Warning to control costs of medicines

More than €2bn is being spent by the State on medicines each year — it is taking an increasing share of the healthcare budget and we should be insisting on getting better value for money from the drug companies, the head of the National Centre for Pharmacoeconomics told doctors.

Michael Barry, clinical director of the centre that rates the cost-effectiveness of new drugs, said getting fair prices and real value would make more resources available for services for the elderly, disabled, and those with mental health problems.

Speaking at the Irish Medical Organisation (IMO) conference in Killarney, Co Kerry, Prof Barry said that the State was being asked by some drug companies to pay for exceptionally expensive drugs that did not work.

He believed some drug companies created an emotional demand, overcharging for treatments by up to 100%. 

“The most cost-effective drugs are the ones that actually work,” he said.

Prof Barry said he was evaluating a drug that would have an annual cost of about €1m per patient per year.

“That is the kind of challenges we are facing on a daily basis,” he said.

Over a 10-year period from 1999 Ireland experienced the highest increases year on year in the cost of medicines compared to most other European countries.

“We were prescribing more medicines, we were prescribing more expensive medicines and it was moving towards unsustainability,” he said.

“Since 2006 we have introduced over 50 cost-containment measures into the system. But it is important to say that it is not for the sake of making cost-containment measures, it to ensure that we can actually afford the newer medicines that are coming on.”

However, the costs of drugs had started to increase again over the last few years and he believed it would continue that way.

Prof Barry also referred to a proposed amendment to the Health Act 2013, saying that “assessment of the value for money of very high cost orphan medicines was not relevant”.

That legislative proposal would not help a single patient, he said.

“What it will do is increase the price of drugs because we can’t bargain. It will increase the burden on taxpayers. It will tie the HSE’s hands behind its back and the only one who wins from this is the pharmaceutical industry. I think this should not go any further,” he said to loud applause from doctors.

The centre looked at 21 cancer drugs between January 2016 and December 2017 and 20 (95%) were deemed not cost-effective at the submitted price.

“The budget impact if we had paid at that level was €600m over five years — massive money,” he said.

One of the drugs slowed the disease progression by 4.3 months. There was no improvement in the patient’s quality of life and it cost €140,000 per patient per year.

“It is not remotely cost-effective,” he said. “Actually, the chances of it being cost-effective were less than 1%, and a budget impact of €65m over five years. Is there anyone in this room that would pay for this?”

Prof Barry said a “huge” reduction on the drug’s cost was achieved and patients were getting access to it.


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