John Crown (Independent) | Oireachtas source

I will make a brief point, more for the information of the committee members than for the IMB witnesses. There are two separate issues I would not like to see get blurred. We as a nation have to look critically at the issue of drug pricing. I am committed, wearing both this hat and my day job hat, to our moving wholesale to generic prescribing. I am very comfortable with generic prescribing and I believe we need to do that. The reality is that if we do not find a way to save some money on some of the drugs for which we have generic alternatives, we will not have the money available to pay for other drugs which are coming on stream and which may be expensive.

I would like to familiarise the committee with the term "biosimilars". These are genetically engineered or manufactured versions of certain drugs that are biological products, such as proteins or glycoproteins. They are not exactly generic; the molecular structures are slightly different, but they will have the same effect. Because the revolution in molecular medicine has now been ongoing for nearly 20 years, we are now getting the first of these biosimilars, which are the biological equivalent of generics. We will be under considerable pressure not to move in this direction, with some potential for misinformation, but I believe we should.

I would like to qualify slightly what my colleague Deputy Kelleher said. Although we see certain drugs available over the counter in many of the countries to which we travel on holidays, this is not always appropriate. The big example people always talk about is antibiotics. I believe that from the point of view of individual health and concerns about the development of resistance of bacteria to antibiotics, there should be medical regulation of the prescription of antibiotics.

It is not obvious to me that there is a big problem right now. I can think of some drugs which in truth probably should be made available over the counter, but it is not obvious to me that there is a big problem in this regard in terms of tardiness in delisting drugs as prescription-only. In response to Deputy Kelleher, part of the reason companies make the decision is to do with liability issues. The companies can have issues of liability if something is prescribed or given inappropriately. At least with a prescription they have an extra level of protection that the product is being used wisely.