Tuesday 18 December 2018

GPs urged to fight for pain relief patches

Only a fraction of doctors have used appeal process to make a case for prescribing Versatis

Stock picture
Stock picture

Alan O'Keeffe

Doctors are being urged to get State-funded painkiller patches restored to patients.

Only a fraction of GPs whose patients were blocked from continuing to use Versatis patches applied to the HSE to approve their continued use for individual patients.

Barbara Donehy, a founding member of the group Patch Us Back Up, said chronic pain after a car accident made her life "a living hell".

She said the patches, which contain a local anaesthetic, made life bearable for her and thousands of other chronic pain sufferers. The patches allowed her to do normal things like driving her children to school, she said.

Last September, health authorities ruled Versatis would be severely restricted on medical cards and the State drug payment scheme for medical problems other than shingles.

The clampdown followed deepening concern about the widespread prescribing of the patches for medical conditions which they were not licensed to treat.

There were 25,000 users of the patches in Ireland - more than in all of Britain. The curtailment saw more than 20,000 patients who do not have shingles deemed ineligible for their continued use.

Doctors made applications for their continued use for less than a quarter of those patients. And only 10pc of those applications were approved.

Only one in 10 of rejected applications were appealed. Around 60pc of those appeals have been successful.

Ms Donehy (45), from Rathdowney, Co Laois, called on all GPs to make submissions to the HSE Medicines Management Programme for the continued use of the patches by their patients.

The patches enable chronic pain sufferers to move around better and to sleep better.

"The majority of people have told me that their GPs told them there was no point in appealing. But doctors should be fighting for all their patients who get benefits from the patches. GPs need to take action and send in all paperwork to the HSE," she said.

She said taking oral opiates for pain relief could prevent her from driving, thanks to new drug-driving laws, so she really appreciated the patches.

"Joe Duffy has been brilliant on Liveline for highlighting all this," she said.

Health Minister Simon Harris acknowledged the large numbers of pain sufferers who called the Liveline programme to express their anguish at losing funding for the patches.

The minister told the Dail last week it was "a clinical decision" to restrict usage of the patches. The minister called on the HSE to use "absolute maximum compassion" in dealing with applications for continued use of the patches.

Professor Michael Barry, clinical director of the National Centre for Pharmacoeconomics, said approval for the use of the patches for non-shingles conditions would continue to be withheld unless doctors can show the patches were necessary.

Cases of neuropathic pain were suitable for treatment with the patches and the success rate of appeals has risen to 60pc, he said. But doctors must show they were not using the patches as "first line therapy" for conditions for which they were not licensed. "We will say yes where possible… But we have not received a huge amount of appeals," he said.

A source in the health sector told the Sunday Independent that there had been "a gross misuse" of the patches.

The source said many people who phoned Liveline had "real neuropathic pain issues" and their doctors should be taking action on their behalf by submitting paperwork to get approval for the patches.

"It's certainly not up to politicians to make clinical decisions about which medicines should be approved no more than there should be politicians performing surgery," he said.

Sunday Independent

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