Róisín Shortall (Dublin North West, Labour)

My understanding is that tysabri is prescribed on the basis of clinical indications. If there are regional variations, I am not aware of them. I will check and revert to the Deputy later in the day.

I agree absolutely with the Deputy that we need to be very vigilant about the prices charged for medicines. In many cases where new drugs are coming onto the market, the suppliers have a monopoly. That is why we need very rigorous assessment of the value for money achieved in the prescribing of the drugs in question. We cannot accept any new drug coming onto the market. There ought to be a very rigorous assessment and such an assessment is absolutely legitimate. History shows that, in many instances, we paid over the odds for drugs. This is partly the reason our drugs bill has increased from €400 million in 1998 to almost €2 billion today. This is not sustainable. We must ensure drug companies, the presence of which in the country we very much welcome because of their research and the employment they provide, are responsible in their pricing systems. If we are paying more for drugs, the cost must be met somewhere else. It means a service cut somewhere else. That is the reality and there are serious implications on foot of a service cut. It is a question of ensuring we are reasonable and that we can bring the drugs budget under some control while ensuring new drugs are made available.

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