Dáil Éireann Debate, Tuesday - 10 October 2023
466. Deputy Alan Dillon asked the Minister for Health the Government's priorities for funding new medicines; how the Government balances the need to provide access to new medicines with the need to be fiscally responsible; and the Government's plans to ensure that all patients in Ireland have access to the medicines they need, regardless of their ability to pay. [43485/23]
View answerThe State is committed to providing timely access to new and innovative medicines to all patients. €50 million in funding was allocated for the approval of new medicines in Budget 2021, €30m in 2022, and a further €18 million in Budget 2023 which will provide access to new innovative medicines for patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess a drug's clinical and cost effectiveness as a health intervention.
Multiple initiatives exist to try to ensure value for money in the medicines purchased. These include the Framework Agreements on the Supply and Pricing of Medicines 2021-2025, a set of Agreements negotiated with Industry to provide medicines for the HSE at sustainable prices. These are expected to lead to between €600m-700m less being spent on medicines over the course of the Agreements. The extra headroom provided by these savings will allow the HSE to do more with their resources.
To ensure access to medicines, in February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. The Report found that the reimbursement process is operating in line with the legislation and that it is delivering results in line with international norms. I fully support the recommendations contained in the Mazars report around improving the process, increasing transparency, providing easier access, and supporting value for money.
An implementation group has been established between my Department and the HSE to consider and progress the various recommendations contained in the Report. The membership of the Group includes representatives of the Drugs Group, the HSE, the NCPE, and the Department of Health. The Working Group has met frequently since its establishment, to consider the involvement of patients, agencies, industry, and clinicians, in each stage of the reimbursement process.
Targeted stakeholder consultation commenced on the 31st of May and concluded on the 20th of June. The insights gained from stakeholders will be considered by the Group as it continues its work on progressing the various recommendations of the Review. A report on this will be submitted to me in the coming months.
Regarding ability to pay, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
