Dáil Éireann Debate, Tuesday - 13 February 2018
325. Deputy Micheál Martin asked the Minister for Health if he is satisfied that prescribed medication addiction is receiving adequate attention; the monitoring mechanisms in place to assess same; the extent of the problem here; and if he will make a statement on the matter. [6693/18]
Amharc ar fhreagra326. Deputy Micheál Martin asked the Minister for Health if his attention has been drawn to the British Government seeking a review of addiction to prescription medication for the treatment of depression and anxiety issues in the UK; his plans to announce same here; and if he will make a statement on the matter. [6694/18]
Amharc ar fhreagra327. Deputy Micheál Martin asked the Minister for Health his views on media reports of a 1,086% increase in the use of pregabalin known as Lyrica amongst medical card holders; and if he will make a statement on the matter. [6695/18]
Amharc ar fhreagra328. Deputy Micheál Martin asked the Minister for Health his views on reports on the 159% increase use of oxycontin amongst medical card holders; and if he will make a statement on the matter. [6696/18]
Amharc ar fhreagraI propose to take Questions Nos. 325 to 328, inclusive, together.
My Department is aware of recent reports on trends indicating the increased prescribing of certain drugs over a ten year period and that the British government has announced a review there.
In Ireland the Medical Council is the statutory body for the registration and regulation of doctors engaged in medical practice. The Council has set out specific requirements for doctors regarding prescribing of drugs at section 42 of its Guide to Professional Conduct and Ethics for Registered Medical Practitioners (2016). While the Guide is not a legal code, it sets out the principles of professional practice and conduct that all doctors registered with the Medical Council are expected to follow. The Guide advises that doctors must be aware of the dangers of drug dependency when prescribing benzodiazepines, opiates and other drugs with addictive potential.
In June 2016 the Early Warning Emerging Trends (EWET) subcommittee of the National Advisory Committee on Drugs and Alcohol, with the agreement of my Department, wrote to health care professionals highlighting the need for vigilance when prescribing and dispensing pregabalin and gabapentin, as these drugs present a risk of addiction and a potential for illegal diversion and misuse. Prescribers were advised to always undertake a risk benefit assessment prior to prescribing either of these medicines for patients under their care.
The HSE’s multi-disciplinary Medicines Management Programme (MMP) works with the National Medicines Information Centre (NMIC) and the National Centre for Pharmacoeconomics (NCPE), in collaboration with the HSE-Primary Care Reimbursement Service (PCRS), to provide sustained national leadership relating to issues such as the quality of the medicines management process, access to medicines and overall expenditure on medicines. It aims to promote safe, effective and cost effective prescribing.
The MMP work plan includes monitoring the utilisation of all medicines with a high prescribing frequency and/or high expenditure based on data from the PCRS.
The MMP has previously identified the high number of prescriptions for certain benzodiazepines and ‘z-drug’ sedatives and, coupled with the safety concerns associated with these medicines and their addictive potential, now monitors the total number of patients on these drugs and the total number of prescriptions issued on an on-going basis.
As a result of increasing trends around their use the MMP has published a toolkit to support the appropriate prescribing of benzodiazepine and z-drugs in the treatment of anxiety and insomnia. The guidance document contains information on initiation, review and deprescribing of these drugs and it is anticipated that the adoption of this guidance by prescribers will lead to a reduction in the long-term inappropriate prescribing of these drugs.
The MMP, in collaboration with the PCRS, has written to all GPs outlining their levels of benzodiazepine and other hypnotics prescribing on the GMS scheme in an initiative to encourage better quality prescribing of these drugs. The reports allow GPs to see exactly how many times they have prescribed these drugs in the preceding months. This is another useful tool for prescribers to monitor prescribing in their practice compared to national rates and also to track changes in their prescribing over time. The next HSE-PCRS prescribing report is planned for circulation in the coming weeks and information from the recently published toolkit will be disseminated to GPs alongside those reports.
Additionally, in October 2017 the Medical Council of Ireland and the Pharmaceutical Society of Ireland launched joint guidance on the Safe Prescribing and Dispensing of Controlled Drugs aimed at registered medical practitioner and pharmacists.
