Professor says HSE should ‘take seriously’ cheaper medicines

By Dan Buckley

The head of the National Centre for Pharmaeconomics says the HSE “must take seriously” the need to replace expensive branded biological medicines with cheaper alternatives.

Professor Michael Barry, clinical director of the NCP, which conducts the health technology assessment of pharmaceutical products for the HSE, said little has happened since the Department of Health launched a consultation process last year on the use of generic biologics known as biosimilars.

Biologics, medicines made from living cells, have revolutionised the treatment of many chronic conditions like arthritis but they are expensive to produce. Despite this, the uptake of biosimilar medication remains low in Ireland compared to other EU countries.

We have seen a low uptake with generic medicines in the past, and we are seeing it again now with biosimilars. We are almost wedded to branded products,” Prof Barry said on RTÉ radio’s Morning Ireland programme.

Prof Barry said while biosimilars are more complex than generic medicines, they should still be used more by the HSE. “There is no doubt about that. It’s an issue that should be tackled. The HSE needs to take this one seriously and to have a good quality team producing a policy and also implementing it and, in addition, empowering excellent pharmacy units in our hospitals.”

“There is also an appreciation among our own colleagues that safety and efficacy is very important but they cannot ignore the cost issue and I think prescribers for a long time have done just that.”

Prof Barry said increased take-up of biosimilar medicines would constitute a better use of scarce resources. He urged the HSE to put structures in place to make this happen.

“The first thing is to have a biologics policy to make it clear, for example, that unless there is a very good reason, someone starting on biologics should start on a biosimilar. Then you have got to put in the structures to enable this to happen at hospital level. We have spent the last five years concentrating on community expenditure because that is where most of it takes place, but we need to get to grips with hospital prescribing.”

His view echoes that of Medicines for Ireland, the representative organisation for generic and biosimilar manufacturers, which has called for the immediate publication of a national biosimilar strategy, first promised by the Government in February 2017 and which, it says, has the potential to deliver €25m in savings.

Describing the use of biosimilars as a no-brainer, Prof Barry said resources are needed to put the strategy in place.

You need to get together a good-quality, experienced team to drive this initiative on and implement it but also to empower our hospital pharmacies to ensure it’s delivered,” he said.

Prof Barry gave examples of two particularly expensive medicines which cost the health service millions of euro each year: Adalimumab, sold under the trade name Humira and used to treat a variety of conditions including Crohn’s disease; and etanercept, an injectable drug used for treating rheumatoid arthritis.

“Between the two you are talking around €200m a year. That’s a lot of money. We need to be putting resources where they are needed, looking after our elderly, etc, so why waste them on medicines when you don’t need to?” said Prof Barry.

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