (Human), Long Acting 56, , Budsonid (Inhald) 55, Eprosartan 53, , Sodium Phnylbutyrat 53, Oxybutynin 52, , Total 54,177, % 1,655, % 87

90 Tabl 20 GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total A Alimntary Tract and Mtabolism 4,599, ,131, A01 Stomatological Prparations 81, , A02 Drugs for Acid Rlatd Disordrs 2,063, ,973, A03 Drugs for Functional Gastrointstinal Disordrs 334, ,027, A04 Anti-mtics and Anti-nausants 17, ,575, A05 Bil and Livr Thrapy 9, , A06 Laxativs 510, ,168, A07 Antidiarrhals, Intstinal Anti-inflammatory/Anti-infctiv Agnts 193, ,184, A08 Anti-obsity Prparations xcl. Dit Products 47, ,038, A09 Digstivs, including Enzyms 8, , A10 Drugs Usd in Diabts 770, ,853, A11 Vitamins 51, , A12 Minral Supplmnts 510, ,083, B Blood and Blood Forming Organs 3,299, ,046, B01 Antithrombotic Agnts 2,765, ,768, B02 Antihmorrhagics 9, , B03 Anti-anmic Prparations 524, ,156, B05 Blood Substituts and Prfusion Solutions

91 Tabl 20 GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total C Cardiovascular Systm 9,377, ,026, C01 Cardiac Thrapy 870, ,137, C02 Antihyprtnsivs 281, ,824, C03 Diurtics 1,735, ,863, C04 Priphral Vasodilators 61, , C05 Vasoprotctivs 94, , C07 Bta Blocking Agnts 1,526, ,118, C08 Calcium Channl Blockrs 889, ,545, C09 Agnts Acting on th Rnin-Angiotnsin Systm 1,995, ,596, C10 Srum Lipid Rducing Agnts 1,922, ,343, D Drmatologicals 1,073, ,448, D01 Antifungals for Drmatological Us 249, ,334, D02 Emollints and Protctivs 116, , D03 Prparations for Tratmnt of Wounds and Ulcrs 1, , D05 Antipsoriatics 47, ,221, D06 Antibiotics and Chmothraputics for Drmatological Us 124, , D07 Corticostroids, Drmatological Prparations 491, ,390, D10 Anti-Acn Prparations 32, , D11 Othr Drmatological Prparations 10, , G Gnito Urinary Systm and Sx Hormons 1,356, ,978, G01 Gyncological Anti-infctivs and Antisptics 23, , G02 Othr Gyncologicals 13, ,042, G03 Sx Hormons and Modulators of th Gnital Systm 791, ,467, G04 Urologicals 527, ,339,

92 Tabl 20 GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total H Systmic Hormonal Prparations, Excl. Sx Hormons and Insulins 1,112, ,098, H01 Pituitary, Hypothalamic Hormons and Analogus 12, , H02 Corticostroids for Systmic Us 457, , H03 Thyroid Thrapy 638, ,368, H04 Pancratic Hormons 4, , H05 Calcium Homostasis , J Anti-infctivs for Systmic Us 2,048, ,650, J01 Antibactrials for Systmic Us 1,974, ,324, J02 Antimycotics for Systmic Us 49, ,238, J04 Antimycobactrials 2, , J05 Antivirals for Systmic Us 20, ,013, J07 Vaccins , L Antinoplastic and Immunomodulating Agnts 181, ,568, L01 Antinoplastic Agnts 13, , L02 Endocrin Thrapy 77, ,790, L04 Immunosupprssiv Agnts 90, ,571,

93 Tabl 20 GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total M Musculo-Skltal Systm 2,451, ,627, M01 Anti-inflammatory and Antirhumatic Products 1,486, ,554, M02 Topical Products for Joint and Muscular Pain 378, ,867, M03 Muscl Rlaxants 31, ,084, M04 Antigout Prparations 138, , M05 Drugs for tratmnt of Bon Disass 415, ,081, M09 Othr Drugs for Disordrs of th Musculo-Skltal Systm , N Nrvous Systm 7,199, ,866, N01 Anasthtics 1, , N02 Analgsics 1,721, ,900, N03 Anti-pilptics 569, ,291, N04 Anti-Parkinson Drugs 194, ,064, N05 Psycholptics 2,911, ,671, N06 Psychoanalptics 1,541, ,329, N07 Othr Nrvous Systm Drugs 260, ,598, P Antiparasitic Products, Inscticids and Rpllnts 63, , P01 Antiprotozoals 38, , P02 Anthlmintics 7, , P03 Ectoparasiticids, incl. Scabicids, Inscticids and Rpllnts 18, ,

