Joanna Tuffy (Dublin Mid West, Labour)
Link to this: Individually | In context | Oireachtas source

142. To ask the Minister for Health the reason there is such a discrepancy in the price of drugs here compared to other European countries (details supplied); his plans to give cancer patients access to free medication during the course of their treatment; and if he will make a statement on the matter. [38700/14]

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context | Oireachtas source

The prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT.

The Government has introduced a series of reforms in recent years to reduce the prices of drugs and medicines which are paid for by the HSE. This has resulted in reductions in the price of thousands of medicines. Price reductions of the order of 30% per item reimbursed have been achieved between 2009 and 2013; the average cost per items reimbursed is now running at 2001/2002 levels.

A major new deal on the cost of originator drugs in the State was concluded with the Irish Pharmaceutical Healthcare Association (IPHA) in October 2012. This agreement provides that prices are referenced to the currency adjusted average price to wholesaler in nine EU member states (Austria, Belgium, Denmark, Finland, France, Germany, Netherlands, Spain, and UK)and these are the maximum prices paid by the HSE for originator drugs supplied through the community drug schemes. The gross savings arising from this deal will be in excess of €400 million over 3 years. €210 million from the gross savings will be available to fund new drugs.

A new agreement was also reached with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry, in 2012. Under this Agreement the maximum price the HSE pays for generic products was 50% of the initial price of an originator medicine, this was further reduced to 40% from 1 May 2014. This has resulted in the price differential between off-patent drugs and most generic equivalents increasing from 5% to approximately 20%.

The Health (Pricing and Supply of Medical Goods) Act 2013 introduces a system of generic substitution and reference pricing. Reference pricing involves the setting of a common reimbursement price, or reference price, for a group of interchangeable medicines. This is the maximum price that the HSE will reimburse to pharmacies for all medicines in the group, regardless of the individual medicine’s prices. It is estimated that reference pricing will yield €50 million in savings in 2014.

The reference price for Anastrozole is €28 per pack of 28 tablets with effect from 1 May 2014. In setting the reference price the HSE took account of prices across the EU, where there is significant variation in price, and sought to balance value for money versus sustainability of supply in a small market. The reference price represents a 39% reduction and is subject to review on an annual basis.

In the case of drugs and medicines which are reimbursed by the HSE, prices are set in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013 or the terms of the framework agreements between the Department of Health and the HSE and the representative bodies for pharmaceutical manufacturers in Ireland. However, neither the Minister for Health nor the HSE has any power to set the prices of drugs and medicines purchased by private patients. It would nonetheless be disappointing if all pharmacists were not passing on the benefits of lower prices to patients.

The HSE advises the public that if they are being charged prices which exceed the reimbursement price listed on the HSE website (), plus a dispensing fee of between €3.50 and €5, then they should discuss the differential with their pharmacist to ensure they get the best possible price for the medicine concerned.

In addition, measures have been taken to increase price transparency among retail pharmacies. In March of this year the Pharmaceutical Society of Ireland issued guidelines to pharmacists on procedures and minimum standards of information to be provided to customers, including a requirement to provide an itemised receipt of purchase of medicines.

There are no plans to extend access to free medication to cancer patients specifically under the community drugs schemes. Support for the cost of medication is provided under the Drug Payment Scheme, whereby no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family.