• A pharmacy can dispense HRT products only on GMS or DPS schemes.

• HRT products under GMS are free of charge to the patient (see the bag label).

  • Rx keeps non-chargeable products in a separate form from regular items.

• A GMS patient (family) will be charged the levy for up to 10 items a month, regardless of the number of free HRT items dispensed in the same month.

• HRT products under DPS are free of charge to the patient (see the bag label).

• Forms with the HRT items are claimable. They are included in the claim even if the patient (family) is still under the €80 threshold.

Claims Module

• HRT items are excluded from the DPS co-payment calculator, similar to PrEP. If a patient has a script with HRT products worth €200 and another with Zantac worth €10, the Zantac prescription should not be claimed. Only the HRT script will be claimed.

• The F5 DPS Analysis dialog: The Fempi Family Total does not include the non-chargeable items (PrEP, HRT). It is the value checked against the €80 threshold to decide if the DPS scripts can be claimed.

• The PCRS allows two new 777 codes. The pharmacy may add code 77791 or 77792 to any HRT product from the "List of EMPs Supported for Reimbursement under ‘777’ Arrangements".

  • Please note that those two codes will make the dispense non-chargeable, regardless of the scheme. The PCRS allows 77791 and 77792 on the DPS scheme only.

The PCRS states that:

• If the HRT product is an exempt medicinal product (EMP) and the patient has GMS eligibility, then the pharmacy should check if the patient also has DPS eligibility.

  • If the patient has DPS eligibility, then the EMP should be submitted under DPS using the 777 codes as outlined in the appendix.
  • If the patient does not have DPS eligibility, then the EMP items should be claimed under the Discretionary Hardship Arrangement via Local Health Offices.

• Claim Defender allows 77791 and 77792 codes to be used only on DPS and HD schemes