Obesity and diabetes cause €168m overrun

IRELAND’S soaring obesity and diabetes levels are being blamed for much of the projected €168 million cost overrun in the Health Service Executive’s (HSE) drug subsidy budget this year.

Every year the Government provides funding for the state’s drug schemes based on the previous year’s cost growth.

While the volume of drug prescribing, particularly for cholesterol-reducing and diabetic drugs, has increased in recent years the budget provision has not kept pace with expenditure.

The HSE said it has been using “contingency” funding to meet the shortfall.

A total of €785 million was spent on statutory drug and allowance schemes last year — an overrun of €114 million on the approved budget.

But a spokesperson for the HSE admitted that the cost of cholesterol-reducing drugs and diabetic drugs was putting extra pressure on the health authority’s budget provision.

“This reflects the significant growth in obesity and diabetes levels in Ireland,” the spokesperson said.

An internal HSE report states that cholesterol reducing drugs account for a total of €122 million paid out under the various statutory schemes last year. In the last three years the prescribing of some insulin products has more than trebled.

The report also warns that the growing use of insulin products is likely to continue for some time because of the continued increase in obesity levels.

Another cost factor noted by the report is a change in clinical practice in relation to the treatment of diabetes. The report says doctors are now transferring patients from oral anti-diabetic medicines to insulin at an earlier stage.

According to the report, diagnostic products such as equipment for checking blood/sugar levels are the highest expenditure items in the long-term illness scheme, costing almost €12 million last year.

It says arthritis is the most expensive condition under hi-tech medicines, costing €23 million in 2005, while multiple sclerosis is the second most expensive, costing €14.3 million in 2005.

The HSE is working on ways of delivering value for money across a number of areas.

The spokesperson said the recently negotiated agreement with the pharmaceutical industry would contain costs in the community drugs schemes.

Both the community pharmacy and GP contracts are being reviewed and the HSE is determined that any new contractual arrangements emerging from both reviews will promote “rational” prescribing and dispensing.

The HSE is also reviewing its arrangements for the supply of non-drug items. The authority wants to exploit its purchasing power in the market so as to achieve greater value for money in this area.