Mary Henry (Independent)

I do not query the Acting Chairman's ruling on amendment No. 17 being out of order but would accepting it not have incurred a saving for the State rather than a charge? As Senator Quinn said, perhaps the Minister of State could re-examine it before Report Stage.

Speaking as a member of the medical profession, there is much pressure to continue prescribing the most heavily advertised drugs. Naturally, they are foremost in one's mind and pharmaceuticals make significant efforts irrespective of cheerleaders encouraging people to prescribe their expensive products. It is difficult to keep names in one's head.

I had an interesting experience a number of weeks ago. A Member of the House forgot his prescribed anti-inflammatory tablets and he asked me whether I could get him some. I went to a chemist and got him ten 100 mg tablets, saying they were for someone who forgot his as I was obviously not his doctor. The pharmacist asked why I had not suggested he get an alternative, which was exactly the same but came in 50 mg tablets as pharmacists were only allowed to give that amount over the counter.

It was the same product, which I had not realised. It is not something one can keep in one's head all of the time, although pharmacists are better than doctors. If a person was buying two 50 mg tablets over the counter, it would be the same as going to a doctor to get a prescription for one 100 mg tablet. It was not a question of a patent. An Internet site would be useful in order to view such information immediately.

The costs of producing drugs from basic research are extraordinarily high. The Minister of State knows that, over the past 20 years, few important drugs have been produced de novo. As Senator Quinn pointed out, most have been variations on themes. Changing them slightly allows drugs to stay in patent for much longer. Someone I know involved in the Global Fund wants to know why, in respect of artemisinin, the drug recently found to be suitable for malaria that has been used in China for years, we could not crush the leaves as Chinese peasants did for hundreds of years and give them to patients rather than having them made into various patented tablets. This incurs a significant cost on treating malaria as we are making matters more expensive and difficult. If one examines the costs of producing a drug, the main cost is advertising, including cheerleaders. By producing something simple, such as an Internet website, people would be able to see whether they want the tablet — expensive due to advertising — or the alternative, which is much cheaper because it is not heavily advertised.

Claims of a new improved product may be greatly exaggerated. The Minister of State knows there have been dreadful situations where trials on drugs have too often been multicentred, involving members of the medical and pharmaceutical professions. The results are sent back to pharmaceutical companies, for example, for reports to be extrapolated. Some years ago, Dr. Marcia Angell, a former editor of the New England Journal of Medicine— one of the most reputable of journals — said she would not produce articles in it anymore when those involved in the research had more than a certain amount of financial involvement in the firms. After approximately two years, she wrote an editorial stating she was removing the stipulation because she was not receiving enough papers.

This is a serious issue. The Minister of State is allowed to incur costs on the State. He would do a great service in terms of saving the State money if he could examine Senator Quinn's amendment and determine how he could frame it to ensure that those involved in the medical and pharmaceutical professions and others who will be allowed to prescribe could determine which drugs are the same and could also make price comparisons more easily.

I was not here for Committee Stage last week as I was in Barcelona with members of the Joint Committee on Health and Children to examine aspects of its health service. A significant difference is the cost of drugs to that service. This amendment would allow people to make a choice without forcing them into any type of prescription. They would have knowledge, which is what people generally want before they make decisions.