Written Answers Nos. 221 - 233
221. Deputy Bríd Smith asked the Minister for Health if there is any provision under the HSE's discretionary hardship arrangements for reimbursements to persons for any drugs or treatments for long-term illnesses that are not listed on the reimbursement list. [38108/16]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply.
222. Deputy Bríd Smith asked the Minister for Health whether there are drugs available, or if there are any plans to make available, drugs for long-term illnesses such as arthritis, thyroid, or fibromyalgia on the HSE reimbursement list. [38109/16]
View answerThe Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975 prescribing the 16 conditions that are covered by the LTI Scheme: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the scheme.
223. Deputy Billy Kelleher asked the Minister for Health the percentage breakdown in terms of public and private treatment in each hospital in each hospital group to date in 2016 in tabular form. [38119/16]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
224. Deputy Richard Boyd Barrett asked the Minister for Health if he will review the case of a person (details supplied); the reason this person's family were told that the person was next on the list for the National Rehabilitation Hospital, NRH, and then subsequently told the person was no longer on the list without explanation; the reason the hospital is offering to do rehabilitation in situ when previously it indicated this was not possible; if the person is on the list for the NRH; if not, the reason; the reason rehabilitation was not started sooner; and if he will make a statement on the matter. [38122/16]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
225. Deputy Hildegarde Naughton asked the Minister for Health further to Parliamentary Question No.211 of 26 May 2016 (details supplied), the number of ambulance call outs to north west Connemara in County Galway and the length of time between each call out and arrival at the scene, in each of the years 2014 to date in 2016; and if he will make a statement on the matter. [38126/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
226. Deputy Mick Wallace asked the Minister for Health the status of the work of the clinical nutritional expert group on new applications for additions to the reimbursement list, particularly in relation to phenylketonuria sufferers and free or discounted rate foods. [38127/16]
View answer228. Deputy Denise Mitchell asked the Minister for Health his plans to extend new low protein foods applicable under the long-term illness card; and if he will make a statement on the matter. [38130/16]
View answerI propose to take Questions Nos. 226 and 228 together.
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply.
227. Deputy Brian Stanley asked the Minister for Health his plans to put physiotherapy services and Schroth therapy in place including early school screenings for children with scoliosis. [38128/16]
View answerAs the question being asked by the Deputy relates to a service matter I have referred the question to the Health Service Executive for attention and direct reply.
229. Deputy Michael Healy-Rae asked the Minister for Health the status of waiting lists for cataract operations (details supplied) in County Kerry; and if he will make a statement on the matter. [38133/16]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to you.
230. Deputy Michael McGrath asked the Minister for Health if the HSE has plans to provide dialectical behaviour therapy in the Cork area; and if he will make a statement on the matter. [38142/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
231. Deputy Niamh Smyth asked the Minister for Health if a preferred site has been selected for a centre (details supplied); if he will provide a step by step programme for this project; the timeframe for this project to be completed; and if he will make a statement on the matter. [38147/16]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
232. Deputy Niamh Smyth asked the Minister for Health the status of a centre (details supplied); and if he will make a statement on the matter. [38148/16]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
233. Deputy Marc MacSharry asked the Minister for Health the reason the Government and the HSE have decided not to grant access to the Orkambi drug which has proved to be a game changer in the lives of those cystic fibrosis sufferers that are suitable to receive it; the reason the cost of this drug is being prioritised over the value of lives saved not least the savings in reduced acute care needs as a result of improved health of those that receive treatment with Orkambi; if he will reverse this decision and grant access to Orkambi for CF sufferers; and if he will make a statement on the matter. [38152/16]
View answer238. Deputy Clare Daly asked the Minister for Health if he will ensure that Orkambi is made available to cystic fibrosis persons that urgently require same as their access to the drug from the trial concludes. [38161/16]
View answerI propose to take Questions Nos. 233 and 238 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching its decision, the HSE examines all the evidence which may be relevant in its view for the decision (including the information/dossier submitted by the Company) and will take into account such expert opinions and recommendations which may have been sought by the HSE at its sole discretion (for example, from the National Centre for Pharmacoeconomics).
In considering an application, the HSE will also have regard to Part 1 and Part 3 of Schedule 3 of the 2013 Act. Part 3 requires the HSE to have regard to the following criteria:
1. the health needs of the public;
2. the cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services;
3. the availability and suitability of items for supply or reimbursement;
4. the proposed costs, benefits and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks;
5. the potential or actual budget impact of the item or listed item;
6. the clinical need for the item or listed item;
7. the appropriate level of clinical supervision required in relation to the item to ensure patient safety;
8. the efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies); and
9. the resources available to the HSE.
I am informed that, following a request from the HSE, the NCPE carried out an assessment of the manufacturer's economic dossier submitted in March 2016 on the cost effectiveness of Orkambi. This dossier included details on all relevant costs and relevant cost offsets including those associated with hospitalisation, disease management costs, intravenous antibiotics, adverse events and any additional costs arising in patients not taking Orkambi.
The NCPE has completed its Health Technology Assessment and this is available on its website. It was submitted to the HSE in June 2016. The NCPE determined, following an evaluation of the economic dossier, that the manufacturer failed to demonstrate cost-effectiveness or value for money from using the drug. The NCPE have confirmed that all relevant costs were included in the analysis.
The HSE has recently completed its most recent round of negotiations with the manufacturer. On foot of this, the HSE’s Drugs Committee, having considered the NCPE recommendation and other expert advice, is in the process of sending its latest recommendation on the cost-effectiveness of Orkambi to the HSE Directorate. The HSE Directorate will then make a decision taking into consideration the manufacturer’s latest price offer. This decision will be made on objective, scientific and economic grounds in line with the 2013 Act.
I share the HSE's disappointment that the manufacturer in this case has maintained a very high price in the course of negotiations in relation to the potential reimbursement of Orkambi for Irish patients.
I appreciate that this is a very stressful time for Cystic Fibrosis patients and their families. However, I want to assure them that I do not consider this to be the end of the process. I would strongly urge Vertex, as the manufacturer in this case, to fundamentally reconsider its position and to table a pricing proposal which can facilitate the provision of Orkambi at a price that will represent value for money for the Irish health service, patients and the taxpayer.
