Mr. Darragh O'Loughlin:

On the outcome of that service, the experience in England has been that one third of patients who were previously not taking medicine properly go on to take the medicine properly following intervention by the pharmacist. Obviously, some work needs to be done to try to get the other two thirds to take their medicine properly, but even to get one third of non-adhering patients to improve their medicine taking has a benefit.

On the timescale for the moving of medicines from prescription to non-prescription status, the Health Products Regulatory Authority, HPRA, formerly the IMB, will publish a list within the next couple of weeks. There are no legislative changes required because, under legislation the authority already has the role of deciding whether a medicine should be a prescription medicine or a controlled drug and whether, within the prescription medicine status, it should be considered an S1A, non-repeatable, or an S1B, repeatable. The authority as an organisation has taken a policy decision to be more proactive in rescheduling medicines which currently require a prescription to non-prescription status because it believes these medicines to be appropriate and safe for use with the advice and support of the pharmacist, as opposed to needing a prescription.

In regard to generic drugs, we have made rapid progress in the penetration of generic medicines in Ireland since the passing of the Health (Pricing and Supply of Medical Goods) Act last summer. It is now obligatory for pharmacists to offer a generic interchangeable medicine once one is available, when medicines have been deemed interchangeable by the HPRA. We know anecdotally from speaking to the Primary Care Reimbursement Service, PCRS, that it has seen the use of generic medicines escalate dramatically. The pharmaceutical industry also tells us that the use of its branded medicines has collapsed where generic alternatives are available.

We also have a process called reference pricing, a rolling process, under way. This is a process by which the HSE sets a reference price - the maximum price it will pay for any generic medicine. These prices are set anywhere between 40% and 70% lower than the price of the products beforehand. Therefore, the combination of the increasing use of generic medicines and the reducing price of generic medicines means that at the lower end of the price scale of medicines, significant savings are coming through. What will drive our medicines bill in the future is not the tablets 95% of patients are taking on a daily basis but the high tech biological type medicines that smaller numbers of patients are taking to treat more serious conditions.