Jimmy Deenihan (Kerry North-West Limerick, Fine Gael) | Oireachtas source

I thank the Senator for raising this issue. Decisions on which medicines are licensed for use in Ireland and which are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmocoeconomics, also known as the NCPE. The NCPE is a team of clinicians, a pharmacist, a pharmacologist and statisticians who evaluate the benefits and costs of medical technologies and provide advice to the HSE. The NCPE conducts health technology assessments on pharmaceutical products for the HSE and can make recommendations on reimbursement to assist the HSE in its decision-making process.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drugs schemes in accordance with the provisions of the Health Act 2013. It is appropriate that these should not be political or ministerial decisions and that a scientific and evidence-based approach is taken to determining the extent to which patients would benefit from treatment with expensive new drugs and whether this represents cost effectiveness for the health service and the taxpayer.

In August 2014, the HSE medicines management programme asked the NCPE to carry out an assessment of the clinical and economic dossiers submitted by Novartis Ireland on the cost-effectiveness of the company's drug, Xolair, for the treatment of severe allergic asthma. Novartis proposed that the drug be reimbursed as a hospital-only drug, as it must be administered in a hospital setting. Following its assessment of the manufacturer's dossier, the NCPE did not recommend Xolair for reimbursement as it did not consider the drug to be cost effective for the indicated treatment at the submitted price. The HSE accepted the NCPE's recommendation and the drug is not currently reimbursed under any HSE scheme.

While I appreciate that some may take the view that the taxpayer should reimburse every licensed medicine for whatever price a drug company demands, the interests of the health service as a whole require that we only reimburse the most effective medicines and only at a fair price. In this way, we can ensure the most appropriate and cost-effective expenditure of the drug budget available to the HSE each year.