On 1st October 2015, the HSE made the very welcome decision to reimburse the drug Fampyra or Fampridine in cases where people with MS ‘satisfy a responder protocol’ and have been prescribed the drug by a healthcare professional.
Since then, MS Ireland has received several enquiries from people with MS who are unclear on what to do next in order to have the cost of Fampyra reimbursed. We have now been able to establish that the process is as follows:
- Your first step should be to speak to your neurologist. Neurologists are the only medical professionals who are authorised to prescribe the drug.
- The criteria for prescribing Fampyra are very strict and you have to be able to show a 20% improvement in a timed walking test. Re-approval then has to be sought every 6 months.
- Your neurologist has to complete an application on the Primary Care Reimbursement Service system to obtain funding from the HSE. Approval is instantaneous if you satisfy the criteria. You will then be registered with the PCRS as a ‘responder’.
- Your Long Time Illness number will then flag up that you have been approved for funding when you next bring your prescription for Fampyra to your pharmacist.
There is no system in place for retrospective reimbursement, so you will not be able to reclaim any payments you made for Fampyra prior to 1st October 2015.
MS Ireland’s campaign handbook, Access to Medicines, provides further advice and guidance on how to engage with the healthcare system if you are having trouble accessing a particular medication that you have been prescribed.