Damien English (Meath West, Fine Gael)
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Question 59: To ask the Minister for Health and Children the action that will be taken on foot of the report (details supplied) to reduce the State drugs bill; if the Health Service Executive has restricted access to oral nutritional supplements for those eligible for the medical card; and if she will make a statement on the matter. [13138/09]

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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Question 69: To ask the Minister for Health and Children if she plans to withdraw any drugs, medicines or supplements from community drugs schemes; and if she will make a statement on the matter. [13143/09]

James Reilly (Dublin North, Fine Gael)
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Question 201: To ask the Minister for Health and Children the details of all instructions issued to general practitioners to limit access, reduce prescribing rates, or withdraw certain drugs, medicines and nutritional supports provided by State drugs schemes, including a list of all drugs, medicines or supplements affected; the estimated cost savings to be achieved from each of same; and if she will make a statement on the matter. [12950/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 59, 69 and 201 together.

The HSE has not withdrawn any products that comply with the existing reimbursement criteria from the community drugs schemes. All patients continue to have access to prescribed drugs and medicines as required. Reimbursement decisions are made with regard to a range of criteria. These include clinical, pharmacoeconomic, patient safety and legal issues, as well as value for money. A number of reimbursement areas are currently under review by the HSE and any reimbursement decisions following those reviews will be made with regard to the existing criteria.

Ensuring value for money in the State's expenditure on drugs and medicines is a priority for both my Department and the HSE. In October last year I established a group, chaired by Dr Michael Barry of the National Centre for Pharmacoeconomics, to develop recommendations for good practice which will ensure safe and effective prescribing for patients while maximising the potential for economy in the use of public funds. An implementation group has since been established to identify and oversee the introduction of specific measures that will deliver more cost effective prescribing by GPs. The group is expected to finish its work by the end of May 2009.

One of the issues identified by the group was the wastage of oral nutritional products. Clinical nutritional products cost the HSE €46 million a year, over €27 million of which is spent on oral nutritional products. The types of oral nutritional supplements most commonly prescribed in the community are ready-made drinks called 'sip feeds'. Audits suggest that up to 50% of prescribed oral nutritional supplements may not be consumed by patients. The HSE are taking steps to reduce the wastage and inappropriate prescribing of these products while ensuring that patients can access them as required. A support pack with prescribing protocols has been distributed to all GPs. HSE dieticians are also developing a training package to support the implementation of the new protocols as well as establishing linkages with primary care teams. I have asked the HSE to forward to the Deputies the support pack with prescribing protocols for their information.

The HSE has also established an internal working group comprising of clinical, commercial and pharmaceutical expertise to review the usage of clinical nutrition products and the introduction of procurement arrangements where appropriate to determine cost effective reimbursement prices for agreed non-drug items.