The head of the HSE has admitted that the rest of the health service will have to suffer because of a decision to pay for expensive drugs for patients with a rare blood disorder.
Tony O'Brien said that the cost of the Soliris drug - which costs €430,000 a year for every patient - will lead to cuts elsewhere in the service.
The HSE last week agreed to pay for the drug for a small number of people with the rare condition paroxysmal nocturnal haemoglobinuria (PNH).
Mr O'Brien said that the HSE is still working to lower the cost of the drug.
"Due to the exorbitant cost of this drug, approximately €430,000 per patient per year, the provision of it for patients will be on the basis of clinical need," he said.
"The opportunity costs of the inordinate price demanded for this important drug will, inevitably, over time, be felt in other parts of the health services, and will impact on the ability to fund important other service developments.
"We will continue to pursue a more reasonable price for this medicine."