Dr. Colin Doherty:

I do not want proceedings to close without a discussion on cost. Within the structures of what we are reviewing here, we will have no capability of jurisdiction for stating that this drug should be made available under the long-term illness scheme, which is the main reimbursement scheme for anti-epileptic drugs. People also get it on the medical card, but as there is a charge per medication there, most people choose to get their medicines under the long-term illness scheme. Getting a drug designated for treatment on the LTI scheme is completely separate and is just not covered by this review. We could recommend it, but it would not necessarily move the situation along.

Cost will be a big issue in this. Certain families accessing the high-CPD versions, as Ms Vera Twomey is, have stopped using it because they cannot afford to continue to pay for it. This meeting should not close without an acknowledgement that the cost issue will be significant and just because there is a recommendation on an individual patient basis that a patient should get it, it is not automatic that the HSE will pay for it.

There is a whole process to get a drug listed on the long-term illness scheme. That sometimes can apply even to established drugs that we use. We sometimes use vitamin supplementation for patients with epilepsy and we have trouble getting the Government to reimburse those because it is not defined as an anti-epileptic drug. I do not think there is an answer to that question.