Sir, – While the news that Minister for Health James Reilly’s deal with the Irish Pharmaceutical Healthcare Association has the potential to reduce the State’s drug bill by €400 million over three years is to be welcomed (Front page, October 16th), may I sound a note of caution?
Paul Cullen reports that “In return for making price concessions the pharmaceutical companies won acceptance of the principle that new medicines will be approved under the HSE’s drug schemes once they have been proven to be cost effective.” Here lies the rub.
Under this system, new medicines just have to prove that they are cost-effective against placebo. A more rigorous test for new medicines would be a requirement that they were at least as effective or an improvement on existing medicines. In other words the State would not pay for new medicines until they had proven that they were at least as good or as effective as existing medicines. This is known as “Comparative evaluation” and we know from international evidence that upwards of 50 per cent of new medicines would fail such a test. Some countries are looking at introducing a system of comparative evaluation and this has the potential for much greater savings than what may be achieved in Mr Reilly’s deal.
Of course there are other considerations in the Irish context given the importance of the pharmaceutical industry as an employer and exporter in the Irish economy. However, we should bear in mind that they are investor-owned organisations whose legitimate goal is to make a profit for their shareholders. On the other hand, the Department of Health has a duty to seek the best healthcare for citizens at the most economical cost and with this in mind, a system of “comparative evaluation” for new medicines would reap much higher savings for the State’s drug bill than this new deal. – Yours, etc,
Sir, – Finally the Government has decided to play hardball with the drug companies. There will be a 10 per cent fall in prices and perhaps a bit more to come (Front page, October 16th). Well done.
My six drugs for heart problems cost €240 per month before the refund scheme kicks in, so I would still have to pay the €132 each month. So no savings for me there. The health service would still pay the balance, but €24 or thereabouts would be saved.
However, a trip to the North gets the same prescription for £75 – for two months. No refund or the like needed. Is it any wonder that the troika have a handy time when they are over here? – Yours, etc,