94 Tabl 20 GMS: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total R Rspiratory Systm 2,745, ,292, R01 Nasal Prparations 183, ,118, R02 Throat Prparations 8, , R03 Drugs for Obstructiv Airway Disass 2,060, ,823, R05 Cough and Cold Prparations 273, ,404, R06 Antihistamins for Systmic Us 217, ,902, R07 Othr Rspiratory Systm Products 1, , S Snsory Organs 955, ,011, S01 Ophthalmologicals 876, ,722, S02 Otologicals 38, , S03 Ophthalmological and Otological Prparations 40, , V Various 1,097, ,842, V03 Othr Thraputic Products 9, ,590, V04 Diagnostic Products 275, ,846, V06 Clinical Nutritional Products 389, ,762, V07 All Othr Non-Thraputic Products: 422, ,643, Ndls/Syrings/Lancts 121, ,601, Ostomy Rquisits 80, ,704, Urinary Rquisits 41, ,030, Drssings 25, , Miscllanous 153, , Total 37,561, % 664,964, % 92

95 Tabl 20.1 DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total A Alimntary Tract and Mtabolism 1,152, ,135, A01 Stomatological Prparations 22, , A02 Drugs for Acid Rlatd Disordrs 632, ,658, A03 Drugs for Functional Gastrointstinal Disordrs 92, , A04 Anti-mtics and Antinausants 7, , A05 Bil and Livr Thrapy 5, , A06 Laxativs 58, , A07 Antidiarrhals, Intstinal Anti-inflammatory/Anti-infctiv Agnts 88, ,220, A08 Anti-obsity Prparations xcluding Dit Products 41, ,699, A09 Digstivs, including Enzyms 1, , A10 Drugs usd in Diabts 33, , A11 Vitamins 14, , A12 Minral Supplmnts 155, ,374, A14 Anabolic Agnts for Systmic Us A16 Othr Alimntary Tract/Mtabolism Products B Blood and Blood Forming Organs 757, ,705, B01 Antithrombotic Agnts 667, ,410, B02 Antihmorrhagics 3, , B03 Anti-anmic Prparations 86, , B05 Blood Substituts and Prfusion Solutions Not: Th abov costs ar inclusiv of th monthly paymnt of 85 payabl to th Pharmacy by an individual or family. 93

96 Tabl 20.1 DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total C Cardiovascular Systm 2,683, ,916, C01 Cardiac Thrapy 103, ,357, C02 Antihyprtnsivs 81, ,501, C03 Diurtics 271, , C04 Priphral Vasodilators 3, , C05 Vasoprotctivs 37, , C07 Bta Blocking Agnts 485, ,216, C08 Calcium Channl Blockrs 229, ,240, C09 Agnts Acting on th Rnin-Angiotnsin Systm 659, ,227, C10 Srum Lipid Rducing Agnts 813, ,197, D Drmatologicals 447, ,253, D01 Antifungals for Drmatological Us 129, ,568, D02 Emollints and Protctivs 26, , D03 Prparations for Tratmnt of Wounds and Ulcrs , D04 Antipruritics including Antihistamins, Anasthtics, tc , D05 Antipsoriatics 41, ,706, D06 Antibiotics and Chmothraputics for Drmatological Us 38, , D07 Corticostroids Drmatological Prparations 153, , D08 Antisptics and Disinfctants D10 Anti-Acn Prparations 43, ,484, D11 Othr Drmatological Prparations 13, ,

97 Tabl 20.1 DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total G Gnito Urinary Systm and Sx Hormons 523, ,348, G01 Gyncological Anti-infctivs and Antisptics 8, , G02 Othr Gyncologicals 15, ,676, G03 Sx Hormons and Modulators of th Gnital Systm 361, ,719, G04 Urologicals 138, ,905, H Systmic Hormonal Prparations, Excl. Sx Hormons and Insulins 360, ,247, H01 Pituitary, Hypothalamic Hormons and Analogus 7, , H02 Corticostroids for Systmic Us 146, , H03 Thyroid Thrapy 207, , H04 Pancratic Hormons , H05 Calcium Homostasis , J Anti-infctivs for Systmic Us 680, ,725, J01 Antibactrials for Systmic Us 626, ,669, J02 Antimycotics for Systmic Us 33, ,009, J04 Antimycobactrials 1, , J05 Antivirals for Systmic Us 18, ,995, J07 Vaccins , L Antinoplastic and Immunomodulating Agnts 85, ,336, L01 Antinoplastic Agnts 4, , L02 Endocrin Thrapy 22, ,724, L04 Immunosupprssiv Agnts 59, ,508,

