Professor Tom Fahey:

Senator Colm Burke asked about comparisons with other countries in relation to polypharmacy and demographic trends into the future. We are not that far out of kilter with other countries. Every country in the developing world has experienced a substantial increase in the use of medicines which, by and large, has been a very good thing. We should not forget that. While we can, rightly, worry about inappropriate medicines, many of these drugs are very efficacious and helpful for patients and they have improved the length and quality of people's lives. While that is likely to continue, I do not know if many projections on demographic trends have been done in that regard. Most of the focus now is on trying to alleviate errors of omission. In other words, we must prescribe drugs which we know are effective to patients who benefit from them. Then there are errors of commission, which are those Dr. Mark Murphy just mentioned where potentially inappropriate drugs are prescribed and the risk-benefit ratio is marginal at best and potentially harmful. That is the context of what has happened. As we have all seen over our professional careers, the main challenge is to get the balance right in terms of drugs which are effective and helpful for patients while reducing as much as we can the use of potentially inappropriate drugs.