Press release

Reforms announced to phased dispensing and enhanced medicine supports under the Community Pharmacy Agreement (CPA)

From: Department of Health
Published on: 31 March 2026
Last updated on: 31 March 2026

The Minister for Health Jennifer Carroll MacNeill TD, the Health Services Executive (HSE) and the Irish Pharmacy Union (IPU) have today announced a significant reform of phased dispensing arrangements alongside the introduction of a new patient-centered medicines optimisation support framework.

The reforms are designed to strengthen supports for vulnerable GMS (medical card) patients and will ensure a more robust system in the future.

Under the Community Pharmacy Agreement (CPA), the State has worked with the IPU to implement a reformed approach and since the agreement was reached:

€20 million has already been invested into increased standard dispensing fees, backdated to September 2025.
A further €20-24 million will fund a new medicines optimisation fee for GMS (medical card) patients; and
€2.5 million will be invested to support targeted enhanced medicines optimisation support fees to support patients who have their medication dispensed more than once per week.

These changes will come into effect from 1 June 2026.

The reforms see rigid phased dispensing fees replaced with a more flexible patient focused model - which empowers pharmacists to use their professional judgment to support patients most in need. It will also reduce administrative burden and further support the profession in the delivery of frontline patient care.

Vulnerable GMS patient groups including those with diagnosed cognitive impairment or dementia, intellectual disability, physical impairment or those patients at risk of medication misuse will be supported where appropriate with a range of tailored supports including:

adjustments to facilitate use of original packaging.
medication reminder systems.
administration charts.
installment dispensing; and
blister packs where clinically necessary.

Blister packs will remain a last resort in line with the international evidence due to associated risks including reduced patient autonomy and potential safety concerns. Where clinically required, and deemed appropriate, blister packs will be provided free-of-charge to eligible medical card patients, in identified cohorts.

Importantly, all patients who were receiving phased dispensing or blister packs free-of-charge prior to the CPA (in August 2025) will continue to do so.

Minister Carroll MacNeill said:

“Today’s announcement sends a strong message to patients and the pharmacy profession that we are recognising the vital role of community pharmacists, giving them greater flexibility to use their professional judgment and putting patient care at the centre of health services. These reforms will ensure that the right supports are provided to patients who need them the most, while safeguarding public funds. I want to thank Department Officials, the HSE and the IPU for their collaborative efforts in reaching this agreement.”

Welcoming the agreement, IPU President Tom Murray said:

“This marks a significant development for patients and for the wider health service. It puts in place a robust, structured support that will improve how medicines are managed in the community while building on the ongoing expansion of the role of pharmacists.”

Notes to Editor

What is the difference between blister packs and phased dispensing?

Phased dispensing and blister packs are both used to help patients manage medication, but they serve different purposes:

Phased dispensing: Medicines are supplied in smaller, scheduled amounts (for example daily or weekly pick-up), usually for high-risk medications like antipsychotics or opioids.
Blister packs: Pre-organised packs showing what medicines to take and when, typically prepared weekly to support patients who might need help remembering when to take their medicines or those who have complex medication routines.

Phased dispensing has been supported by the State for GMS (medical card) patients since 1996. Community pharmacists receive an additional fee to provide the service. Blister packs have never been State funded.

What exactly is changing?

Better clarity and flexibility for how pharmacists can engage with and support their vulnerable medical card patients using their professional and expert judgement.
The agreement reached between the parties will see rigid phased dispensing fees replaced with a flexible, patient focused Medicines Optimisation supports that will allow community pharmacists to focus on direct patient care.

Why is the system changing?

The old system linked payment too closely to packaging rather than care. The new approach focuses on outcomes for GMS patients, not the number of items dispensed or blister packs.

The new flexible system is also designed to help pharmacists in their direct patient care role as it supports professional judgement and reduces administrative burden. The funding provided will support a range of appropriate and practical interventions adherence supports, for example:

Medication reminder charts
Easy-open packaging
Large print or braille labels
Medication alarms
Phased dispensing
Blister packs (where clinically appropriate)

It is important to remember that the available evidence, and international practice, recommends that blister packs are only used as a last resort because they can negatively impact patient independence.

