Pregnancy support group reiterates call for Cariban to be free for women struggling from hyperemesis

Image credit: Anna Bizon (CC BY-NC 4.0)

Pregnancy support groups have reiterated calls for the drug Cariban to be provided free of charge as essential healthcare for women struggling from hyperemesis gravidarum. 

It comes as concerns were voiced regarding access for women to the drug, which treats nausea, headaches, and severe vomiting in pregnancy. Cariban is the first line of treatment for the debilitating illness Hyperemesis Gravidarum (HG), however campaigners have long shone a spotlight on limited access to the drug due to its high cost.

The drug treating the severe and potentially life-threatening levels of vomiting can cost between €1,500 and €3,000 during the course of a pregnancy.

A spokesperson for the pregnancy support group Gianna Care told Gript that the current scheme of access to the drug is failing women and making it difficult to access the drug.

It comes as Social Democrats TD Jennifer Whitmore on Thursday told a briefing in Leinster House that the announcement in Budget 2023 that Cariban would be covered by the Drug Payment Scheme was initially welcomed.

However, further inspection showed that the scheme is not as easily accessible as many would have hoped. Gianna Care has pointed out that in order to qualify for the scheme to get the drug funded, the patient must get their initial prescription for Cariban from a consultant obstetrician.

Gianna Care said that while those who have the condition and attend high-risk clinics can fill in the relevant three-page form to get the drug, others they have come into contact with are still struggling to access it despite the announcement of the scheme.

The pregnancy support group told Gript that in some cases, women are facing a wait of at least 12 weeks to see a consultant – even though the illness can set in during the very early stages of a pregnancy. Gianna Care has long supported women with the condition who are struggling to navigate their pregnancies by funding the cost of the drug in some cases.

They say that despite the announcement in the Budget, they are still continuing to cover the cost of the drug for some women who continue to face barriers to accessing it.

“This drug is so, so expensive, and we still hear from many women that it is extremely difficult to get the consultant to sign them off for this scheme”.

“This is still in the very early stages, and the Government is making it very difficult to get it reimbursed”.

They say that their work assisting women with unexpected or difficult pregnancies has shown them first-hand that the high cost of the medication is even causing some women to consider abortion.

While the illness can start to subside for some women after a matter of weeks, for others, they struggle with severe sickness and debilitating nausea right up until their due date, making pregnancy “horrendous” for some women.

Between one in every 100 and one in 200 women suffers from Hyperemesis Gravidarum or HG, and roughly 1 in 100-150 pregnant women will be admitted to hospital due to the dehydration and malnutrition that hyperemesis can cause.

Last year, Gianna Care said that they had seen women failing to pick up repeat prescriptions; rationing the medication because they could not afford it every week. This was despite the fact the drug needs to be taken multiple times a day, and at set times in many cases.

“Some pharmacies are seeing so many women coming in who will purchase the medication on a weekly basis, and they might not come back for two or three weeks because they can’t afford to pay for it weekly,” the organisation said when it called for the medication to be funded last year.

Many more women will need to take time off work because of nausea and vomiting in pregnancy induced by the condition. Hyperemesis Ireland says that living with severe levels of nausea and/or vomiting for any length of time can have a profoundly negative impact on a person’s physical and mental health and well-being.

The briefing at Leinster House on Thursday also heard that some women are forced to attend emergency departments, and face hours waiting, to get access to the drug.

Campaigners have urged Minister for Health Stephen Donnelly to meet with Hyperemesis Ireland representatives and work alongside them to make access to the drug easier through the drugs payment scheme.

Thursday morning’s briefing was attended by representatives from Hyperemesis Ireland, an advocacy organisation for those who suffer from the condition in pregnancy, along with a number of high profile medical professions.

In a statement released on Thursday, the Department of Health said that the Health Minister has requested a review of the current arrangement around the prescription of Cariban by the HSE. The Department explained that because Cariban is unlicensed, an external arrangement was organised which requires that the initial prescriber has to be a consultant. While the drug is not licensed, this is because the maker has not applied for a license, and not because the Cariban is inappropriate for use.

Data released last year showed that there were over 3,300 hospital admissions for hyperemesis gravidarum in 2021. Hyperemesis Ireland said that many costs could be avoided if more women had timely access to affordable medication, with the group urging people to highlight the issue by writing to their TDs.

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This piece was first published on Gript.