The director of haemophilia treatment in the State advised the Blood Transfusion Service Board (BTSB) to continue ordering blood products despite their "being rapidly removed from the world market" because of their association with HIV and hepatitis transmission, the tribunal heard yesterday.
Prof Ian Temperley advised the BTSB by letter in June 1988 to select the products because other safer substitutes would be twice the price.
The products continued to be supplied by the Armour pharmaceutical company up to early 1990 despite the fact the company itself wished to discontinue supplying them after 1988. Armour wished to change to a different product with a more effective viral inactivation technique to safeguard against transmission of hepatitis C.
"The board should understand that in the present period of financial stringency the hospitals could not be expected to meet a doubling of the cost of concentrate in 1989," Prof Temperley wrote.
"Some balance will have to be struck between cost and the infection danger associated with blood products. "The present product using Irish plasma fractionated by Armour is heat-treated for 72 hours at 68 degrees C and belongs to the first generation group. This group is being rapidly removed from the world market partly because of previous HIV disasters and also because dry-heat treatment seems inadequate to destroy non-A, non-B hepatitis (NANBH)," his letter continued.
He explained that second-generation products were either wetheat treated or dry-heat treated to 80 degrees and they decreased the risk of NANBH, later defined as hepatitis C, infection.
"The problem with commercially available second-generation products is the price," he said.
He pointed out that these and third-generation products would be twice the price.
Prof Temperley added that virtually all treated haemophiliacs in the State had been already exposed to NANBH, He suggested they continue therefore on the Armour product but that a safer, second-generation blood-clotting agent be given to "virgin patients" who hadn't received any blood products before.