Wednesday, 17 April 2013
Medicinal Products Prices
I thank the Minister for coming to the House at this late hour to deal with this matter. The issue I am raising relates to what happens when people purchase drugs or medications from their local pharmacies. I understand that after they have made the maximum monthly payment of €144, they are not given a detailed breakdown of the total cost of the rest of the medication from which they are benefitting. I am open to correction in this regard. I have spoken to a number of people on this issue. One receives a receipt for the first €144 of one's medication, but one does not get the full details of what one receives thereafter. A person who uses medication costing €300 or €400 does not get a breakdown of what the full amount of money is spent on.
I believe this is one of the issues we need to tackle, particularly given that the cost of drugs in this country increased from €574 million in 2000 to €1.894 billion in 2010. I have raised this matter already in this House today. It is estimated that this country's drugs bill will reach approximately €2 billion this year. A number of recent reports have indicated that there are substantial variations in the cost of medication. An item that cost €16 in one pharmacy was found to cost €46 in another pharmacy in the same town or city. There are significant price variations between pharmacies.
I would like to mention a second aspect of this issue. In Ireland, some medication costs up to 25 times more than a similar item would cost in the UK. Nobody seems to be in control. I am giving a simple example of the urgent need to make people aware of how much their medication is costing. People should take a proactive approach to helping to reduce the cost of medication in this country. I reckon we are spending between 25% and 30% more than we should be spending at present. I appreciate that the Health (Pricing and Supply of Medical Goods) Bill 2012, which is being considered at present, advocates the use of generic drugs. However, generic drugs are between ten and 20 times more expensive in this country than in other jurisdictions. This issue needs to be tackled urgently.
I apologise for the inability of the Minister for Health to be present to respond to the matter raised by Senator Burke. He has asked me to convey his apologies in that regard. The Minister is in favour of pharmacists publishing details of dispensing and other fees. Under the code of conduct of the Pharmaceutical Society of Ireland, pharmacists are required to provide honest, relevant, accurate, current and appropriate information to patients regarding the nature, cost, value and benefit of medicines provided by them. Every pharmacist has an obligation to comply in full with the statutory code of conduct. Perhaps they do not always do so.
The PSI advises patients that their pharmacist should be in a position to provide them with whatever information or clarification they require about prescribed medicines, although, as Senator Burke has just said, they often do not ask for this information. Each pharmacy has a professional management structure comprising of a superintendent and supervising pharmacist, and it may be appropriate to seek further information or clarification from them.
The price charged by a pharmacy for dispensing a prescribed medicine typically consists of a dispensing fee, the ingredient cost and a retail mark-up. The HSE reimburses pharmacists for products dispensed under the general medical services scheme and other community drug schemes in accordance with rates set out in its list of reimbursable items. Under the Financial Emergency Measures in the Public Interest Act 2009, the fees and allowances paid by the HSE to pharmacists were reduced in 2009 and again in 2011. These measures included a reduction in the wholesale mark-up on drugs from 17.66% to 8%. In addition, the retail mark-up payable under the drug payment scheme and the long-term illness scheme was reduced from 50% to 20%. The reduction in the cost of medicines should be of benefit to all patients who hold a drug payment scheme card, whether or not they reach the €144 threshold per month.
It is open to patients to move their custom to a different pharmacy if they are dissatisfied with the prices being charged. However, as we all know, it is often difficult for customers, particularly those in rural areas, to move their custom because they have built up a relationship and they have a traditional outlet.
I wish to advise that the Health (Pricing and Supply of Medical Goods) Bill 2012, which was passed on Committee Stage in the Dail on 19 March, provides for the introduction of a system of generic substitution and reference pricing. This legislation is expected to complete its passage shortly. This will provide an opportunity to highlight the issue the Senator has raised in the House today and is perhaps an opportunity for the Minister for Health to do something along the lines advocated by the Senator.
I thank the Minister. My principal issue is that people should get a detailed statement at the end of the month regarding the total cost of the medication, including what refund is coming from the Department. There is a huge lack of knowledge as to what medication is now costing. If one is under the €144 threshold, one knows exactly what it is costing, but if it is over €144, one is not given the information and the pharmacy is not required to give a full detailed statement on the total amount being paid to the pharmacy for the medication. That needs to be changed. I certainly intend to raise this with the Minister when we are discussing the Bill and also at the Committee on Health and Children. I thank the Minister, Deputy Hogan, for his response. It is a matter that needs to be sorted out.
The Minister for Health is quite sympathetic to the principles and practice the Senator has outlined. I will bring the matters he has raised to the Minister's attention tomorrow.