Patients’ fury over decision to restrict use of painkiller
Health chief curbs ‘poor prescribing’ of lidocaine anaesthetic patches which cost the State €36m a year
A CLAMPDOWN on painkilling patches has caused uproar among sufferers who rely on them.
While Versatis patches are licensed to treat pain associated with shingles, they have been increasingly used for other painful conditions.
The medicated plasters contain a local anaesthetic, lidocaine, which temporarily blocks the pathway of pain signals along the nerves.
Doctors increasingly prescribed the patches to manage pain from a wide variety of conditions. So much so, in fact, that the 25,000 or so Irish pain sufferers using the patches meant Ireland’s usage exceeded the total amount used in Britain each year.
Then last September, health authorities ruled that Versatis would be severely restricted on medical cards or the drug payment scheme for any medical problems other than shingles.
This resulted in a dramatic curtailment of people granted access to Versatis and caused alarm among large numbers of people who said they needed the pain-killing plasters to help them live a normal life.
Many chronic pain suf- ferers pleaded their cases on RTE Radio 1’s Liveline last week. For days, callers told broadcaster Joe Duffy of their anguish at losing access to the patches.
When contacted later, some sufferers spoke in more detail of their battles with continuous pain and how Versatis prevented bad days from getting worse.
Jennifer O’Meara (39), a mother of two, said: “I’ve suffered from Maignes Syndrome which affects the muscles and nerves in my back. The nerve pain is horrific. I get treatment using electrical pulses called rhizotomies to relieve the pain. But, in between treatments, when its effects wear off, I use the patches so that I can move around and have some semblance of a normal life.”
Jennifer lives near the sea in Kilkee in Clare and the patches enable her to leave the house or accompany her children on outings, she said.
“Without the patches, I often could not bear to put weight on my left leg or walk any distances. I also suffer from trigeminal, a neuralgia pain around my eye and face. I cut up the patches and put them on my face because they work,” she added.
She said she cannot afford to buy the patches, which cost up to €130 for a month’s supply, privately. She is urging people “in dire straits” to write to Health Minister Simon Harris on March 1.
Anne Marie O’Neill (51), from Wexford town, began to suffer an aggressive form of rheumatoid arthritis nine years ago.
“It’s affected my hands, shoulders, feet, neck, and spine, and nerve pain shoots up through my head,” she said.
“I was on morphine which made me sleepy and I became dependent on Solpadol. The Versatis patches helped to numb the pain and allowed me to move better,” she said.
She appealed to the health authorities to be allowed to continue receiving State-funded patches on compassionate grounds but she was turned down, she said.
Val Robus said her son Jonathan (24) was prescribed the patches for a painful back problem. He underwent a scoliosis operation at 16 but problems returned when he was 21, when his spine began to curve again beyond the reach of inserted rods.
“The patches allowed him to leave the house and move around. He is suffering since the patches were withdrawn,” she said from the family home in Coolaney, Co Sligo.
Jonathan gets painkilling injections. He takes Solpadol which makes him feel sick and drowsy. But the patches had no side effects, she said.
Professor Michael Barry, clinical director of the National Centre for Pharmacoeconomics, spearheads efforts to get the best value for the State’s €2bn annual medicines bill.
He told the Sunday Independent that many Irish doctors were guilty of “really poor prescribing” when they gave patients Versatis “inappropriately” in a great many cases, he said. The annual State bill for Versatis jumped from €16m to €36m, he said.
He said conditions such as rheumatoid arthritis, deep venous thrombosis and gout should be treated with far more appropriate medications.
But the problems of neuropathic pain and some painful symptoms of multiple sclerosis and cystic fibrosis were suitable for treatment with the patches.
The patches are “not banned” for other conditions but there is now “an extra layer of supervision” on its use, he said. But nine out of 10 applications for its use for other conditions are now turned down.
Doctors can apply to the HSE Medicines Management Programme (MMP) for the use of the patches for non-shingles patients.
The MMP received more than 4,500 such applications from GPs but only 10pc were approved.
Where a GP’s application is rejected, it may be appealed. The HSE stated there were only 200 appeals made following more than 4,000 rejections and half of those appeals were successful.
Prof Barry has been dealing with such appeals. He said the success rate of appeals was “much higher” than 50pc as he had approved eight out of nine appeals in recent days.
The appeals system requires doctors to supply all documents about the case. It was an efficient process which delivered decisions within a couple of days, he said.
‘He is suffering ever since the patches were withdrawn’