Mr. Tony O'Brien:

Generally we do not fund trial drugs. Most trials are funded by the developers of the drugs. In Ireland we are fortunate that we have good access to trial medicines and programmes. We have a new drugs approval process which uses the quality adjusted life years, QALY, calculation. Where the calculation is that the QALY figure is less than €45,000 which signifies that the cost of medication is less than €45,000 per quality adjusted life year and it is passed by our medicines approval committee regarding quality and safety, as well as being licensed by the Health Products Regulatory Authority, it is automatically added to the list of available medications. Above that figure, we get into negotiations on price and sometimes it has to come up to my level or the leadership team and we have to make difficult judgments on whether to allow a particular medication to be added to the list. If we are subject to an overall cash limit, it will create a context in which we make the decisions which may be different from the present context.