THE CALL by Minister for Health James Reilly for all doctors employed by the State to prescribe cheaper generic drugs “in the national interest” reflects concern about the growing Health Service Executive (HSE) spending overrun of some €280 million. And while drugs savings in the second half of the year cannot fill a financial hole of this size, more prudent prescribing by doctors and cost-effective dispensing by community pharmacists can provide some savings for the exchequer.
It reflects poorly on the present Minister and on his predecessor Mary Harney that it is only now that legislation has been published. Sensible ways of cutting costs have been mooted in several reports commissioned by Government, such as the introduction of reference pricing and an increased use of generic medicines, but there has been a singular failure to implement these policies. The State’s spend on pharmaceuticals is among the highest in Europe and reference pricing has the potential to save the exchequer up to €100 million a year.
The Bill provides for the introduction of a system of generic substitution and reference pricing. A generic medicine has the same active substances as the original, branded medicine and is made to the same standard. Reference pricing involves the setting of a common reimbursement price for a group of interchangeable medicines.
What does this mean for patients? They will not face any additional costs for products priced at or below the reference price. If a patient would like to receive a familiar brand that costs more than the reference price then they will have to pay the additional cost. These measures will apply to those who have full medical cards, who receive medication under the long-term illness scheme and patients who enrol in the drug payments scheme. Pharmacists may also suggest a cheaper generic alternative to private patients whose doctor has prescribed the branded version of a drug.
There are additional savings waiting to be made. Dr Michael Barry of the National Centre for Pharmacoeconomics, in a report commissioned by Ms Harney, questioned the reimbursement status of drugs such as clinical nutrition products. There is undoubtedly room to prune the range of products currently available under the medical card scheme. The evidence is there to undertake such a cost-saving move; all that is needed is the political will to do so.