Mr. Tony O'Brien:

There are multiple factors, one of which is prescriber behaviour. Last week we launched a medicines management programme in regard to two categories of drugs - statins and proton pump inhibitors. One of the factors which has been referenced by Professor Michael Barry, our clinical lead, in this instance is an analysis which shows that for drugs of comparative value in terms of their clinical effectiveness, there is a tendency to prescribe the dearest as opposed to the cheapest. Therefore, we have engaged in a significant programme of educating both the public and prescribers of the relative value involved. The aim is to switch prescribing behaviour towards prescribing drugs of equal clinical value but of much lower cost. There is significant potential in this regard, notwithstanding the fact that it remains the case that 49% of the top ten prescribed drugs by value are generic. It is not all a negative picture, but there is significant room for cost reductions by enhanced prescribing of generic or lower cost branded drugs.

That is one part of the picture. Another part of the picture is, obviously, related to the market price of drugs in this country. As the Deputy is aware, the Department of Health in association with the troika is commissioning a study - a comparative study - through the ESRI of the relative costs, which will provide a more informed base for that. The key issue - the thing we can do most about most quickly - is changing prescriber behaviour and consumer behaviour. There are significant gains for the health budget, but also for individuals. In PPIs, for example, last week it was demonstrated that by switching to the lowest cost drug in that category, those who are paying from their own pockets for their drugs could save €300 per annum, with similar things across the spectrum. So we will be rolling out a whole series of preferred medicine guidance in relation to those things, clinically based through the medicines information centre throughout the course of this year and so far we are having a very positive response to it from prescribers.