98 Tabl 20.1 DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total M Musculo-Skltal Systm 782, ,905, M01 Anti-inflammatory and Antirhumatic Products 516, ,740, M02 Topical Products for Joint and Muscular Pain 75, , M03 Muscl Rlaxants 3, , M04 Antigout Prparations 49, , M05 Drugs for tratmnt of Bon Disass 136, ,991, M09 Othr Drugs for Disordrs of th Musculo-Skltal Systm , N Nrvous Systm 1,592, ,500, N01 Anasthtics , N02 Analgsics 352, ,003, N03 Anti-pilptics 95, ,616, N04 Anti-Parkinson Drugs 14, , N05 Psycholptics 583, ,409, N06 Psychoanalptics 513, ,332, N07 Othr Nrvous Systm Drugs 31, , P Antiparasitic Products, Inscticids and Rpllnts 24, , P01 Antiprotozoals 22, , P02 Anthlmintics 1, , P03 Ectoparasiticids, incl. Scabicids, Inscticids and Rpllnts 1, ,

99 Tabl 20.1 DP: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total R Rspiratory Systm 1,086, ,206, R01 Nasal Prparations 131, ,751, R02 Throat Prparations 2, , R03 Drugs for Obstructiv Airway Disass 795, ,080, R05 Cough and Cold Prparations 53, , R06 Antihistamins for Systmic Us 104, ,072, R07 Othr Rspiratory Systm Products , S Snsory Organs 214, ,883, S01 Ophthalmologicals 179, ,768, S02 Otologicals 14, , S03 Ophthalmological and Otological Prparations 20, , V Various 186, ,676, V03 Othr Thraputic Products 1, , V04 Diagnostic Products 12, , V06 Clinical Nutritional Products 91, ,832, V07 All Othr Non-Thraputic Products: 81, ,136, Ostomy Appliancs 33, ,842, Ndls/Syrings/Lancts 16, , Drssings 9, , Urinary Appliancs 7, , Miscllanous 14, , Total 10,581, % 233,161, % 97

100 Tabl 20.2 LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total A Alimntary Tract and Mtabolism 512, ,730, A01 Stomatological Prparations , A02 Drugs for Acid Rlatd Disordrs 12, , A03 Drugs for Functional Gastrointstinal Disordrs 1, , A04 Anti-mtics and Antinausants , A05 Bil and Livr Thrapy , A06 Laxativs 6, , A07 Antidiarrhals, Intstinal Anti-inflammatory/Anti-infctiv Agnts , A08 Anti-obsity Prparations xcluding Dit Products 2, , A09 Digstivs, including Enzyms 8, , A10 Drugs usd in Diabts 458, ,411, A11 Vitamins 14, , A12 Minral Supplmnts 3, , A13 Tonics A14 Anabolic Agnts for Systmic Us A16 Othr Alimntary Tract and Mtabolism Products 1, , B Blood and Blood Forming Organs 173, , B01 Antithrombotic Agnts 161, , B02 Antihmorrhagics , B03 Anti-anmic Prparations 11, , B05 Blood Substituts and Prfusion Solutions ,

101 Tabl 20.2 LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total C Cardiovascular Systm 508, ,512, C01 Cardiac Thrapy 10, , C02 Antihyprtnsivs 19, , C03 Diurtics 34, , C04 Priphral Vasodilators , C05 Vasoprotctivs , C07 Bta Blocking Agnts 59, , C08 Calcium Channl Blockrs 42, , C09 Agnts Acting on th Rnin-Angiotnsin Systm 175, ,696, C10 Srum Lipid Rducing Agnts 166, ,510, D Drmatologicals 7, , D01 Antifungals for Drmatological Us 2, , D02 Emollints and Protctivs 1, , D03 Prparations for Tratmnt of Wounds and Ulcrs D04 Antipruritics including Antihistamins, Anasthtics, tc , D05 Antipsoriatics , D06 Antibiotics and Chmothraputics for Drmatological Us , D07 Corticostroids, Drmatological Prparations 1, , D08 Antisptics and Disinfctants , D10 Anti-Acn Prparations , D11 Othr Drmatological Prparations , G Gnito Urinary Systm and Sx Hormons 17, , G01 Gyncological Anti-infctivs and Antisptics , G02 Othr Gyncologicals , G03 Sx Hormons and Modulators of th Gnital Systm 2, , G04 Urologicals 15, ,

