Alan Kelly (Tipperary, Labour)
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I thank the witnesses from both bodies for their honesty in answering our questions, as this is obviously a very emotional topic. I will digress here slightly. There are media reports out today about the drug Entresto. The issues around this particular drug have been talked about for some time now. Seeing as they are here with us today, perhaps the witnesses will clarify the situation because we need to get to the bottom of this and this is a life-changing drug. On what date did the NCPE pass Entresto? When did the HSE receive that recommendation? When did the HSE pass that recommendation on to the Minister? Is it true that it took ten months, and if so, why? Is it true that the HSE claims it cannot afford Entresto? If that is the case, that is fine, but it means the Minister must make a decision on this. A total of nine drugs were passed together and the Minister said that they would cost approximately €120 million, although I do not want to misquote him here. Of those nine drugs, is it true that this drug is cost-effective? If it is, that differentiates it from everything else.

The figures I have gone through indicate the cost of the drug amounts to less than €5 a day, adding up to approximately €1,700 a year per patient. We are looking at approximately 20,000 patients. The real issue for me is that the average cost for someone who has to go into hospital with cardiac problems amounts to approximately €8,700 a year. We get figures all the time at this committee. The differential here amounts to more than €6,000, meaning that the new drug is cost-effective. It has been passed across a whole range of other European countries and has also been passed at rapid speed across all states in the US, which is in itself quite unusual. Not alone will this drug help approximately 20,000 patients in Ireland change their lives, it will also save the taxpayer money. I ask the witnesses to tell me please if I am wrong on any of this. We need to get to the bottom of what is going on here, so we need the dates of when this was passed, why the HSE took ten months if this is in fact true, whether it has been referred on to the Minister, whether the witnesses have any awareness of where the matter stands, and whether it is cost-effective and life-changing compared with other drugs.

When the HSE says it cannot afford certain drugs, it can pass the matter on to the Minister to make a decision. I understand the Minister's situation and the difficulty around having to fund a range of different drugs. A package of nine drugs has supposedly been referred on to him. If there a serious cost attached to these drugs, that has to be taken into consideration. What I want to tease out, however, is if the differential involved makes the drug cost-effective and it will help 20,000 people, why did it take so long, from July of last year to May of this year, for the HSE to pass this on to the Minister on the grounds that it could not afford it? Why did this take ten months? How many people in this country have been affected by this, and possibly even have died, while this vacuum has been in place?