It is a big deal but is it a good one? - Drug savings agreement

THE new drug savings agreement between the State and the pharmaceutical industry is certainly a big deal but is it a good deal?

It has been hailed on both sides as good for both the taxpayer and for patients but that remains to be seen. It has also been welcomed by the Irish Pharmacy Union (IPU), which represents community pharmacists around the country.

Under the agreement, the Government will save in excess of €750 million over four years. That is the promise and the positive spin being put on the deal but caution should be observed with such figures, as the last agreement was due to deliver €400m in savings but has still to be fully quantified.

The Irish Pharmaceutical Healthcare Association, which represents 38 international pharmaceutical companies, has said that the agreement will ensure that patients have early access to life-saving new medicines.

“With this agreement in place, patients and their doctors can rightly expect that priority will be given to funding innovative, new medicines in the health services,” said Dr Leisha Daly, president of IPHA, who led the organisation’s delegation during negotiations.

That would clearly be valuable for patients but also for drug manufacturers as the price of new drugs is often very high. It also ignores the fact that the purpose of the deal from the Government’s perspective is to save money in the medium to long term. Indeed, it was only arrived at after the pharmaceutical industry was threatened with price cuts.

One of the more bizarre aspects of the agreement is that some new, high-cost drugs will be referred to Cabinet for a funding decision for the first time.

That means that Government ministers will, literally, be deciding life and death issues around the cabinet table. Whatever about individual abilities, the Cabinet is ill equipped to do this.

While compassion and need should, ideally, be the only guides to good healthcare, the reality is that, even in the wealthiest countries, there is still a limited budget.

New and innovative life-saving medicines may often be hideously expensive and if the decision is taken to fund a drug that, for instance, costs €40,000 a year per patient, the money spent will invariably mean that funding for other health services will suffer.

The pity of it is that this new deal does not relate to the cost of medicines for private patients and the danger is that some pharmacies may be tempted not to pass on savings to them.

Neither does it appear to address in full the issue of so-called ‘biosimilar’ medicines which are an almost identical copy of an original product manufactured by a different company.

According to the pharmaceutical reform group, the Healthcare Executive Alliance, the agreement is a missed opportunity that protects more expensive drugs and blocks cheaper biosimilar medicines.

Considering the strides made in the last agreement in 2012, it is hard to argue with that assessment.


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