asked the Minister for Health the steps which are being taken to reduce the cost of drugs purchased for the General Medical Service; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - GMS Drugs Cost.
10.
The total cost of drugs prescribed and dispensed in the GMS is a function not only of unit costs, but is also dependent upon the particular formulation selected and upon the choice made by the prescriber in selecting a generic or branded product within that formulation. The total cost of GMS drugs is most crucially related, however, to the total volumes prescribed within the scheme.
Effective unit price control is maintained by an agreement with the Federation of Irish Chemical Industries. The agreement controls the prices charged by manufacturers for drugs and medicines, by direct reference to the comparable UK prices. The vast majority of drugs and medicines on the Irish market are imported from the UK. The present agreement with the FICI also provides for a voluntary freeze on manufacturers' prices for drugs and medicines to the end of October 1988, regardless of currency movements or increases in UK parent prices.
Participating doctors and pharmacists in the GMS are regularly circulated by the GMS (Payments) Board with detailed information on the relative cost of a standard course of treatment with various alternative versions of the drugs most commonly in use. The current GMS negotiations with the Irish Medical Organisation have, as one of their primary objectives, the development and promotion within general practice of a style of practice which is less reliant upon prescribing and drug therapy. These negotiations are currently in progress and are being intensively pursued under the chairmanship of Mr. John Horgan of the Labour Court.
Will the Minister consider putting greater exphasis on the prescription of generic drugs rather than on branded drugs as a means of reducing the cost in the GMS on drug expenditure? Could he indicate if any guidelines have been issued to the health boards or GPs with regard to generic drugs?
The question of introducing mandatory generic prescribing in the GMS is one which is always under review. As I have already pointed out in the reply, the GMS payments board regularly circularise doctors in the GMS with the prices of various drugs and certainly, all things being equal, general practitioners should prescribe the generic preparation if they are satisfied that that preparation is as potent as the proprietary brand.
The Minister must be aware of the massive promotions which the drug companies undertake with regard to branded drugs. It is, therefore, perhaps difficult for GPs to make a choice as to whether to prescribe generic or branded drugs. Could the Minister undertake to indicate to GPs, and presumably to health boards, that the Department would prefer if generic drugs which have been tested and proved to be adequate and correct drugs were prescribed in order to save costs?
GPs are aware of that and the GMS regularly circularise doctors with detailed information on the relative costs of a standard course of treatment and of various alternatives to the drugs most commonly used, and most of the variations would be generic preparations.
Could the Minister give the House the cost of the drugs scheme for 1988? Would he agree that British prices are out of line with the cost of drugs in many other European countries. Would he consider relating the cost of drugs here to the prices applying in continental Europe rather than in Britain? The Minister said previously that he was examining that possibility and I would like to know what has happened since he gave that commitment.
I am not in a position to give the exact cost of drugs in 1988. In 1987 the total cost of drugs and medicines prescribed in the GMS came to £62 million. On the question of the FICI agreement, it has another year before it expires but we are monitoring the situation in relation to drug prices generally to ensure that we get the very best value available.
In relation to the £62 million which the Minister has indicated has been spent what proportion of that has been spent on generic drugs? Is he satisfied that it is adequate and that sufficient is being done to prescribe generic rather than branded drugs?
I do not have that information in the reply to the question. It is not part of the question that the Deputy asked.
The time would seem to have come to deal with questions nominated for priority.
There are only three priority questions.
Shall we try to deal with Question No. 11 then as quickly as we can.