102 Tabl 20.2 LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total H Systmic Hormonal Prparations, Excl. Sx 23, , Hormons and Insulins H01 Pituitary, Hypothalamic Hormons and Analogus 1, , H02 Corticostroids for Systmic Us 3, , H03 Thyroid Thrapy 11, , H04 Pancratic Hormons 6, , H05 Calcium Homostasis , J Anti-infctivs for Systmic Us 20, ,070, J01 Antibactrials for Systmic Us 19, , J02 Antimycotics for Systmic Us , J04 Antimycobactrials , J05 Antivirals for Systmic Us , J06 Immun Sra and Immunoglobulins , J07 Vaccins L Antinoplastic and Immunomodulating Agnts 1, , L01 Antinoplastic Agnts , L02 Endocrin Thrapy , L04 Immunosupprssiv Agnts ,

103 Tabl 20.2 LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total M Musculo-Skltal Systm 15, , M01 Anti-inflammatory and Antirhumatic Products 5, , M02 Topical Products for Joint and Muscular Pain , M03 Muscl Rlaxants 5, , M04 Antigout Prparations 1, , M05 Drugs for tratmnt of Bon Disass 1, , M09 Othr Drugs for Disordrs of th Musculo-Skltal Systm , N Nrvous Systm 252, ,719, N01 Anasthtics , N02 Analgsics 11, , N03 Anti-pilptics 189, ,805, N04 Anti-Parkinson Drugs 22, ,934, N05 Psycholptics 16, , N06 Psychoanalptics 12, , N07 Othr Nrvous Systm Drugs 1, , P Antiparasitic Products, Inscticids and Rpllnts , P01 Antiprotozoals , P02 Anthlmintics P03 Ectoparasiticids, incl. Scabicids, Inscticids and Rpllnts

104 Tabl 20.2 LTI: Distribution of Mdicins and Appliancs by Anatomical Thraputic Chmical Classification continud ATC Class Product Catgory Prscribing Frquncy % of Schm Total Ingrdint Cost E % of Schm Total R Rspiratory Systm 13, , R01 Nasal Prparations 1, , R02 Throat Prparations R03 Drugs for Obstructiv Airway Disass 9, , R05 Cough and Cold Prparations , R06 Antihistamins for Systmic Us 1, , S Snsory Organs 5, , S01 Ophthalmologicals 5, , S02 Otologicals S03 Ophthalmological and Otological Prparations V Various 376, ,993, V03 Othr Thraputic Products , V04 Diagnostic Products 222, ,801, V06 Clinical Nutritional Products 28, ,131, V07 All Othr Non-Thraputic Products: 125, ,027, Ndls/Syrings/Lancts/Swabs 108, ,843, Drssings 2, , Urinary Appliancs 4, , Nutritional/Ancillary Dvics 2, , Ostomy Appliancs 1, , Miscllanous 6, , Total 1,929, % 57,887, % 102

105 Tabl 21 GMS: Avrag Paymnt to Doctors in Panl Rangs Halth Srvic Excutiv Avrag Panl Rangs in ,000 1,001-1,500 1,501-2,000 2,001 and Ovr East Coast Ara 24,132 (22) 83,213 (37) 159,768 (49) 259,741 (61) 381,048 (3) - - South Wstrn Ara 22,295 (28) 57,500 (34) 129,070 (46) 227,766 (81) 316,294 (42) 392,451 (4) 459,056 (3) Northrn Ara 26,625 (13) 69,073 (22) 133,552 (42) 225,660 (71) 337,143 (28) 416,438 (10) 569,490 (1) Midland 72,512 (6) 61,931 (7) 140,738 (22) 270,116 (47) 340,191 (20) - - Mid-Wstrn 12,363 (10) 77,161 (27) 144,921 (33) 233,721 (75) 355,889 (18) 338,187 (4) - North Eastrn 35,133 (6) 57,615 (18) 110,493 (30) 223,455 (81) 321,353 (19) 426,855 (1) - North Wstrn 33,874 (7) 62,494 (10) 153,336 (21) 238,801 (47) 348,807 (36) 455,707 (7) - South Eastrn 9,157 (7) 70,033 (19) 152,170 (39) 252,908 (112) 353,367 (28) 491,889 (5) - Southrn 25,508 (30) 66,723 (45) 144,998 (79) 249,327 (136) 353,422 (30) 549,759 (2) 434,053 (1) Wstrn 22,441 (13) 64,151 (29) 125,019 (55) 263,759 (101) 366,360 (28) 499,295 (1) - National ,556 (142) 68,250 (248) 139,553 (416) 244,750 (812) 343,234 (252) 434,176 (34) 476,142 (5) National ,911 (159) 57,689 (228) 110,548 (388) 185,932 (783) 267,713 (262) 334,930 (32) 357,897 (5) Not: (i) Doctors not in th GMS Schm for th full yar hav bn xcludd from th abov tabl. (ii) Th numbr of Doctors in ach rang is shown in brackts. (iii) Th avrag paymnt to Doctors in ach panl rang is th gross paymnts dividd by th numbr of Doctors in that rang. (iv) Doctors paymnt is xclusiv of suprannuation paid to rtird DMOs. 103

