Dr Muiris Houston, Medical Correspondent, explains the difference between generic drugs and other medications
The proposal from the junior Minister for Health, Mr Tim O'Malley, to limit prescribing under the drug refund scheme is reminiscent of a similar idea from the PDs which was subsequently incorporated into last year's health strategy.
Then, it was the novel idea of reducing waiting lists by sending "long waiters" for hospital treatment abroad. This led to the establishment of the National Treatment Purchase Fund.
Now, it is the equally novel but very simple idea that Budget increases in the threshold for the drug repayment scheme - already signalled in the health estimates - could be avoided by a cost-capping mechanism.
Rather than allowing doctors a carte blanche in writing private prescriptions, GPs and others would come under pressure from their patients to specify a cheaper, generic version of the drug, where such existed.
Generics are drugs whose exclusive patents have run out. International drug conglomerates spend large amounts of money and time researching new medications.
In return, they are awarded exclusive rights to world markets for a defined period of time.
However, when the patent runs out, other pharmaceutical companies can then gain access to the exact chemical make-up of the drug and are free to reproduce it.
From a safety and efficacy point of view, the quality of generics marketed in the Republic is assured by the Irish Medicines Board.
Although generic medications sold in some parts of the world have a questionable reputation, all generics licensed here are as safe and as efficacious as the originals they supplement.
They are also considerably cheaper, which is where the PD proposal enters the equation. With the Drug Payment Scheme (DPS) exceeding its budget by a third this year - in 2001, 1.15 million people availed of the scheme at a cost to the State of €177.6 million - the potential for savings is significant.
At present, once an individual or family exceed a monthly threshold of €65, all other medication dispensed under the DPS is free. There is no incentive for either the doctor or the patient to seek value for money when a decision to prescribe is made.
Under Mr O'Malley's proposal, patients who wish to obtain reimbursement under the DPS will put pressure on the doctor to prescribe a generic product, where one is available.
If a patient and his doctor decide that the original, branded medication is the best option, then no reimbursement will be available through the State.
The proposal makes financial sense and is not without precedent. Objections to the idea will come primarily from international drug companies, although that part of the industry that specialises in generic drugs will obviously be in favour.
Some doctors, too, will object, citing the principle of autonomy and objecting to State interference in the doctor-patient relationship.
But, if as seems likely, the calculations add up and the proposal offers a way out of further health "bad news" in next week's Budget, expect the generic drug idea to feature when Charlie McCreevy delivers his Budget speech.