Mr. Michael Cullen:

With the economies of scale in the Irish market, there are products for which pricing is going the other way. Mr. Gallagher alluded to this and Mr. Darragh O'Loughlin, secretary general of the Irish Pharmacy Union, mentioned it earlier. Over the past year, there have been massive price reductions and we encourage competition and generic prescribing because it delivers the big savings that have been delivered over the past year or two, which we have highlighted. The reference price of an ordinary pack of penicillin in the Irish market is €1.57 compared to £16.06 in the UK market. Prices have totally changed. A standard bottle of Flucloxacillin is priced at €6.43 in the Irish market compared to £26.04 in the UK. These are standard antibiotics that are used by adults and children.

Senator Crown commented on expanding employment in generics manufacturing. There is a new facility at Athlone Laboratories, which employs 150 people and manufactures penicillin. Athlone Laboratories has told us selling penicillin in the Irish market does not cover its costs. Our members are supplying such products on compassionate grounds, given that it is a loss-maker in the Irish market. We need concessionary pricing on such day-to-day products. In the UK, there are concessionary prices for products that reach a certain threshold above which they are unsustainable. We have seen this in recent weeks with the antibiotic trimethoprim, which is priced in the Irish market at €13.48 for 100 compared with £51 in the UK market. There are massive differences which result in practices such as parallel export, which we are trying to deal with.

In response to Deputy Healy's question, a biosimilar is slightly different in that it is not made from a chemical composition or is not manufactured in that way. It is made by natural sources or biotechnology methods. For example, expenditure on anti-TNF drugs, which I was looking at yesterday and which are used for auto-immune diseases like rheumatoid arthritis, rose by 12.5% over the past 12 months to a value of about €190 million. There are biosimilars for those products now and massive savings could be delivered by making the substitution.

Senator Burke asked a question about the high-tech scheme. It is less immediately about legislation. At the moment, if products are prescribed in the hospital setting, the patient takes the prescription to the retail pharmacist, who gives the product to the patient although the pharmacy does not buy the product. The product is given it by the State free of charge. There is no incentive for the retail pharmacy to substitute that with a generic. We can supply generic versions of products on the high-tech scheme, many of which are now off patent. There is currently no mechanism or incentive for the pharmacists to do that. We ask for that to be provided.