Vol. 396 No. 5
4 Mr. Ferris asked the Minister for Health if he has completed investigations into the possible savings which might be achieved in the General Medical Service drugs bill through the use of Irish branded equivalent medicines; and if he will make a statement on the matter.
Drug prices in Ireland are governed at present by an agreement between the Department of Health and the Federation of Irish Chemical Industries. The current agreement permits either party to give one year's notice of intention to renegotiate or terminate the agreement after its expiry on 31 July 1990. My Department have served 12 months' notice to this effect.
In this regard, an inter-departmental committee, representative of the Departments of Health, Finance and Industry and Commerce, are currently examining a number of options for containing the State's total drugs bill, and will finalise their report shortly. I intend to bring forward proposals for Government in this area in the very near future.
It has always been my view that in the interest of patients generally and of the economy generics should be prescribed as much as possible and that Irish-branded generics should also be used, all things being equal.
The Minister has obviously done some research into this. Is he aware of estimates that £20 million could be saved to the health services and the taxpayer by the wider use of generic drugs? In the short term this would be a definite advantage for the Minister's Department and for the taxpayer. Is the Minister aware of the amount of production of generic drugs in my constituency and of the total import cost of non-generic drugs, even drugs that are off patent?
Certainly there are savings to be made by using generic products. We are governed by an agreement with the Federation of Irish Chemical Industries — an agreement originally entered into by my predecessor, the then Minister for Health, Deputy Barry Desmond. At the time the cost of drugs here was so far ahead of the cost of drugs in the UK that it was a good agreement in its day. We have given notice that we intend to terminate the agreement. Certainly I encourage doctors who are responsible for prescribing drugs to use generic drugs. They have a responsibility to prescribe what they believe is in the best interest of the patient. One consoling word I can say to Deputy Ferris is that when I was in general practice I was a great user of Clonmel products.
Is the Minister aware that of the £165 million spent on drugs last year, some £80 million worth of those drugs are off patent and substitutable by branded equivalents? Will the Minister give a commitment to the House that this agreement with FICI will be terminated at the end of July or, if renegotiated, the exclusion clause for the systematic use of generics will be arranged so that generics can be substituted where they are off patent? Will he give a commitment either to terminate the deal altogether to ensure better value for money or will he ensure that the element in relation to generics will not be repeated?
My Department and the Departments of Finance and Industry and Commerce are currently examining a number of options. The best possible deal will be put in place to ensure that we get drugs at the best possible price, at all times remembering that the prime responsibility is to ensure that the patient is properly treated.
As well as sending pressing letters to GPs to prescribe generic drugs, will the Minister prescribe regulations now or at the appropriate time to ensure that under the GMS scheme at any rate it would be obligatory on doctors to prescribe generic drugs? Is the Minister aware of the incredible inducements and pressures brought to bear on doctors by the manufacturing drug companies? They send them free gifts and all manner of inducements. Does the Minister intend to do anything about that and to put restraints on the unfair inducements and pressures put on doctors?
I have appealed for brevity, especially having regard to the lack of progress at Question Time today. I again appeal for brevity.
Would the Minister agree that failure to cope with that aspect of the matter will not lead to much success in promoting generic drugs?
The question of whether we should have a legal instrument to insist that only generic drugs are used is always under consideration. We want to ensure that the State get the best value in relation to the £140 million spent on drugs each year. As I said, we are bound by an agreement until 31 July but I should like the doctors to use branded generic products, preferably Irish ones. If that is not satisfactory we must look at the question of regulations along the lines which Deputy Taylor has outlined.
A brief question from Deputy Ferris.
The Minister quoted a figure of £140 million for drugs. Is that figure up to date? Our figure in this area is £165 million for total drug usage, £125 million of which is in the area of general practitioners. This is the area over which the Minister has the most opportunity for control because the hospital services obviously use as many generics as possible.
My figure is up to date although it does not include certain items which some people might consider to be drugs, such as blood products. Therefore, the figure is £140 million excluding blood products.
