HSE says price is not an issue affecting medicine supply

Price is not an issue affecting the supply of drugs into Ireland, according to the HSE.

The health service says there are just 36 medicines where suppliers say they are no longer able to supply the Irish market at the price previously agreed. Ellen McGrath, the head of the HSE’s “industry-facing” corporate pharmaceutical unit, said this amounted to less than 0.01 per cent of the almost 8,000 reimbursable medicines in the Irish market.

Ms McGrath was addressing a briefing on how the State manages medicine shortages following public concern over widespread shortages of certain products over the past year or so, with particularly acute issues on some antibiotics used to treat strep infections.

The figure runs counter to the case made by a leading figure in the generics industry – makers of off patent but still widely used drugs – who has argued for months that price is a factor in a growing list of medicines in Ireland facing supply issues. Sandra Gannon, chief executive of generic manufacturer Azure Pharma, has said that Ireland is now paying “substantially less than neighbouring countries for a range of medicines. As a result, manufacturers are choosing to supply their medicines to those countries who will pay better prices.”

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Her position was bolstered by comments from the lead author of a European Commission report on medicine shortages in 2021. Attending a conference in Dublin earlier this year, Thyra de Jongh said pricing was “part of the issue”.

“The link is there in terms of its effect on supply security. Low margins on medicines have changed the structures of supply chains making the whole system more vulnerable,” she said, adding that it was one of a number of variables affecting security of medicine supply over the past winter.

However, Ms McGrath said that as recently as February of this year, Medicines for Ireland, which represents makers of generic and biosimilar medicines in the Irish market, had recognised in a letter that “reimbursement price was not an issue” affecting the supply of such medicines in the Irish market.

And she noted that the 289 drugs on the medicines shortage list maintained by medicines regulator, the Health Products Regulatory Authority (HPRA), amounted to less than 3 per cent of the close to 10,000 medicines licensed in the Irish market.

HPRA director Gráinne Power said the issues affecting the Irish market were common across Europe and she added that 20 per cent of expected shortages notified to it by suppliers as required were prevented through its collection of the information and subsequent working with suppliers to avert problems.

She said too much should not be read into the figures because the HPRA actively encouraged early reporting. She also warned against reading too much into one year’s data, noting that notification rates during the early years of the pandemic – 2020 and 2021 – were actually lower than in previous years.

Also addressing the briefing, Joanne Kissane, the registrar and chief officer of the Pharmaceutical Society of Ireland – which regulates pharmacies and pharmacists – said: “In almost all case, patients can be assured that shortages can be managed.”

She advised patients to submit prescriptions as early as possible to allow pharmacy staff address any shortages in their own stocks before the issue becomes critical for the patient.