Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I support my colleagues on this issue. We have teased it out at length and I will not dwell on it to any great extent. In fairness to the Minister of State, it is clear on all sides of the House that in practical terms we will not see the interchanging of anti-epileptic drugs, considering the risk it poses to those who rely on them for the treatment and management of their epilepsy. Anti-epileptic drugs, be they generic medicines or some of the more expensive medicines, are not ideally suited to substitution because of the difficulties associated with their formulation. We have had this debate.

Neither the Minister of State nor I believe anyone would deliberately substitute one anti-epileptic medicine for another, given the associated risks. General practitioners and consultants will, as a matter of form, state on the prescription "Do not substitute". This will happen consistently across the board in regard to anti-epileptic drugs but human nature is such that mistakes do happen. A consultant or general practitioner may forget to write "Do not substitute" in a particular month. A new pharmacist may read the prescription and give the patient a generic substitute. This amendment is about preventing fear in this regard among those with epilepsy.

I have no doubt that the vast majority of people with epilepsy will be very conscious of the risk and careful when picking up their medicines. However, we are relying heavily on the patient, who trusts the general practitioner and pharmacist. The difficulty arises where older patients with epilepsy may be in receipt of a series of medications, in that they may not spot that their anti-epileptic drug has been changed. Alternatively, a person with an intellectual disability may be relying on a relative, parent or sibling to ensure he or she receives the right medicine. What happens where there is an older person with epilepsy who is relying on an elderly parent to pick up the prescribed medication? The parent may not identify that the medicine has been changed, with the result that the epileptic will end up being hospitalised.

We are trying to avoid fear by removing anti-epileptic drugs from the provisions of this legislation. We all believe the Irish Medicines Board will not approve anti-epileptic drugs for substitution or interchangeability but the risk and fear will always arise if the safety net is not in place. Even at this eleventh hour, I urge the Minister of State to reconsider his position.

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