Friday 18 January 2019

Living with pain

Margaret Roddy talks to local people affected by the Government's decision to remove pain relief patches from The Drugs Payment and Medical Card Schemes.

Mandy Cumiskey
Mandy Cumiskey

A number of local people suffering from chronic pain are among those affected by the decision to remove pain relief patches from the Drugs Payment and Medical Card Schemes.

Around 25,000 people nationally were affected when the patches which contain a local anaesthetic were removed from the schemes in December following a review by the HSE last year. The patches are now being approved only for patients with post- shingles symptoms although individual patients who had got prescriptions from their doctors for other conditions may make an appeal.

Blackrock resident Mandy Cumiskey has joined the Patch Us Back Up Facebook group which is campaigning to have the decision reversed.

The 37 year old mother of one says 'I'm one of the lucky people as I don't have to use the patches every day but I have serious health issues and am living with chronic pain.'

'I have arthritis in my hands, feet and hips and I also have fibromyalgia which causes pain everywhere as well as daily migranes with complex headache syndrome.'

Mandy also suffers from sciatic pain which is caused by the arthritis in her hips.

'When it flares up, my back goes into spasm and I can barely stand up straight.'

She was prescribed the Versatis pain relief patches by the pain management team which she attends at St Vincent's Hospital.

'The patches are a Godsend when I need them,' she says. 'I don't need to use them all the time but when my back goes into spasm, I need them.'

Due to her complex health issues, Mandy is already on a lot of medication and is upset at the list of medicines which the HSE suggests patients take instead of using the Versatis patches.

'There are very few side effects with the Versatis patches apart from skin allergies, while the list of side effects of the alternatives being suggested are horrific,' she says. 'They are recommending people take medicines which have been developed as anti-depressants and anti-seizure medicines and are not licenced for pain relief.'

Mandy says that as a result of taking these medicines she put on weight which causes her arthritis to worsen and she has been told that she would be better off if she could loose weight. 'It's a Catch 22 as it's because of these medications that I am putting on weight.'

She uses the Versatis patches to cope with 'break through' pain and says she doesn't know how she could cope without them.

'Stress makes the pain worse so worrying about what is going to help doesn't help.'

As the mother of a six year old, she says she tries to do 'all the Mammy things but sometimes I can't and it's bad when a 37 year old has to ask her pensioner Mum to come and help with the housework but if I have the pain relief patches I can do it.'

Mandy says she is 'very, very annoyed' at the way in which the Government and HSE have handled the situation.

'The patches are very expensive and there's no way people could afford to buy them, especially on top of other medication.'

Despite all her problems, she insists that she is one of the lucky ones as she can still manage to live a full life.

'It's people with life altering pain who cannot get out of bed and people with cancer who really need to use these patches every day.'

She accuses the HSE of fobbing patients off by saying GPs can appeal individual cases. 'A lot of people in the Facebook group are having trouble getting their GPs to make the appeals as it takes a lot of time to fill in the form and, on top of that, the appeal is only for three to six months if successful. GPs are stretched enough as it is without having to do this extra work.'

Linda Norton Jackson from Ashbrook also lives with chronic pain. She was diagnosed with Fibromyalgia two years ago and had a hip replacement last summer. She has a liver condition and diabetes which means that she can't take opioid analgesics to ease her pain.

'I get great relief with the patches - nothing else hits the pain as opiates and other painkillers don't work for me.'

Even with the patches, she can experience a bad day when the pain is so great that she can't move around and has to stay in bed.

'My GP is very good and he lodged an appeal so I have got approval to get a box of patches this month but I don't know how long the appeal is for or if I'll have to make it every month.'

In addition to coping with her own health issues, Linda is carer for her husband who has heart disease and underwent a by-pass last year.

'A box of Versatis patches can cost between €120 and €180 per box depending which chemist you get it in and there is not a hope that I could afford to buy them.'

Linda is also a member of the Patch Us Back Facebook group which has launched a petition calling for the Minister for Health Simon Harris to reinstate the provision of Versatis patches for chronic pain to the Drugs Payment and Medical Card schemes. So far over 10,000 people have signed the petition on the website.

Louth TD Fergus O'Dowd raised the matter in the Dail during the week. He was told in a written reply that: 'Lidocaine 5% medicated plasters are licensed for the localised relief of post-shingles pain in adults. This is the only licensed use for the patch in Ireland.'

The replay stated that:'When the plasters were first introduced, the budget impact was low, because of the specific indication for which they are licensed.

It was a cause of clinical concern that, from 2012 on, usage increased significantly, to the point where more plasters were being prescribed in Ireland than in the entire UK National Health Service, with ten times our population.

This realisation had led to the HSE Medicines Management Programme reviewed the use of the plasters in 2016 which estimated that only 5-10% of prescribing had been for the licensed indication.

Non-shingles patients were given a three month grace period, in which their GP could move them to other treatments or apply for continued reimbursement. However, from 1 December 2017, non-shingles patients were no longer automatically reimbursed under the community drugs schemes.

Deputy O' Down was told that: 'As of 5 March 2018, there have been 5,156 online applications from GPs requesting the reimbursement of Versatis. Of these applications, over 17%, or 896 patients, have been approved. In addition, 437 online appeals have been made, and over 66% of these patients have been approved.'

The Argus