Catherine Murphy (Kildare North, Independent) | Oireachtas source

I move amendment No. 1:

In page 10, between lines 34 and 35, to insert the following:

“ “non-interchangeable medicinal product” means a medicinal product which is not interchangeable with any other medicinal product for prescription purposes in the opinion of the Irish Medicines Board in accordance with the provisions of section 5 of this Act;”.

Most of us would support a reduction in the cost of drugs. The move towards the use of generic drugs is a very good idea and it has been a long time coming.

My amendment has in mind conditions such as epilepsy where the move towards the use of generic drugs is a false economy. People with epilepsy may require lengthy treatment before their condition is stabilised. I know quite a number people with epilepsy. It is not a benign condition. I know of a woman with epilepsy who nearly died recently. She is attempting to stabilise her condition. She has two children aged nine and 11 years. There could be repercussions for her if her condition is not stabilised. I recently met a man with epilepsy who lost his job as a result of losing his driving licence. He is now trying to meet his mortgage repayments. Trying to get his condition stabilised was a big deal. I also know of an 18 year old who developed epilepsy in her leaving certificate year which had an impact on the exam and on her life opportunities. It meant the loss of her independence. Finding the right concoction of drugs is critical to stabilising the condition and preventing breakthrough seizures; it is not something that should be played with. The use of generic drugs can be a false economy in this regard. In Northern Ireland, certain drugs are not permitted to be substituted. There can be very small differences between drugs and the dosages may need to be ramped up to achieve the desired level that will work for the patient. In some cases, patients may not be prescribed their drugs by a consultant. It cannot be presumed that pharmacists will second guess what is contained in each component. Small amounts or variations can make a difference.

A person's epilepsy may be stable for two years but a breakthrough seizure may result in the loss of a driving licence for a year which will have an impact on employment. Physical injuries such as a fractured skull or broken teeth can result from seizures. The Moran report specifically recommended that treatment for epilepsy be excluded from generic substitution. This is the case in the United Kingdom and in other EU countries. I have concerns about the ability of the Irish Medicines Board to properly evaluate or monitor what is being substituted. Breakthrough seizures can have all sorts of impacts on people's lives. General practitioners write the prescriptions in many cases. Without specialist oversight we may well cause problems for ourselves without any savings to the State in the longer term.

I appeal to the Minister of State in this regard. Generic substitution is long overdue but it may be counter-productive in some areas and the treatment of epilepsy is one such area. It makes sense for the Government to step back. I make this appeal on behalf of 40,000 people. I refer to an Australian survey which found that quite a number of people believed they had experienced some form of discrimination in the workplace because they had epilepsy. Success in the good maintenance of epilepsy has been the good news story of the past decade. Let us not put that at risk. It is very difficult to achieve the correct maintenance treatment but this is what gives people back their independence. This should not be put at risk. The Bill has some good provisions and I do not wish to vote against it but this provision must be changed.

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