106 Tabl 21.1 GMS: Numbr of Doctors in Paymnt Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 30,000 30,001-60,000 60,001-90,000 90, , , , , , , , , , , , , , , , ,001 and Ovr East Coast Ara South Wstrn Ara Northrn Ara 19 (20) 13 (24) 23 (26) 17 (14) 14 (21) 15 (15) 11 (17) 13 (14) 10 (9) 31 (7) 5 (1) 1 (-) 29 (27) 20 (26) 18 (25) 15 (29) 23 (26) 23 (25) 13 (23) 19 (14) 19 (15) 41 (21) 15 (2) 3 (1) 10 (11) 13 (20) 19 (14) 15 (32) 17 (15) 13 (27) 16 (19) 22 (11) 13 (12) 32 (14) 11 (5) 6 (2) Midland 6 (5) 4 (7) 4 (7) 4 (7) 4 (10) 10 (13) 10 (16) 8 (17) 10 (8) 32 (14) 10 (-) - (-) Mid- Wstrn North Eastrn North Wstrn South Eastrn 15 (7) 8 (13) 9 (16) 12 (20) 17 (28) 21 (16) 14 (17) 13 (17) 18 (10) 30 (13) 8 (1) 2 (-) 6 (8) 16 (14) 16 (11) 6 (18) 15 (15) 8 (24) 16 (19) 24 (20) 14 (8) 27 (11) 6 (-) 1 (-) 6 (6) 5 (6) 6 (12) 8 (8) 8 (7) 8 (14) 9 (13) 10 (19) 13 (11) 35 (21) 15 (3) 5 (-) 8 (5) 9 (15) 8 (11) 12 (20) 14 (29) 19 (28) 19 (29) 21 (24) 28 (20) 51 (20) 16 (2) 5 (-) Southrn 25 (34) 20 (27) 32 (33) 25 (38) 23 (41) 34 (32) 30 (39) 24 (30) 36 (19) 53 (21) 15 (4) 6 (-) Wstrn 15 (14) 18 (28) 21 (23) 18 (20) 16 (19) 8 (24) 22 (25) 23 (19) 18 (20) 43 (28) 18 (2) 7 (-) National 139 (137) 126 (180) 156 (178) 132 (206) 151 (211) 159 (218) 160 (217) 177 (185) 179 (132) 375 (170) 119 (20) 36 (3) Not: (i) Doctors not in th GMS Schm for th full yar hav bn xcludd from th abov tabl. (ii) Abov tabl rlats to th paymnts listd in Tabl 3 and includs th arrars paid rsulting from th implmntation of th 2005 LRC Agrmnt. (iii) Doctors paymnt is xclusiv of suprannuation paid to rtird DMOs. 104

107 Tabl 22 GMS: Numbr of Pharmacists in Dispnsing F Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 20,000 20,001-40,000 40,001-60,000 60,001-80,000 80, , , , , , , , , , , , , , , , ,001 and ovr East Coast Ara South Wstrn Ara Northrn Ara 5 (6) 13 (6) 17 (9) 19 (13) 10 (12) 11 (15) 9 (7) 3 (7) 6 (5) 4 (7) 2 (2) 3 (3) 2 (6) 17 (17) 22 (16) 16 (17) 26 (24) 20 (15) 11 (14) 14 (14) 8 (10) 8 (7) 9 (7) 5 (9) 4 (5) 3 (5) 12 (9) 9 (8) 19 (16) 21 (17) 21 (16) 19 (14) 5 (17) 9 (7) 3 (7) 7 (6) 1 (6) 5 (3) 10 (10) Midland 2 (1) 5 (5) 4 (3) 4 (3) 3 (4) 8 (14) 10 (10) 10 (7) 6 (5) 3 (4) 3 (1) 3 (5) 4 (4) Mid- Wstrn North Eastrn North Wstrn South Eastrn 2 (2) 12 (11) 13 (11) 15 (13) 18 (12) 10 (17) 19 (10) 9 (7) 9 (8) 6 (4) 2 (3) 1 (1) 5 (3) 2 (4) 8 (7) 7 (6) 15 (10) 14 (17) 15 (10) 12 (13) 10 (13) 4 (6) 4 (3) 5 (3) - (2) 5 (3) 4 (3) 2 (4) 6 (4) 11 (9) 9 (11) 7 (7) 5 (6) 6 (4) 3 (4) 5 (4) 2 (4) 3 (5) 8 (4) 6 (6) 5 (4) 7 (7) 16 (10) 13 (13) 16 (15) 19 (16) 8 (13) 12 (9) 8 (9) 4 (4) 4 (4) 13 (8) Southrn 7 (9) 13 (8) 18 (23) 34 (32) 21 (20) 26 (22) 21 (17) 15 (14) 11 (8) 13 (8) 4 (7) 1 (5) 11 (7) Wstrn 5 (2) 11 (10) 9 (10) 14 (18) 20 (16) 12 (11) 12 (13) 7 (7) 10 (6) 9 (7) 6 (9) 4 (3) 7 (5) National 62 (59) 100 (79) 116 (106) 175 (149) 149 (136) 135 (139) 126 (123) 85 (89) 72 (65) 68 (59) 34 (48) 28 (36) 68 (55) Not: Pharmacis that lft or ntrd th Schm during th yar ar not includd in th abov tabl. 105