Will vulnerable patients still be supported?

Vulnerable medical card patients who including those with diagnosed cognitive impairment or dementia, intellectual disability, physical impairment or those patients at risk of medication misuse can be supported with optimisation aids where indicated. The reform ensures that resources are targeted towards those who genuinely need them.

If, after an assessment, a pharmacist determines, using their professional and clinical judgement, that a GMS patient requires a blister pack for clinical or patient safety reasons, it will be provided without charge.

It has also been agreed that all GMS patients who were getting phased dispensing or a blister pack free-of-charge in August 2025 (i.e. immediately prior to the Community Pharmacy Agreement (CPA)) will continue to receive those supports free of charge.

Are pharmacies losing funding overall?

Not a single euro is being taken out of pharmacy funding. €20 million has already been reinvested to support the level of standard fee increases agreed under the CPA which was backdated to 1 September 2025.
A further €24 million will fund a new GMS medicines optimisation fee which will be provided for each GMS item dispensed by the pharmacist. This will be €0.35 per GMS item dispensed.
An additional up to €4.5 million from the CPA medicines optimisation fund will support a €32.50 Enhanced Medicines Optimisation Support Fee: a targeted monthly fee paid per patient who clinically require their medicines to be dispensed more frequently than weekly (e.g. daily or several times per week).

These funding arrangements will commence 1 June 2026.

Will a medical card holder be able to get their medicines in a blister pack from their pharmacy free-of-charge?

Patients are encouraged to talk to their pharmacist about any difficulties they may have in managing their medicines. Pharmacists will be able to advise patients of the different options that are available to help with managing their medication.

Supports to help patients take their medicines are varied and include interventions including reminder charts, easy open lids and reminder alarms. Blister packs should only be used as a last resort.

Pharmacists will be able to advise patients about the risks and benefits of different supports, in order to determine the most appropriate one for them.

If a medical card holder is recommended to use a blister pack by their pharmacist, it will be provided free-of-charge.

If a patient receives their medicines under the Long-Term Illness Scheme; will they be able to get their medicines in a blister pack, free-of-charge?

If a patient needs help managing their medicines their pharmacist will be able to advise them about the risks and benefits of different supports, in order to determine the most appropriate one for them.

If a pharmacist recommends a blister pack this will be provided free-of-charge only if the patient is in receipt of a medical card.

If the patient does not have a medical card, their pharmacist will be able to advise them on the supports that are available and the associated cost.

If a patient does not have a medical card, will they be able to get their medicines in a blister pack free-of-charge?

Patients are encouraged to talk to their pharmacist about any difficulties they have managing their medicines. Their pharmacist will be able to advise them of options which may help.

If a patient does not have a medical card, their pharmacist will be able to advise them on the supports that are available and the associated cost.

How much can a pharmacist charge a patient for putting their medicines in a blister pack?

Pharmacies are independent businesses and set the price for the services they provide. As a result, prices may vary from pharmacy to pharmacy. All pharmacies are required to provide clear and accessible pricing information to the public, in accordance with regulatory guidance.

If a patient’s doctor has always recommended that they receive their medicines in a blister pack, and the pharmacist gives it to them free-of-charge. Will this continue?

If a patient was receiving their medicines in instalments or in a blister pack free-of-charge in August 2025 they will continue to receive their medicines in this way. They will not be charged for this service.

If a doctor has not written on a prescription that a patient needs phased dispensing; can the pharmacist decide if phased dispensing is needed in each case?

Patients are encouraged to talk to their pharmacist about any difficulties they may have managing their medicines. Pharmacists will be able to advise patients of options which may help.

If a patient has a medical card and their pharmacist is of the opinion that phased dispensing would help them manage their medicines, then this service will be provided at no additional cost.

If a patient does not have a medical card, their pharmacist will be able to advise them on supports that are available and the associated cost.

If a patient has home carers who remind them to take their medicines, will the patient receive their medicines in a blister pack free-of-charge?