asked the Minister for Health the total cost of drugs and medicines under the health services in 1963-64 and in 1968-69 distinguishing between general medical services and hospital services; the principal reasons for the substantial increases indicating the extent to which each reason is responsible; and what steps are being taken to analyse the causes and prevent any avoidable increases.
Ceisteanna — Questions. Oral Answers. - Cost of Drugs and Medicines.
39.
The total cost of drugs and medicines provided under general medical services was £608,000 in respect of 1963-64 and £2,072,000 in respect of 1968-69. Corresponding figures for hospital including mental hospital services provided by local authorities are £693,000 and £1,346,000, respectively.
The increase in expenditure on drugs and medicines supplied under general medical services is due to a variety of factors. It is estimated that increased prices, an increase in the numbers covered by medical cards and in the numbers provided with medicines on hardship grounds would account for about one-third of the increase in expenditure. The remaining two-thirds arises from factors whose relative effect cannot be measured precisely. These include increasing issues at dispensaries to patients after their discharge from hospital, in particular psychiatric patients who are provided with the initial supply of drugs at a psychiatric clinic but frequently obtain subsequent supplies from dispensary stocks.
Apart from price increases, the increase in expenditure on drugs and medicines used in hospitals may be attributed to increased usage particularly of newly developed and more effective drugs which are usually more costly than those which they replace. This development has helped to achieve a reduction in the average length of stay in hospital and an increase in the numbers of patients treated with no significant increase in the extent of hospital accommodation.
The experience in this country in regard to the cost of medicines used in the health services is consistent with experience in other comparable countries. In view of the rate at which the cost has been increasing, however, the matter is constantly under review in my Department, and the attention of health authorities is drawn to any situation in which economies appear to be feasible.
Under the proposed new arrangements for the provision of a general practitioner service for lower income group patients medicines will, in general, be provided through retail chemists. It is envisaged that more detailed analyses of medicine costs will be possible when the revised arrangements are introduced.
The remaining questions will appear on tomorrow's Order Paper.