108 Tabl 23 DP: Numbr of Eligibl Prsons and Numbr and Cost of Pharmacists Claims Halth Srvic Excutiv *Numbr of Prsons Covrd Uniqu Numbr of Claimants Numbr of Itms Cost pr Itm E Gross Cost E Nt Cost pr Claimant E Paid by HSE E Eastrn Aras 508, ,601 4,135, ,770, ,457,911 Midland 91,933 32, , ,603, ,105,133 Mid-Wstrn 153,566 48, , ,418, ,726,149 North Eastrn 130,931 49, , ,293, ,564,876 North Wstrn 64,325 19, , ,448, ,422,499 South Eastrn 151,560 54,692 1,122, ,080, ,996,493 Southrn 248,023 89,438 1,622, ,132, ,371,322 Wstrn 130,119 45, , ,274, ,841,555 National ,478, ,052 10,581, ,021, ,485,938 National ,469, ,664 9,932, ,144, ,958,892 Not: *As at 31st Dcmbr

109 Tabl 23.1 DP: Numbr of Pharmacists in Dispnsing F/Mark-Up Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 20,000 20,001-40,000 40,001-60,000 60,001-80,000 80, , , , , , , , , , , , , , , , ,001 and ovr East Coast Ara South Wstrn Ara Northrn Ara 9 (6) 12 (18) 26 (21) 12 (17) 20 (15) 8 (9) 7 (4) 4 (1) 1 (1) - (3) 5 (2) - (1) 1 (-) 21 (20) 32 (27) 23 (31) 25 (22) 12 (16) 11 (10) 6 (7) 12 (9) 10 (9) 3 (3) 2 (1) - 7 (6) 17 (14) 25 (25) 17 (20) 23 (22) 9 (9) 20 (17) 10 (6) 3 (7) 2 (6) 6 (6) 5 (-) 2 (3) 4 (3) Midland 4 (6) 13 (12) 13 (15) 10 (13) 8 (6) 7 (8) 5 (4) 2 (-) - (1) 2 (1) 1 (-) - - Mid- Wstrn North Eastrn North Wstrn South Eastrn 14 (12) 29 (26) 23 (27) 25 (14) 14 (7) 5 (8) 4 (3) 3 (1) 3 (3) - 1 (1) (10) 29 (30) 20 (20) 15 (11) 6 (7) 10 (7) 3 (6) 5 (4) 3 (2) 1 (1) 1 (-) - 1 (-) 15 (20) 22 (18) 15 (14) 8 (8) 4 (3) 2 (3) 2 (-) - (1) - 1 (1) (11) 27 (28) 31 (29) 20 (24) 14 (8) 11 (8) 8 (7) 2 (1) (1) - Southrn 14 (19) 53 (58) 42 (35) 39 (30) 14 (10) 13 (10) 8 (7) 3 (4) 3 (1) 2 (4) 2 (1) 2 (1) 1 (1) Wstrn 28 (26) 30 (35) 23 (21) 16 (16) 10 (10) 10 (5) 5 (3) 2 (1) 1 (1) 1 (-) National 145(144) 272 (277) 233 (233) 193 (177) 111 (91) 97 (85) 58 (47) 36 (29) 23 (24) 16 (19) 17 (5) 6 (6) 14 (10) Not: (i) Pharmacis that ntrd or lft th Schm during th yar ar not includd in th abov tabl. (ii) Th abov figurs do not includ th monthly co-paymnt of 85 payabl to th Pharmacy by an individual or family. 107

