Written Answers. - Indicative Drug Target Scheme.

Ivor Callely

Question:

29 Mr. Callely asked the Minister for Health the ethos behind the introduction of the incentive-based drug saving schemes; and if he will make a statement on the matter. [8725/96]

Batt O'Keeffe

Question:

54 Mr. B. O'Keeffe asked the Minister for Health if he has satisfied himself with the savings made on drugs by general practitioners throughout the various health boards. [7610/96]

,Limerick East): I propose to take Questions Nos. 29 and 54 together.

The indicative drug target, IDT, scheme has its origins in discussions with the Irish Medical Organisation and the Irish College of General Practitioners in the context of the 1992 GMS review when it was agreed that medicines were not always prescribed in the most effective manner and that, accordingly, there was significant potential for an improvement in prescribing practice leading to better patient care and better use of the resources in the development of general practitioner services.
Each doctor was, accordingly, encouraged to examine his-her existing prescribing practices with a view to availing of any available opportunities to make prescribing more effective and less costly for all his-her patients. To assist in the process, doctors were provided with indicative drug targets which had been constructed on the basis of average prescribing costs weighted on the basis of age and sex.
The duty and obligation of individual doctors to provide the most appropriate management for each patient who presented and, in so doing, to utilise resources available for the optimum care of patients individually and collectively was emphasised by all parties to the scheme. In this context the right of the doctor to prescribe, as he-she considers necessary, remains absolutely in place and there is no limitation on the range of items from which he-she can choose to prescribe.
As an incentive to doctors to embark on this review process, the scheme provided that a portion of the savings made would be made available to the individual doctor concerned for practice development projects which received the prior approval of the health board. This resource has been allocated towards improving facilities within general practice for the purposes of providing a more comprehensive and better quality service for patients.
Generally, I am satisfied that a considerable number of doctors are making a genuine effort to achieve more rational and cost-effective prescribing. Prior to the introduction of the incentive based indicative drug target scheme, the average annual rise in general medical service drug costs was much greater than that occuring since the introduction of the scheme. The rise in the ingredient cost of medicines in the GMS has decreased from an annual average of 11 per cent prior to the inception of the scheme to less than 6 per cent in the past three years. This containment is in no small way directly related to the impact of the scheme and the achievement of more effective prescribing by doctors.
My Department, in consultation with the Irish Medical Organisation and the Irish College of General Practitioners, will continue to evaluate and refine the scheme with a view to achieving rational, safe and cost-effective prescribing.