Sir, – Dr Muiris Houston's article "Cost of high-tech drugs a bitter pill" raises important arguments that are worthy of national debate (Health + Family, June 3rd).
Advances in biomedical science are rapidly translating into new therapies and interventions that can extend and enhance quality of life. However, we must not lose sight of the overall importance of providing support for all of our citizens in an equitable manner, including the provision of adequate community services for those who are disabled but capable of living independently with support. The “pause ” in the provision of new homecare packages, and the frequently inadequate level of services for those in receipt of homecare and those in need of respite, must be juxtaposed to the increasing demand for expensive medications and treatments.
The National Centre for Pharmacoeconomics provides a valuable service in balancing the need for new drugs and therapeutics. However, unlike the National Institute for Health and Care Excellence in the UK, its recommendations are not binding. This has led to calls for approval of some drugs “by the stroke of a ministerial pen”. Such an approach without a strong data-driven base of evidence could disenfranchise those whose conditions are not within the remit of articulate professionals who advocate on their behalf.
As Dr Houston states, for approval of any new innovation within the same envelope of funding, cuts are required in other parts of our service. This indeed merits a national debate. Perhaps the proposed all-party committee on health would be a good place to start. – Yours, etc,
Prof ORLA
HARDIMAN, MD
Clonskeagh,
Dublin 14.
Sir, – The unaffordability of new drugs is a recurrent problem and one that needs to be addressed. The price of a new drug bears little relationship to research and development or manufacturing costs. The reason for high prices is that the inventor (usually a pharmaceutical company) of a drug is rewarded by a patent which confers monopoly marketing rights. In the absence of competition, the price of a new drug will be that which the market can bear, and when new drugs save lives that price can be very high indeed.
A solution to this problem has been proposed by organisations such as Médecins Sans Frontières and Oxfam and is supported by organisations such as the United Nations and the World Health Organisation. This involves governments abandoning the patent system and instead commissioning and funding drug research directly. Such a model has been shown to be far more cost-effective and will result in affordable drugs in public ownership. – Yours, etc,
Dr KIERAN HARKIN,
Primary Care Centre,
Inchicore, Dublin 8.