ALTHOUGH WILLIAM Osler may have said that one of the first duties of a doctor is to educate the masses not to take medicine, drugs are a key component of modern healthcare. However, drug costs in the Republic have risen inexorably in recent times to the point where the State’s spend on pharmaceuticals is among the highest in Europe. Between 1997 and 2007, the annual cost of drugs under the community drugs schemes reached €1.74 billion, a 500 per cent increase. This level of growth was unsustainable and the announcement by the Minister for Health this week of drug cost savings is therefore most welcome.
According to the Irish Pharmaceutical Healthcare Association (IPHA), with which the Minister negotiated the new deal, many people will now see savings of €3-€4 for each €10 they spent on drugs before the change. A patient paying for the cholesterol lowering drug pravastatin will see the monthly cost drop from €24 to just over €14. Perhaps of greatest economic significance is the drop in price of proton pump inhibitors. These drugs are used to treat peptic ulcers; collectively, three medicines from this family of drugs feature in the top six most costly medications dispensed to medical card patients in 2007. Now, a person prescribed Omeprazole, the original proton pump inhibitor, will pay €13.41 for a month’s supply, down from €22.35.
Such huge savings beg the question: were we being overcharged by the pharmaceutical industry until now? When asked, Mary Harney noted there was “no doubt” Irish people weren’t getting value for money. Unfortunately, this is an indictment of the Minister and her Cabinet colleagues who have been aware for some years of major disparities in drug costs across Europe.
Mary Harney must explain also an additional anomaly that arises from her failure to secure a similar price reduction deal from the manufacturers of generic drugs: the branded versions of many drugs are now cheaper than similar generic medicines. This is a complete reversal of the pricing structures found in most developed countries. Left uncorrected it will damage a much needed drive towards a greater prescribing of generic medications by doctors; it also calls into question the Minister’s plans to introduce legislation making the substitution of generic brands mandatory in State schemes to further reduce drug costs.
Further initiatives, such as the removal of drugs with little proven benefit from State reimbursement, are also badly needed.