Mr. John Hennessy:

Deputy Caoimhghín Ó Caoláin referred to rational prescribing. Professor Barry's programme is getting to grips with that issue. He will be able to allude to it further, in addition to the use of the nine country basket. These are issues that are subject to scrutiny in the context of a new and successor agreement, wherein we would not necessarily be working on the basis of the average. We will be looking for a better approach. Sometimes the pace of adoption has been an influence. Traditionally, Ireland has been one of the early adopters of new products and medicines which, again, reduces the number of countries involved in making up the average. That has now changed, subject to the 2012 agreement and the processes in place courtesy of Professor Barry's programme.

The quality adjusted life year and the maximum of €45,000 comprise a considerable debating point. The debate is occurring worldwide on health economics. The issue for us in that regard is that the measure is a tool. It is used for automatic qualification of a product. This is by no means the only issue, but it is a useful assessment tool to get business done and products into the reimbursement process. There are obviously bigger picture issues that have to be borne in mind. We saw examples recently of where the cost of products far exceeded the €45,000 threshold. We will try to address the cross-border issue and why drugs are cheaper elsewhere.

Senator John Crown's point on the size of the market was significant. It is part of the bigger picture issue in determining why companies locate in Ireland

Senator Colm Burke raised issues concerning Northern Ireland and the amount saved. We can clarify the discrepancies he is finding in his figures concerning what is reimbursed and total expenditure on pharmaceuticals. Any discrepancy between 2012 and 2014 will be addressed by Mr. Burke.

Generics were referred to. We have an explanation as to why last week companies were citing a figure of 48% and why we are at 68%. We will be able to clarify that issue. I will ask Professor Barry to answer the question on whether there is more we could do on drug prices in securing a better deal for taxpayers. As to why there is a reluctance to use generics, the quality of life issues Deputy Catherine Byrne raised are very important. Perhaps Professor Barry might address the issue of reluctance on the part of the public. It may still feature in respect of generics, but I believe the attitude is changing. We have seen evidence of change in the figures very recently.