110 Tabl 24 LTI: Numbr of Eligibl Prsons and Numbr and Cost of Pharmacists Claims Halth Srvic Excutiv *Numbr of Eligibl Prsons Uniqu Numbr of Claimants Numbr of Itms Cost pr Itm E Total Cost E Cost pr Claimant E Eastrn Aras 52,044 22, , ,061,181 2, Midland 5,410 3, , ,940,055 1, Mid-Wstrn 7,001 4, , ,557,278 1, North Eastrn 7,888 4, , ,928,228 1, North Wstrn 5,492 3, , ,534,647 1, South Eastrn 9,936 5, , ,267,489 1, Southrn 6,852 6, , ,597,622 1, Wstrn 4,657 3, , ,660,143 1, National ,280 53,006 1,929, ,546,643 1, National ,504 50,526 1,674, ,551,069 1, Not: *As at 31st Dcmbr

111 Tabl 24.1 LTI: Numbr of Pharmacists in Dispnsing F/Mark-Up Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 10,000 10,001-20,000 20,001-30,000 30,001-40,000 40,001-50,000 50,001-60,000 60,001 and ovr East Coast Ara 12 (12) 25 (26) 18 (21) 13 (10) 14 (14) 7 (4) 16 (11) South Wstrn Ara 22 (21) 39 (45) 24 (26) 23 (22) 20 (18) 11 (9) 24 (19) Northrn Ara 21 (17) 22 (27) 28 (31) 21 (24) 21 (15) 12 (11) 16 (11) Midland 11 (11) 13 (17) 12 (17) 14 (11) 7 (7) 4 (1) 4 (2) Mid-Wstrn 35 (37) 47 (37) 23 (15) 7 (8) 4 (1) 1 (3) 4 (1) North Eastrn 18 (23) 27 (34) 18 (13) 20 (11) 6 (10) 5 (3) 7 (3) North Wstrn 12 (17) 15 (17) 17 (17) 13 (7) 3 (6) 6 (-) 2 (2) South Eastrn 24 (25) 36 (35) 33 (33) 19 (11) 8 (9) 6 (-) 4 (4) Southrn 51 (60) 71 (65) 37 (31) 19 (14) 9 (7) 5 (2) 2 (1) Wstrn 44 (41) 39 (45) 21 (17) 15 (11) 3 (1) 1 (1) 2 (1) National 250 (264) 334 (348) 231 (221) 164 (129) 95 (88) 58 (34) 81 (55) Not: Pharmacis that ntrd or lft th Schm during th yar ar not includd in th abov tabl. 109

112 Tabl 25 EEA: Numbr and Cost of Pharmacists Claims Halth Srvic Excutiv Numbr of Itms Cost pr Itm Total Cost East Coast Ara 3, ,303 South Wstrn Ara 4, ,307 Northrn Ara 2, ,192 Midland 3, ,502 Mid-Wstrn 8, ,670 North Eastrn 4, ,683 North Wstrn 11, ,913 South Eastrn 9, ,992 Southrn 19, ,790 Wstrn 14, ,257 National , ,879,609 National , ,791,

113 Tabl 26 DTS: Numbr of Tratmnts Halth Srvic Excutiv Abov th Lin Blow th Lin Total Eastrn Aras 264,154 26, ,248 Midland 51,924 6,728 58,652 Mid-Wstrn 82,458 10,833 93,291 North Eastrn 77,217 9,795 87,012 North Wstrn 75,373 5,329 80,702 South Eastrn 115,584 14, ,406 Southrn 178,104 17, ,549 Wstrn 118,122 15, ,542 National , ,466 1,069,402 National , ,850 1,073,

