Thursday, 8 November 2012

Ceisteanna (4)

Billy Kelleher


4. Deputy Billy Kelleher asked the Minister for Health if he will provide details of medicines and patient products that have been removed from the medical card and drug reimbursement schemes to date in 2012; and if he will make a statement on the matter. [49291/12]

Amharc ar fhreagra

Freagraí ó Béal (13 píosaí cainte) (Ceist ar Health)

I thank Deputy Kelleher for having raised this question. In the current financial environment the Health Service Executive is facing a challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, it has become necessary for the HSE to suspend certain products from its list of reimbursable items. These include glucosamine, omega-3 triglyceride products, orlistat, and gluten-free products.

Glucosamine is indicated for the management of symptoms of osteoarthritis. The National Centre for Pharmoeconomics has assessed the cost-effectiveness of glucosamine on two occasions and concluded that it did not offer value for money to the HSE. However, it should be noted that glucosamine products are available over the counter without prescription.

Omega-3 triglyceride products - for example, omacor - have been identified both nationally and internationally as not being cost-effective or being of lesser benefit to patients. However, these products are also available over the counter without prescription, as is orlistat.

Gluten-free products have become more widely available in supermarkets in recent years and tend to be significantly cheaper than products sold through community pharmacies. A supplementary welfare allowance adult diet supplement may be awarded by the Department of Social Protection to eligible persons. Persons wishing to apply for this allowance can do so by completing an application form which can be downloaded at Separate application forms are available for children on that site. For persons who are not awarded a diet supplement, moneys spent on gluten-free foods can be taken into account for tax purposes.

A full list of items available under the community drug schemes is available on the HSE's primary care reimbursement service website, If one goes on to that site, one should choose the "List of Reimbursable Items" option. In addition, the monthly updates, additions and deletions, to the product list are provided at the same location under "Updates to the List of Reimbursable Items and High Tech Scheme List".

Briefly, I accept that savings must be made in certain areas. However, I am very concerned about a particular inclusion on the list, namely, xenical, which is the trade name for orlistat, an anti-obesity drug. This is a life-saving drug and is not something a person can do without. It is an anti-obesity drug and many people with disabilities who have different syndromes need this drug to ensure that diet is suppressed and that they do not overeat and cause difficulties with obesity. One family in particular has contacted me and stated the first they heard of it was when they visited their pharmacist, only to be told the drug no longer is available under the medical card scheme. As it has been withdrawn, it will cost the family in question €64 per month to keep their daughter alive basically, because without this drug, she potentially could eat herself to death by virtue of not being able to suppress her diet. While I am fair in respect of what a Government can do, of all the drugs included in the withdrawal, I ask the Minister of State to consider orlistat, the anti-obesity drug with the trade name of xenical, given the serious nature of the difficulties its withdrawal is causing.

I certainly will take a look at the particular item to which the Deputy refers. In fairness, the Deputy asked a general question on the items that have been removed from the list and orlistat is one such item. As for the other item to which the Deputy referred, I certainly will ascertain what information is available on it and will relate that to the Deputy. I must state that my clear advice with regard to orlistat is that it is an adjunct to diet in obese patients and is available over the counter. As to whether it is necessary at the level suggested by the Deputy, I simply cannot comment on that. He puts the point very strongly with regard to it being a drug he states essentially is a life-saving drug. That is quite a claim and I cannot respond to the specifics of that point. It was not contained in the question but I certainly will have a look at it and will relay any information on it back to the Deputy.

I do not expect the Minister of State to have to hand the knowledge on the individual query that I have available to me via e-mail on my iPhone here. However, the family contacted me and asked me to raise this matter specifically when they saw this particular question had been tabled. They are very concerned, primarily with this particular drug, orlistat, the trade name of which is xenical.

If the Deputy makes a specific point to me, I will address it.

I am specifically naming this particular drug about which, as I stated, I am very concerned. It is an appetite suppressant and some people with various syndromes need this suppressant to ensure they do not overeat and have the difficulties associated with obesity.

While I do not believe it is a suppressant-----

It is an anti-obesity drug.

-----as the Deputy has the details on his telephone, it probably would be better to have a specific question related to a specific item. Were it committed to paper and sent to me, I certainly can address it for the Deputy-----

It is not a suppressant.

-----and, if necessary, refer it to the experts I have available to me. I cannot take it any further.

For clarity, it is an anti-obesity drug.

Perhaps if that was committed to paper and relayed to me, it could be dealt with in that way.