James Reilly (Dublin North, Fine Gael) | Oireachtas source

This particular drug costs approximately €6,000 per year. As I understand it, many of the people who are using it are being supplied by the manufacturer on a trial basis. Approximately 7,000 people in this country have multiple sclerosis, which would equate to a bill of €42 million per annum. Fampridine does not work in all cases - far from it. It is estimated that it will only be effective for 20% to 25% of multiple sclerosis sufferers. Admittedly, for those patients for whom it does work, the effects can be dramatic, with the ability to carry out the activities of daily living greatly improved to the point where they can go to work and lead a much more normal life. We would dearly love to be able to provide the drug for them, but we cannot do so at its current costing. We have a limited pot of money available and €42 million would be an enormous sum to take out of it. What other items would we sacrifice to do this? The price of the drug must be more realistic.

I call on the pharmaceutical industry, as I did earlier in Dáil Éireann, to enter into risk sharing with the Government, on behalf of the taxpayer, for whom we are trying to provide services and medication. There is no risk sharing. For example, there is no arrangement whereby we could agree and pay a certain price for those patients for whom the drug is working. In the first instance, we must demonstrate that the drug works, as it clearly does for some. We also need to have a sense of the type of patient for whom it is likely to work and limit its prescribing to such patients.

I am acutely aware, therefore, of the impact on families and the stress caused for them. He was a smoker and a doctor.

We have made great progress. The principle underlying health policy is that patients should be treated at the lowest level of complexity that is safe, timely, efficient, and as near to home as possible. Early intervention is part of this to allow for better outcomes for the patient and more treatment nearer to home. We need to develop stroke rehabilitation services in the context of primary care. I have opened many health centres in the past three years. We have opened them at a rate of one a month. Many of them have physiotherapy and occupational therapy facilities; therefore, the service is evolving. I look forward to us continuing to improve outcomes for patients. However, the Senator is correct that prevention is better than cure and in moving from hospital-centric services to primary care we also have to move resources. There is only one pot of money which is constrained, but we continue to move as much of the service as possible out of the hospital into the community where it is more cost effective and convenient for patients to use it.