Claims by Taoiseach Leo Varadkar that patient safety concerns were part of the reason for rationing the prescription of the Versatis pain patch were described as "beyond comprehension" by a doctor.

Dr Camillus Power, a pain specialist in Tallaght Hospital, said the patches were the "least dependent agent" doctors can prescribe to provide relief to patients.

He was responding to the ongoing controversy over the decision to issue new prescribing rules, directing doctors to automatically give them only to patients with nerve pain related to shingles. Doctors who want to give them to patients due to other conditions must appeal to the HSE.

In the Dáil, Mr Varadkar, who was questioned on the issue by Fianna Fáil leader Micheál Martin, said the new rules were due to the number of patches prescribed for conditions it was not licensed for as well as the "long-term side-effects".

He said: "It is not a matter of money but patient safety as well."

However, Mr Varadkar's statement was "beyond comprehension", Dr Power told RTE's 'Liveline'.

He pointed to alternative pain relievers in the form of medication, some of which can cause side-effects such as memory problems and weight gain.

Asked about Versatis, the Health Products Regulatory Authority (HPRA) said it contains the active ingredient lidocaine.

It is licensed to treat the symptoms of nerve pain associated with shingles. The HPRA added: "All medicines have the potential to cause adverse reactions and known potential adverse reactions are listed in the approved product information."

The most commonly reported adverse reactions were to the site where the patch was placed on the skin, such as burning, dermatitis, red bumps, rash, skin irritation and small cysts containing fluid.

The HSE said the review of prescribing patterns in Ireland conducted by the HSE-Medicines Management Programme showed more than 18,800 patients in Ireland were in receipt of this medicine as of December 2015 - at a cost to the HSE of €28m per annum.

Patients

The total numbers of patients being treated as of June 2016 had increased to more than 20,000 with an estimated expenditure in 2016 of €30m.

By August 2017 more than 25,000 patients were being treated and expenditure was running at just over €3m per month or €36m a year.

"The key concern however was the apparent widespread and prolonged prescribing of the medicine for unlicensed indications," said the HSE.

While patients with nerve pain due to shingles can be seamlessly prescribed the patches, an online application must be made for others.

A spokeswoman for the HSE said yesterday it had received 284 online appeals to prescribe the patches for patients whose nerve pain has not been caused by shingles.

"The total number approved was 185. That equates to 65pc approval," she said.

"The turnout time for appeals is within one week. These figures will be updated next week."

About 1,500 patients have been approved to get the patches for a shingles-related nerve pain.

A spokesman for the Taoiseach declined to clarify his remarks further yesterday.

Irish Independent