Professor Michael Barry:

Entresto did. With Respreeza, for example, we believed that the cost and health benefits did not match, in that it was not cost effective. Usually, that outcome sends the company into a negotiation with the HSE. As such, it is not a "No", but a recommendation. The HSE will follow up on that. This is often where the price reductions are obtained. One can achieve price reductions of between 20% and 50%, but not in all cases. As my colleague beside me who handles these negotiations will tell the committee, not all drug companies are prepared to negotiate in a meaningful way. That leaves us with a significant problem.

We make a recommendation. We usually know the price at which a drug would be value for money. That is the recommendation that we forward to the HSE.