Feargal Quinn (Independent)

I welcome the Minister of State to the House and the Bill. The Minister of State said the Bill is largely technical and I accept that is the case. I want to use the occasion to make the case for adding another function to the role of the Irish Medicines Board, one I am sure it can discharge as effectively and efficiently as it has done for many years, along with all its other functions. The matter I want to raise concerns the drugs doctors prescribe for their patients, which represent a major and growing cost to our overall health services. I am concerned to ensure we get the best possible value for that spending but that does not appear to be the case.

I speak from a grocery background. A revolution took place on the shelves of grocery stores and supermarkets throughout Europe about 20 years ago with the arrival of what we call generic products, which were often practically identical to the highly branded product. They were often made by the same companies that made the top brands on the grocery shelves but they were sold at a much lower price and a battle ensued between the generic and the branded product. The revolution that occurred on the grocery shelves quickly moved on to the chemist shops and the pharmaceutical area but it has not been availed of correctly.

When a doctor seeks to prescribe for a patient, he or she often has a choice between a branded drug and a generic one, although that choice does not exist in all cases. The important point is that in most cases the only significant difference between the two drugs is the cost. Invariably, the branded drug costs much more than the generic one, and sometimes considerably more. That difference is paid ultimately by the taxpayer and the amount goes into the coffers of the big drug companies.

I want to be clear that I am not trying to undermine the business model of the giant drug companies. That model is based on the idea that they recoup the vast costs of research and development from what they charge for those drugs that make it to the market for the length of time they continue to enjoy patent protection. I have no problem with that and what I am suggesting is not a threat to that way of doing business. Generics come into the picture when the patent protection expires, which to the best of my knowledge is after 16 years. They do not have to carry the burden of recouping the research costs and therefore the prices they are sold at can often be much closer to the cost of producing the drugs, which invariably is much lower.

That whole process can be seen as a classic example of the patenting process working very well. In other words, the original inventor's costs are covered and he or she makes a profit in the short term while the public benefits from the advances in the long term. Understandably, the large drug companies do not like to see their revenues cut off in that way. Ideally, they would like to continue receiving premium prices for what they produce, and to continue that indefinitely. They have a number of techniques to ensure that happens, one of which is to continue making small and largely insignificant changes to the drugs they produce, which allows them to claim that the tweaked drug is new and improved. Much of the time it is sheer marketing bluff.

Another technique they use is to expose medical practitioners to a blitz of publicity, pushing their wares. All doctors — Senator Henry will be in the Chamber later — speak of the pressure they come under from the big drug companies pushing them to use their products. That pressure is all one-sided. There is no corresponding marketing from the producers of generic drugs because their cost structure does not allow for large spending on marketing. The inevitable result is that we, the members of the public, end up paying far more for many drugs than we should pay to get the medical result we want. The individual patient is not directly involved in the process. Naturally, the patient leaves it to the doctor to prescribe what is best and often does not pay directly for what is prescribed. In most cases it is the taxpayer who ends up paying the bill.

It appears obvious that if we strive to improve our health service we should try to ensure that the money we spend on it is well spent. This is a clear example of throwing considerable amounts of money down the drain year after year, and those amounts are getting bigger all the time.

We cannot force doctors to prescribe one kind of drug over another. The freedom to choose a particular drug appears to be regarded as an important issue of clinical independence. That might explain the reason the Minister for Health and Children and the chief executive of the Heath Service Executive restrict themselves to exhortations to doctors to use generic drugs more frequently. What I propose is a modest measure to back up these exhortations, which do not seem to be having much effect. The Irish Medicines Board should maintain a register of those drugs for which there is a generic equivalent, and it should be published on the Internet for the benefit of the medical profession and pharmacists. Such a register would be considered a statement by an authoritative and respected body that there is no significant therapeutic difference between these drugs, other than price. It would place the truth about the drugs that doctors choose in the public domain, and as such, would be a small but useful counterweight to the marketing efforts of the major drug companies as they seek to preserve their revenues. Doctors, moreover, would have a readily available reference to consult in ascertaining whether a generic equivalent for a particular drug is available.

Such a register could be set up and maintained at a tiny cost relative to the significant amounts that might be saved if the prescribing practices of doctors are changed. I accept we cannot do this by compulsion. This does not mean, however, that we should not take every possible step to set out the facts of the matter and put them before the medical profession. I ask the Minister of State to consider this proposal. If necessary, I will put it forward in the form of a Committee Stage amendment.

It is interesting that the issue of subsidiarity constantly arises in the context of the EU. It encompasses the notion of bringing decision-making as close as possible to the citizen. Both Senators Feighan and Feeney observed that a person can buy St. John's wort off the shelf in the North but that strict conditions apply to its sale on this side of the Border. That is what subsidiarity is about, namely, the freedom for this State to take such decisions. There will always be differences in practice across the Border.

I did not expect the provisions on meat labelling to be included in this legislation and I congratulate the Minister on this welcome measure. This is a topic that is strongly debated in the United States of America, where retailers are battling against the obligation to disclose the country of origin, whether Canada, Mexico, Chile or elsewhere.

The Minister has acknowledged that this measure presents some difficulty in the context of our EU membership. The EU is quite restrictive in terms of the ability to specify an individual country within the Union and we may well encounter some difficulty in this regard. Even if the Minister does not manage to achieve what has been set out on this issue in legislative terms, the solution is for the matter to be determined by the marketplace. The market will decide the respective fortunes of those restaurants and hotels that advertise their willingness to disclose the source of the meat products they serve, whether chicken from Thailand or pork from Poland, and those that do not.

It seems the regulatory impact of which Senator Feeney spoke presents problems. Given that dangers arise every time we pass legislation without taking into account its costs and other consequences, some type of regulatory impact analysis should be done on a case-by-case basis.

Senator Feeney mentioned the restrictions in regard to the sale of paracetamol. The introduction of scanning has facilitated the management of such restrictions. For example, adherence to the legislation prohibiting the sale of alcohol until 12.30 p.m. on Sundays was simple because the scanning system could be programmed so that the bar codes on any alcohol products could not be processed before that time. A similar system can deal with those instances where a person attempts to buy multiple packets of a particular drug in respect of which quantity restrictions apply. Technology can achieve a great deal in this respect. On the other hand, however, a person who wants to cheat can easily visit several different supermarkets or chemists.

I welcome the Bill and thank the Minister of State for his efforts in this regard. It is interesting that he has added some extra elements we did not expect to see. The legislation deserves support.