Exploring Trends in Contraception and HRT Prescription in Ireland: An Application of Reimbursement Data

Fintan Stanley, Noirin O' Herlihy, Ciara Mc Carthy, Mike O’ Callaghan

Keywords: Contraception, HRT, reimbursement data

Background:

GPs are the main prescribers of contraception and hormone replacement therapy in Ireland. The WHO advocates for high quality, affordable sexual and reproductive health services. Information should be provided about the full range of family planning methods. Similarly, as women enter their post reproductive years, they should have access to information on how to optimise their menopause transition.

As of December 2022, the GMS scheme provides 31% of the Irish population with free or heavily subsidized medical care, underscoring the significance and limits of understanding prescribing trends within this framework.

Research questions:

Can reimbursement data shed light on the changing trends in contraception and HRT (Hormone Replacement Therapy) use in Ireland? What insights can be derived from such data to guide policy-making and medical education?

Method:

This study uses anonymized, aggregated records from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS) to assess trends in hormonal contraception and HRT prescriptions from 2010 to 2022.

Results:

The analysis of reimbursement data revealed significant trends: a decrease in the use of short-acting contraceptive methods (down 35% of peak in 2013), an increase in progesterone-only pills usage (up 46% since 2013), stable usage of long-acting reversible contraceptives (LARCs) despite a dip during the COVID pandemic, and a near threefold increase in HRT prescriptions between 2018 and 2022(up 129% since 2013).

Conclusions:

These prescribing trends, which appear to coincide with changes in clinical guidelines, illustrate how reimbursement data can provide valuable insights for informing policy decisions and medical education.

Points for discussion:

In an Irish context reimbursement data is a largely untapped source of health data, but its limitations leave real gaps in the analysis.

Could reimbursement data be used to systematically interrogate/evaluate changes in policy and coverage?

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