Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 13) Order 2014

Information about the publication of Ministerial Decisions

A formal published “Ministerial Decision” is required as a record of the decision of a Minister (or an Assistant Minister where they have delegated authority) as they exercise their responsibilities and powers.

Ministers are elected by the States Assembly and have legal responsibilities and powers as “corporation sole” under the States of Jersey Law 2005 by virtue of their office and in their areas of responsibility, including entering into agreements, and under any legislation conferring on them powers.

An accurate record of “Ministerial Decisions” is vital to effective governance, including:

demonstrating that good governance, and clear lines of accountability and authority, are in place around decisions-making – including the reasons and basis on which a decision is made, and the action required to implement a decision
providing a record of decisions and actions that will be available for examination by States Members, and Panels and Committees of the States Assembly; the public, organisations, and the media; and as a historical record and point of reference for the conduct of public affairs

Ministers are individually accountable to the States Assembly, including for the actions of the departments and agencies which discharge their responsibilities.

The Freedom of Information Law (Jersey) Law 2011 is used as a guide when determining what information is be published. While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.

A decision made 28 October 2014:

Decision Reference: MD-S-2014-0134
Decision Summary Title :	Make HI Pharm Ben (Gen Pro) (No2) (Amendment No 13) Order		Date of Decision Summary:	24 October 2014
Decision Summary Author:	Policy Principal		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	Make HI Pharm Ben (Gen Pro) (No2) (Amendment No 13) Order		Date of Written Report:	24 October 2014
Written Report Author:	Policy Principal		Written Report : Public or Exempt?	Public
Subject: Health insurance (Pharmaceutical Benefit) (General Provisions) (No2) (Amendment No 13) Order 2014
Decision(s): The Minister made the Health insurance (Pharmaceutical Benefit) (General Provisions) (No2) (Amendment No 13) Order 2014
Reason(s) for Decision: Following a recommendation by the Pharmaceutical Benefit Advisory Committee and consultation with States of Jersey Public Health Department, the Minister intends to add oral contraception to the Prescribed List with effect from 1st December 2014. The existing Pharmaceutical Benefit Legislation restricts the period of supply for Pharmaceutical Benefit to 30 days (which may be repeated on 3 occasions) and this restriction conflicts with prescribing advice for oral contraception where prescriptions covering 6 months up to 12 months may be appropriate. The period of supply in existing legislation would therefore necessitate additional repeat prescriptions and GP consultations, increasing costs to women and to the Health Insurance Fund. Following recommendation from the Pharmaceutical Benefit Advisory Committee, the Minister decided to add oral contraceptives to Schedule 4 of the Health Insurance (Pharmaceutical Benefit) (General Provisions) (No2) (Jersey) Order 2002 which enables items to be prescribed for periods up to 90 days.
Resource Implications: The making of this Order will reduce cost to the Health Insurance Fund which would otherwise be incurred by a 30 day period of supply.
Action required: Policy Principal to notify the Greffier of the States and the Law Draftsman that the Order has been made so that it may be notified to the States, and forward the signed and sealed Order immediately to the States Greffe for publication and archiving.
Signature:		Position: Minister
Date Signed:		Date of Decision (If different from Date Signed):

Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Amendment No. 13) Order 2014

Requirement to amend the Health Insurance (Pharmaceutical Benefit) (General Provisions) (Jersey) Order 2002

Summary

The Minister for Social Security will add oral contraceptives to the prescribed list, effective from 1st December 2014. It is necessary to amend the Health Insurance (Pharmaceutical Benefit) (General Provisions) (Jersey) Order 2002 as of 1st December 2014, to ensure GPs can offer a period of supply for oral contraception which meets good prescribing practice and does not inflate costs to women or the Health Insurance Fund.

Contraception on the Prescribed List

Prescribing advice from the Faculty of Family Planning and Reproductive Health Care (FFPRH) states that the initial prescription for combined oral contraceptive pills (COCP) should be issued following screening questions. It is recommended that a follow up consultation is held 3 months after the initial consultation, if no issues arise the next follow-up should be undertaken at 6 months. Women who are established on their contraceptive pill, with no health concerns arising, may be offered up to 12 months’ supply of oral contraceptives following these initial consultations.

Current legislation governing the period of supply would restrict the maximum prescription period to four 30 day periods (17 weeks, roughly 4 months). GPs would not, therefore, be able to follow prescribing advice and if medically appropriate prescribe for periods in excess of four months. It would be possible for women to collect repeat prescriptions; however this would frequently incur a charge from the surgery and could be considered inconvenient.

The Pharmaceutical Benefit Advisory Committee considered this issue and recommended that oral contraceptives are added to the ’90-day list’ in schedule 4 of the Health Insurance (Pharmaceutical Benefit) (General Provisions) (Jersey) Order 2002.

Oral contraceptives will be added and identified by generic ingredients. All products currently in use by women in Jersey will be available. If new oral contraceptive products come on to the market comprising ingredients other than the generics listed, these would be subject to scrutiny by the Pharmaceutical Benefit Advisory Committee. In this way future costs can be contained.

Further amendment to Schedule 4

The schedule is split into parts: Part 1 refers to UK items which do not attract a prescription charge and Part 2, Didronel PMO, is a local Jersey addition. Didronel is no longer on the Prescribed List and can be deleted. Part 2 will therefore be replaced with the generic ingredients list for oral contraception.