Professor Bryan Lynch:

That is an excellent question. I was on the HPRA committee that initially looked at these products and I was on the advisory committee that ultimately produced the recommendation for MCAP. In the HSE document, we clearly stated the indications. I am an expert on epilepsy only and can only speak to that. On that document, we clearly stated that it involved severe epilepsy where there has been a failure to respond to five or more standard anti-epileptic drugs. Separately, there are two specific and very severe epilepsy syndromes of childhood - Dravet syndrome and Lennox-Gastaut syndrome - in that document. Those are two different criteria. If we look at what was available to treat epilepsy, it is perfectly reasonable to try better evidenced-based options first in general for severe medically refractory epilepsy. I would not apply those criteria to those two childhood syndromes, of which can be life-threatening. That is what is in the document and that is what we agreed as committee relevant to epilepsy.