Aspirin scripts on medical card cost €5.1m per year

Aspirin is the most commonly prescribed drug under the general medical card scheme (GMS), with 2.5 million scripts written each year at a cost of €5.1m.

Medications for tackling excess acid reflux and lowering cholesterol cost in excess of €200m annually, and account for over 20% of entire scheme costs.

Figures from 2010 show acid reflux pills cost €88m and were prescribed 3.2m times. Drugs for the treatment of high cholesterol cost €113m and accounted for 12% of the cost.

In 2010, Mary Harney introduced a 50c charge for each item on scripts. This caused much controversy, but given it raises €27m annually, Health Minister James Reilly said it was simply not possible to abolish the charge without adversely affecting frontline services.

It was thought this charge would prevent card holders from overusing medicines, but researchers at University College Cork found medical card holders are still “stocking up” on medicines while on a visit to the GP.

Steps have been taken to bring down costs of supplying GMS and drug payment scheme medications.

* In 2006 agreement between the HSE and the Irish Pharmaceutical Healthcare Association resulted in a 35% reduction in the price of patent-expired medicines with estimated savings of €248m.

* The agreement has been extended to 2012 providing a further 40% reduction for off-patents. Reductions in wholesaler margins and pharmacy reimbursement will provide annual savings of €130m.

However, although the costs of some drugs will go down, figures indicate that prescribing rates are going up year-on-year.

The number of scripts for anti-depressants and sleeping tablets rose again between 2009 and 2010, as did the number of scripts for benzodiazapenes — despite growing concern over their long-term use and addictive nature.

Another area of concern is the growth in expenditure on the hi-tech drugs scheme which caters for more serious illness and where drugs can be very expensive. For example. in 2010, adalimumab (Humira), a medication used for reducing the signs and symptoms of rheumatoid arthritis, cost €52m even though just 39,000 scripts were written for it.

Enbrel, a drug that treats autoimmune diseases cost more than €42m in 2010 and was prescribed just over 37,000 times.

The National Centre for Pharmacoeconomics (NCPE) says this is a “real cause of concern” adding the scheme is “under increasing pressure with the emergence of very high-cost drugs”.

“In the future, we anticipate further downward pressure on drug expenditure and growing challenges for healthcare payers to fund very high-cost medicines with insufficient evidence to prove cost-effectiveness,” NCPE said.

The HSE said price reductions implemented in January 2011 saw Lipitor reduce from 13% to 47%.

However, generic manufacturers are precluded by the patents from launching products before May, when the patent held by Pfizer for Lipitor expires.