Billy Kelleher (Cork North Central, Fianna Fail)
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Xolair is a medication for the treatment of severe allergic asthma. The product was licensed for use in 2005 but is not reimbursable under any Government schemes. This means it is primarily a matter for hospital pharmacists to decide whether to dispense Xolair to people who have allergic asthma. All available scientific evidence and analysis shows that the medication gives a certain cohort of people great relief from allergic asthma. The current difficulty in respect of dispensation of Xolair is that its availability is determined by geographical location and the budget available to hospital pharmacies.

It is estimated that 450 people who suffer from allergic asthma are suitable for treatment using Xolair. If this medicine were prescribed to these individuals, it could have a life-changing impact. Ms Breda Flood, a board member of the Asthma Society of Ireland, stated the following about her treatment using Xolair:

After many years of severe asthma I struggled in everything I did. I was hospitalised on numerous occasions and had persistent infections, coughing and difficulties breathing. I have been on Xolair for a year now. After 4 months I saw an improvement and now after a year on the medication I cannot tell you how much this has changed my life and my family's life.

I can now go to bed and sleep through the night without having to take my inhaler during the night. I can walk without coughing and I can talk without coughing. Every day I get up I feel better. Xolair has given me a new lease of life and it has taken years off me. The improvement to the quality of my life is so great, it is impossible to quantify.

Speaking earlier about the geographical spread of discretionary cards, the Minister of State at the Department of Health, Deputy Alex White, stated variations in the way in which medical cards are assessed and granted are not right. The same logic applies in this context. Decisions on the dispensation of Xolair are based on geographical location, which means patients in some hospitals do not have any difficulty obtaining the drug, while patients in other hospitals, including Cork University Hospital, do not have access to it. I ask the Minister of State to raise the matter with the Minister whom I accept is detained in the Seanad.

Novartis, the company which manufactures Xolair, has agreed to reimburse hospitals in cases where the drug is found to be ineffectual. This is a fair offer as it will mean no costs will accrue to the State where the treatment does not work. I wish more companies would adopt the type of positive attitude shown by Novartis. I hope the Minister of State will be able to provide a positive response to the many people who suffer from allergic asthma.

Alan Kelly (Tipperary North, Labour)
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On behalf of the Minister for Health, I thank the Deputy for raising this important issue. I am aware of the challenges people with asthma face in managing their condition and fully acknowledge the need for the provision of appropriate services for all asthma patients.

The treatment of asthma is one of the ten chronic diseases identified by the Health Service Executive as priorities for intervention. Clinically, the management of asthma through elective treatment is more effective than emergency treatment. The vision of the national asthma programme is that every person with asthma should reach their maximum health and quality of life potential through the prevention, early detection and effective treatment of his or her asthma. The key aims of the programme are to reduce asthma mortality by 90% in ten years; reduce general practitioner out-of-hours visits due to asthma by 10% or 5,000 over three years; reduce emergency department visits due to asthma by 10% or 2,000 over three years; and reduce asthma bed days by 10% per year over three years.

Each hospital or hospital group must make its own decisions regarding the provision of expensive or complex treatment. Xolair is a very expensive drug, costing on average between €12,000 and €15,000 per annum and is not a suitable treatment for all patients. Xolair treatment entails subcutaneous administration in an infusion centre. Treatment requires clinical supervision during and after administration, because of the possibility of adverse outcomes, as for many complex drugs, in a small percentage of cases. The south-south west hospital group supports the use of Xolair as part of the treatment pathway for appropriate patients with severe asthma. Treatment with Xolair has been provided within the group through the Mercy, Waterford and south Tipperary hospitals. Action plans in terms of direct patient treatment are being progressed in Cork University Hospital. The Minister for Health is committed to providing the best possible health service and will continue to work with the HSE to ensure the best possible outcomes are achieved for asthma patients.

There is no doubt that Xolair has a significant impact in the treatment of certain patients, depending on clinical circumstances and prognosis. However, not every hospital is in a position to meet the conditions attached to supervising use of the drug. I understand this issue is being addressed in Cork University Hospital. Given the size of the hospital, I hope some progress will be made in this regard in the near future.

Billy Kelleher (Cork North Central, Fianna Fail)
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The purpose of the national asthma programme is to ensure that asthma sufferers do not have to present at emergency departments when they have an asthma attack. In any one year, 25,000 people will present at hospital with an asthma attack. Any treatment that can prevent this is of immediate benefit to the patient, as well as reducing costs for the State. Novartis which manufactures Xolair has agreed to reimburse hospitals in cases where the drug is found to be ineffectual. Coupled with that would be the cost savings for emergency departments.

I hope the use of this treatment at Cork University Hospital will be looked upon favourably. We all accept Xolair needs clinical supervision when being administered because it is a subcutaneous implant. I hope, however, the Minister of State will convey to the Minister for Health that this treatment should be examined with a certain urgency and that finance would be made available for it. There should be some assessment of the number who will benefit from this treatment, the costs that would incur and the savings that would be made by reduced numbers presenting at emergency departments due to asthma attacks.

Alan Kelly (Tipperary North, Labour)
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I will convey that to the Minister for Health. Elective treatment is better than an asthma attack sufferer presenting at an emergency department. It is really just a process to ensure that Cork University Hospital can facilitate such a treatment. I hope it can be looked upon positively once the conditionality is established. The fact Novartis is willing to reimburse for ineffective treatments is also helpful. I will convey all of this to the Minister for Health.