Ms Aideen Kenny:

On Deputy Peter Fitzpatrick's questions about the proposed savings, wearing one of the many hats I wear within Teva Pharmaceuticals Ireland, I am involved in setting the opportunity to bring products - predominantly of a generic nature - to the Irish market. Prices continue to fall to levels which are extremely low. For example, Ms Gannon referred to atorvastatin, the price of which stands at €2.52 for a 28-pack of 10 mg tablets. The price of a 28-pack of 5 mg amlodipine tablets, a widely prescribed therapy for cardiovascular disease, is €2.16. For a pack of 28 simvastatin 10 mg tablets, which are used in the treatment of high cholesterol, the cost is €1.96. I could continue to list other products. More frequently, we are unfortunately being obliged to make decisions on the basis that economic circumstances dictate that it makes no sense for us to launch particular generic products in the Irish market.

The first €60 million of the proposed savings of €113 million relates to products which are on the market at below the target price of €1.5 million to €2 million. At that price and allowing for the competition provided by five or six players in the generics market, it certainly makes no sense for us to bring a product to the market. We are of the view, however, that if certain enablers were facilitated by the Government, it would improve the competitiveness of the sector. I will return to these enablers.

The next €25 million in savings relates to expanding the level of uptake of biosimilar products. Teva Pharmaceuticals Ireland has experience in this area because it launched three such products in the market, with mixed results. It has been a hard slog to try to convince prescribers to recommend them. This has predominantly been as a result of a perceived lack of safety in respect of these products and doubts as to whether they constitute effective therapies. Ms Gannon will expand further on this issue.

Savings would also result from allowing pharmacists to dispense more affordable products which would not normally be substituted for patients' prescribed medicines. This is a very interesting subject and would require patients who are perhaps not eligible to switch by virtue of the fact that the products they take are not included in the interchangeable list to start from scratch on these newer therapies. We are of the view that considerable savings could be made in this regard.

The final area in which savings could be made is respiratory devices. Again, the products would not be those included in the interchangeable list. Therefore, potentially, savings would be more difficult to achieve in the absence of enablers.

The enablers we are proposing would involve straightforward amendments to existing legislation; making them agenda items as part of the negotiations with the IMO later in the year; taking these enablers into account when the current industry agreements were being amended in order to change the price entry points; and ensuring prescribers and procurers took a more proactive approach to cost savings in their prescribing and procurement.