Michael Harty (Clare, Independent) | Oireachtas source

I will go to our second round of speakers soon. From what I can gather from the contributions so far, the tension is between the pharmaceutical industry, a commercial entity driven by profit and responsible to shareholders, and health services with limited budgets, responsible to the populations and patients they serve. That is where the negotiations start. The EU Council has stated it is within the competency of each member state to decide what drugs are approved and what price is paid. Are we being exploited by pharmaceutical companies playing one country off against another? We have seen representations made in the Dáil from groups stating that a certain drug is available in ten or 20 other European countries and asking why it is not available in Ireland. Moral pressure is being applied to Governments and politicians. We are all also subject to lobbying from big pharma companies concerning making orphan drugs available for rare and ultra-rare diseases.

We have presentations on that issue in the audiovisual room here. The most recent was on Spinraza but there have been others for many other drugs. Moral pressure, therefore, is applied to Government and politicians but the same moral pressure does not seem to be applied to the pharmaceutical industry. It should clearly also have a moral and ethical responsibility if it has produced an effective drug. To withhold such a drug on the basis of exorbitant cost does entail a moral and ethical responsibility. The spotlight, however, is not shone on the company. Many representative groups do not go to the headquarters of pharmaceutical companies and make a presentation there. They come here instead and put moral pressure on the Government and politicians to pay. There should be a rebalancing of those responsibilities. The witnesses might comment on that.

I know the IPHA would contend it regularly negotiates prices with the Government. There was an expectation that the resultant cost reduction, I think it was in 2016, would be redeployed to the approval of new drugs as they came on the market. The IPHA would also contend that Ireland is way below the European average in approving new drugs. Of 153 drugs referred to by the IPHA, Ireland has approved 49. That may have increased in the past few months. There is an expectation from the pharmaceutical industry that savings generated from using generic drugs or negotiating cost price reductions should be ploughed back into new drugs. The IPHA would contend that is not happening. The witnesses might also comment on that.

There are, therefore, two issues. One concerns existing drugs and how costs can be reduced. We are all familiar with people who go to Spain or Portugal and buy certain drugs across the counter for a fraction of the cost here. There is obviously variation in cost. Why is Ireland not using its power as a member of European Union to get other European states to negotiate a common price? Why should a drug in Spain cost a fraction of what it costs here? Finally, there is also the issue of the new orphan and cancer drugs, drugs for hepatitis C for example, that come on the market all of the time. How can a small country like Ireland negotiate a price with a global pharmaceutical company? Surely, as Deputy Durkan said, we should be using our power within Europe to secure a common price for all countries. I ask the witnesses to comment on all of those points.