Tim O'Malley (Limerick East, Progressive Democrats)

I thank Senators Quinn, Henry and Browne for their contributions on this matter. The Department is examining the increased use of generics as part of a wider review of all aspects of the GMS and community drugs schemes. As a first step, negotiations will shortly commence on the renegotiation of the IPHA-APMI agreement which sets the supply terms, conditions and prices of medicines supplied to the health services. As the increased use of generics will be discussed in this context, an amendment of the kind proposed would be premature. The appropriate body to have the role of formulating therapeutic substitution groups for generics has yet to be decided in the context of the present examination of all the policy, legal and administrative issues involved.

If it were decided to publish a register of generic drugs and therapeutic equivalents, it may not necessarily require legislation as it would be expected that the relevant body would make such a register publicly available and update it regularly, in line with best practice. Therefore, amendment No. 17, which was ruled out of order, is premature in the context of ongoing policy examination of the issues and I could not have accepted this proposal.

I wish to comment on a few of the issues to which the Senators referred. I thank Senator Quinn for raising the matter of generic medicines. I certainly do not disagree with anything he stated. I have always held the view that there should be far greater penetration of generics in the Irish market. Off the top of my head, there is only about 6% or 7% penetration in the Irish market compared with 26% to 30% in other European countries. There must be a rethink about the education of doctors on the use of generic medicines. I find it difficult to believe that students use the generic name in their training in the universities and in the hospitals, and then there is considerable promotion in the hospitals to get them to forget about the generic name and use the trade name.

I agree with the Senators who referred to the problems with clinical trials and research being put to the top of the agenda of the pharmaceutical industry. I have stated publicly on many occasions that I have considerable concerns about the overuse of medications in my own area of responsibility, the mental health area, which is not as clearcut as other areas like diabetes where one can measure the results of treatment. Much work is being done internationally and many share my concerns. I do not want what I say to be misconstrued. Many of the drugs are good but I, and many others, would suggest they are being too widely used.

I note a concerted effort, promoted by the medical council, to inform doctors about drug promotions and the way in which drug companies can use promotions to influence the choice of the medical profession. Much work has been done by the medical council in the past few years in that area. I agree with all the Senators who spoke about generics. In my view, there should be far greater use of generics in Ireland. It would result in significant savings, not just for the taxpayer. One must remember that many people pay for their own medicines. I have always felt that many such people, were they better informed, would choose to use generic medicines which are the equivalent of the branded product, which is no longer under patent.

Some Senators spoke about education. I commend the Consumers Association of Ireland. For years it has been doing much useful work in supporting the greater use of generics in the Irish market and from time to time it publishes leading articles on the greater use of generics in Ireland. Some of its articles in the past few years have been very useful and informative to people who are members of the Consumers Association of Ireland.

As we are on the topic of generics, another issue of which the Senators may be aware and which is causing a problem, not alone in Ireland but all over Europe, is that many inexpensive products are going out of stock and pharmacists and doctors are encountering a major problem as a result. These are essential medications for many people. While I am not saying this is being done deliberately, unfortunately some of the drug companies are allowing situations to develop where these products go out of stock and this causes major problems for both doctors and pharmacists. Sometimes there would be an equivalent alternative. It may be worthwhile for European Health Ministers to come up with a register of these products, as Senator Quinn suggested, so that there are enough of these medicines in Europe. While some of the products concerned are inexpensive, they are essential. I am aware of several such products. Aspirin is one that went out of stock a while ago. Eltroxin-thyroxine is another. At present, cytamen and neocytamen are out of stock. These are products that have been on the market for years. There may be a necessity for the EU Health Ministers to get together to ensure there is a sufficient supply of these products to meet the needs of patients in the European Union.

I thank the Senators for raising this matter on which I have strong views. I agree totally with the points made by Senator Quinn. However, there are legal implications at which we must look and my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney, is looking at all of these in the context of upcoming discussions. I am sure that there will be quite an amount of movement in this area in 2006.