Mr. John Hennessy:

There were quite a few questions and some key themes which I will try to address with the help of my colleagues. They concern the basket of countries used in making a determination on price. I will ask colleagues to address that issue. The cross-border issue was raised in quite a few of the questions asked. Issues of currency arise in that context that I believe we will be able to deal with and clarify. Professor Barry will address for members the prescribing patterns, the use of generics and the quality adjusted life year issues.

I will go through the list of questions quickly and ask colleagues to comment, as necessary. I will begin with Deputy Billy Kelleher's questions on why savings were possible or even achieved in the period after 2006. There are a number of key reasons. First, there was exponential growth in costs from 2004 onwards. Much of this growth was attributable to a population increase and new products and also the expansion of eligibility. That was the period in which the over-70s became entitled to medical cards automatically. This gave rise to a considerable additional cost.

A factor to which I am sure colleagues will be able to allude further was early adoption of new products in Ireland as part of the nine country basket approach. The approach is subject to the original agreement of 2006. I will ask Mr. Flanagan to speak about who decided on the nine countries and why they were decided on.

I understand Soliris is available, but colleagues will confirm this. I believe there were four additional patients registered on it. Obviously, we are still not happy about the price being charged for the product and the process of seeking an improved price for Irish patients continues.