HSE Budget: Drugs - Chief warns of ‘finite’ budget in 2016

HSE chief Tony O’Brien has warned that there is a “finite” amount of money for new drugs next year.

The health authority intends to make no change to the amount of money spent on costly high tech drugs, including new drugs next year.

The National HSE service plan 2016 provides €68m for “drugs cost growth”. There is also a €110m targeted reduction in prescribing and drug costs within the primary care reimbursement service.

Mr O’Brien said there was a finite overall amount for new drugs and the money would have to be found elsewhere within the overall budget if the allocated spending was exceeded.

“Every euro can only be spent once. You spend it on this, you can’t spend it on that. This is why the service plan has drawn out choices.”

Mr O’Brien said they would undoubtedly have to make some decisions that would vary from their current expectations as the year progressed.

Health Minister Leo Varadkar said the new drugs and technologies would be treated as they were in the past and the HSE would then engage with the company to get a fair price.

However, it was pointed out to the minister that a lot of drugs had been approved that have not been deemed cost effective, even at the discounted or negotiated price.

One such drug, Soliris, that costs about €430,000 per patient annually, was made available to patients with two rare blood diseases even though the HSE said the cost was exorbitant.

Asked if that trend would continue or be halted, Mr Varadkar, said he did not think it was “sustainable” to refuse the drugs available in other countries.

If he was still minister for health in a few months time he would like to address the issue on a Europe-wide basis.

He said drug companies were “picking off small countries” and getting them to set unbelievably high prices and then went to the bigger countries and offered them discounts.

“This is really unfair and it is greed incorporated quite frankly.” he said.

“If Europe is worth anything, we should be coming together and using the European Medicines Agency to actually negotiate on behalf of Europe and not allow this situation whereby patients are used as pawns and small countries are picked off by companies that turn absolutely enormous profits, pay absolutely enormous dividends and pay their executives unbelievable salaries.”

— Evelyn Ring