114 Tabl 26.1 DTS: Numbr of Dntists in Paymnt Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 10,000 10,001-20,000 20,001-30,000 30,001-40,000 40,001-50,000 50,001-60,000 60,001-70,000 70,001-80,000 80,001-90,000 90, , , , , , ,001 and ovr Eastrn Aras 43 (34) 39 (43) 40 (32) 28 (28) 17 (28) 18 (21) 15 (19) 21 (16) 14 (12) 11 (8) 10 (9) 4 (4) 17 (12) Midland 4 (5) 4 (3) 4 (4) 1 (4) 6 (4) 4 (3) 5 (5) 4 (6) 2 (5) 2 (2) 4 (2) 3 (1) 3 (1) Mid- Wstrn 5 (4) 7 (9) 8 (10) 10 (8) 11 (11) 12 (5) 4 (6) 4 (2) 2 (-) 2 (2) 1 (2) 1 (3) 9 (9) North Eastrn 13 (18) 4 (9) 8 (12) 10 (6) 9 (4) 8 (6) 5 (3) 8 (8) 3 (6) 6 (7) 4 (2) - (1) 3 (1) North Wstrn 3 (-) - (1) 3 (3) 3 (4) 3 (8) 4 (1) 3 (1) 2 (4) 5 (4) 2 (-) 2 (1) 2 (4) 9 (6) South Eastrn 9 (6) 5 (6) 3 (11) 14 (9) 11 (14) 12 (10) 10 (8) 5 (8) 7 (8) 8 (3) 3 (2) 2 (4) 8 (5) Southrn 19 (23) 27 (33) 37 (28) 26 (28) 25 (20) 10 (18) 21 (17) 14 (10) 3 (6) 11 (3) 8 (3) - (4) 9 (7) Wstrn 18 (25) 5 (3) 8 (10) 11 (7) 10 (11) 3 (8) 8 (8) 9 (7) 10 (9) 7 (3) 3 (4) 3 (4) 14 (12) National 114 (115) 91 (107) 111 (110) 103 (94) 92 (100) 71 (72) 71 (67) 67 (61) 46 (50) 49 (28) 35 (25) 15 (25) 72 (53) Not: Dntists who ntrd or lft th Schm during th yar ar not includd in th abov tabl. 112

115 Tabl 27 HSE-COS: Numbr and Cost of Claims Halth Srvic Excutiv Numbr of Tratmnts Cost of Claims E Eastrn Aras 123,221 4,771,686 Midland 26,141 1,075,739 Mid-Wstrn 37,518 1,409,210 North Eastrn 33,420 1,225,170 North Wstrn 35,392 1,283,706 South Eastrn 59,379 2,198,744 Southrn 64,070 2,438,926 Wstrn 38,392 1,430,759 National ,533 15,833,940 National ,184 16,273,620 Not: Optomtrists/Ophthalmologists wr also paid in rspct of: Halth (Amndmnt) Act ,541; Optical srvics for Tnagrs 83,210; Optical srvics for Childrn 1,038,

116 Tabl 27.1 HSE-COS: Numbr of Optomtrists/Ophthalmologists in Paymnt Rangs 2005 (2004 in brackts) Halth Srvic Excutiv Up to 10,000 10,001-20,000 20,001-30,000 30,001-40,000 40,001-50,000 50,001-60,000 60,001-70,000 70,001-80,000 80,001-90,000 90, , , , , , ,001 and ovr Eastrn Aras 48 (49) 34 (35) 11 (12) 13 (14) 8 (8) 5 (4) 1 (1) 1 (1) 1 (1) - - (1) 2 (-) 1 (1) Midland 12 (13) 6 (7) 3 (3) 6 (5) 3 (3) 1 (1) - - (1) (1) - (-) 1 (-) Mid- Wstrn North Eastrn North Wstrn South Eastrn 13 (9) 6 (6) 3 (3) 1 (4) 2 (2) (-) - (1) (2) 17 (14) 10 (6) 3 (7) 2 (3) 3 (2) 1 (1) 1 (1) (3) 3 (2) 4 (5) 2 (2) 2 (3) 1 (1) 2 (2) - - (1) 1 (-) (11) 6 (7) 4 (3) 3 (1) 5 (5) 6 (4) 2 (1) 1 (1) 1 (2) 1 (2) 1 (-) - (1) - Southrn 16 (16) 17 (9) 10 (13) 7 (7) 5 (2) 1 (5) 1 (-) - - (1) (-) 1 (1) Wstrn 18 (15) 9 (8) 8 (5) 4 (8) 1 (-) - 1 (1) - - (1) 1 (-) - - (1) - National 145 (130) 91 (80) 46 (51) 38 (44) 29 (25) 15 (16) 8 (6) 2 (3) 3 (6) 3 (3) 1 (2) 3 (2) 5 (4) Not: Optomtrists/Ophthalmologists who ntrd or lft th Schm during th yar ar not includd in th abov tabl. 114

117 Tabl 28 GMS: Invstmnt in Gnral Practic Dvlopmnt Halth Srvic Excutiv 2005 E 2004 E Eastrn Aras 1,999,647 4,914,331 Midland 262, ,723 Mid-Wstrn 572,431 1,507,143 North Eastrn 409, ,410 North Wstrn 2,683,123 2,390,467 South Eastrn 1,895,603 2,074,580 Southrn 2,851,906 1,848,155 Wstrn 1,258,308 1,681,815 National 11,932,845 15,791,624 Not: Th abov ar paymnts from th Indicativ Drug Targt Savings. 115

118 116

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