Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the witnesses. This is an issue that causes much concern. Legislation has been brought through the Houses of the Oireachtas in recent years to try to address the cost of medicines to the taxpayer. Clearly, our obligation is to ensure we get the balance right so that we have a vibrant market and we get value for the taxpayer. We have a strong pharmaceutical base in this country, which is critically important to the broader development of the economy, but we cannot subsidise that by paying a great deal for patented medicines or even generics, which are very much to the fore and manufactured here. We have a role to play to ensure there is openness, transparency, and a mechanism in place to ensure value for the patient and the taxpayer.

In the past there were sweetheart deals with companies. The reason the pharmaceutical companies are here is that there was incentivisation above and beyond the traditional grant aid and supports for research and development, employment and so on. That issue has always been left hanging in the air. It has always been denied, and in a previous role I had as Minister of State with responsibility for trade, I denied it. Nevertheless, it has consistently been raised, not only in the context of pharmaceuticals but also with reference to many other multinationals that locate here.

I wish to put a question to the Irish Pharmaceutical Healthcare Association. Most of the companies that locate in Ireland are multinational companies, so obviously the Irish market is very small. I assume they are not locating in Ringaskiddy, Little Island and other places because they want to supply the Irish market but because of other incentives - that fact that there is already a critical mass of pharmaceutical companies, our high-quality graduates, the taxation system, the infrastructure, and the link between the United States and Europe. That is a given, but there is always a concern that we pay particularly high costs for medicines as a sort of a sweetener. That has consistently been said, and I would like to hear the views of the witnesses on that issue.

Dr. Leisha Daly made two points in regard to agreement on supply and pricing. Having an agreement helps the State and the HSE. It results in predictability and consistency in pricing and supply, it involves a detailed test of value for money before any new medicine is paid for, and it deals with the risk that medicines meant for Irish people may be sold to higher-priced countries. I assume there is a contractual arrangement in place between a company and the State in terms of the supply of medicines. Therefore, how could there be leakage if there is a contractual arrangement in terms of medicines that are meant to be sold to the Irish market going to a higher priced market? As that would be a breach of contract, I am wondering how that could happen. It it happens, it should not happen.

In her presentation Dr. Leisha Daly said:

Competition law prevents our association from making individual pricing or other commercial decisions for members. However, the agreement means that, when a member company proposes a new medicine to the HSE, it must offer it at a price which is at, or lower than, the average of its price in the nine member states.

I have two questions which I have asked in other areas before. Who defines the nine countries in that basket? Clearly, if there is limited supply going into that basket of nine countries, obviously there is an inflationary pressure on prices. Is there potential to artificially inflate prices in those nine countries if supply is restricted to those nine countries?

I welcome all the employers in Cork. However, we cannot have a view that they are here because we are paying higher costs for our medicines. That is not a tenable position to hold, but it is certainly a tenable position terms of attracting attention among the broader public.Medicines must be purchased based on the merit of the medicine and not because of the number of people employed.

In regard to generics, the poor relation in the pharmaceutical industry, obviously great strides have been made in recent years. How helpful has the legislation been in trying to tip the balance not in favour of generics but in favour of value for the taxpayer? How receptive is Government, the HSE and the Department of Health to the witnesses' presentations from time to time in terms of reductions in the cost of medicines, and how it can make savings for taxpayers? This issue will not go away.

There is another major issue of concern. Irish people are prone to travel far and wide and make comparisons in their own mind in regard to medicines that they can buy in Málaga or Marbella, or Puerto Banús, sometimes without prescription, although when they come back they must get it on prescription and it costs a great deal more. Perhaps we could have an explanation as to why that is the case. I know there are reasons for it. I appreciate that we have a more restrictive prescription system here, but to a family going on holidays it does not make sense, given that we are all in the European Union.