Mr. John Hennessy:

I might deal with the savings issue to give Mr. Shaun Flanagan a chance to draw breath. I might ask Professor Barry to elaborate a bit more on the rare disease plan as well.

Senator Colm Burke and Deputy O'Connell raised issues about savings and what has been achieved under the 2013 legislation. I will give the committee a flavour of that. The big change in the 2013 legislation was the enabling of reference pricing. To date, more than 40 products have been reference priced in Ireland with price reductions of up to 90% achieved on many of the commonly prescribed items. The overall savings achieved under reference pricing to date since the Act was commenced are in excess of €120 million. Generic prescribing, where it is appropriate and empowered, is in excess of 70% compared with approximately 30% as recently as five years ago.

On the various price agreements with the pharmaceutical industry, which have been involved since 2006, our calculation of cost reduction and cost saved in the period from 2006 to date is €1.5 billion. The current agreement, which is scheduled to run to 2020, is expected to produce savings in excess of €600 million by our calculations. While IPHA companies will assess it as being slightly higher than that, we assess it at about €600 million.