Colm Burke (Fine Gael) | Oireachtas source

While I agree with the witnesses that the cost of drugs has come down, I am still concerned. I gave the example last week of someone who comes to my clinic in Cork. He is in receipt of an old age pension, he does not have a medical card and he has had two heart attacks. He travels to Northern Ireland, from Cork to Dublin to Newry, once every two months and is paying less in Northern Ireland for two months of his medication than he would for one month in Cork. I am concerned when I hear that. It is a genuine case where someone is slightly over the qualifying criteria for a medical card, he does not have a huge level of income coming into the house, and his wife does not qualify for the old age pension as she is not over 66. They get the additional allowance for her, but it is still much cheaper for him to travel to Northern Ireland to buy medication. I am not talking about travelling from Dublin or Monaghan but from Cork. That concerns me.

I will go through the figures presented on the €1.5 billion savings since 2006 that the witnesses mentioned. The Oireachtas Library and Research Service presented figures to us showing that savings of €765 million have been made since 2006. It gave a breakdown. In 2006 to 2010, €250 million was saved; in 2010-2011, another €250 million was saved; in 2013, €120 million was saved; and in 2014, €148 million was saved, giving a total of €768 million. We are being told here that it is €1.5 billion. I am a bit concerned about the presentation of figures. The current expenditure level for 2014, according to the witnesses, is €1.92 billion. Again, the Library and Research Service tells us that the total 2012 PCRS expenditure was €1.92 billion. We are, therefore, coming up with the same figures in a two-year period. We might go through the figures a little more closely in respect of where we are making savings because I am not convinced that we are making the inroads we should.

It was mentioned that the figures for generic drug use are now up to around 68% for the fourth quarter of 2014. We were told last week that the figure was 48%. Why are we getting all these confusing figures on generics? It was the pharmaceutical industry itself that made a presentation to us last week saying that the figure for generic usage was 48%, but we are now talking about a figure of 68%. Perhaps we might get some clarification on this.

The other issue that was raised goes back to the ESRI report in 2013. When we talk about the negotiating price, we are talking about the basket of nine countries and we are coming out with the average. Deputy Ó Caoláin asked why we cannot be the lowest of the nine, rather than the average. We are not making enough progress on this matter. It is a huge cost factor. The Library and Research Service refers to the overall cost in 2012. Total PCRS expenditure for all schemes was €2.56 billion in 2012. Those are the figures the service is giving to me. We seem to be getting different figures from different people. I want to see by the end of 2015 some real change in cost. I am not convinced we are making enough progress in this matter. Legislation was brought in on the use of generic drugs and we are making substantial progress, but could we make much more progress and do we all need to do much more, from hospitals to general practitioners across the board? Are we doing enough and can we do much more? It is not that we do not want to use the money for health, but we could use that money far more effectively in other areas if we could save on the cost of drugs.