Ireland’s medicine reimbursement system is not fit for purpose, a pharmaceuticals industry conference heard on Wednesday, with patients currently taking over twice as long to net access to new cutting edge medicines than expected – if they are approved at all.
Former HSE director general Tony O’Brien told the Irish Pharmaceutical Healthcare Association (Ipha) annual conference that the current structure for approving new medicines was put in place in 2013 when the economy was still emerging from the crash.
“The system was not put in place to produce the speediest possible decisions,” he said, adding that
to meet the aspirations of the Programme for Government, which commits to “ensuring that patients have access to new innovative new medicines and treatments as quickly as possible”, the current system will need to be redesigned.
Getting patients faster and fairer access to new medicines was the central theme of the conference which was held in Dublin.
Minister for Health, Jennifer Carroll MacNeill agreed the State can do things faster and said she was open to taking steps that ensure quicker access to vital drugs. But she added that industry needs to do its part.
“I’m really keen to try to work with all of you to really listen to where you say there are issues. Tell me where there are issues and, on the other side, let’s just try and resolve any issues from the industry perspective, because we basically want the same thing which is easier, quicker access.”
She stressed that State expenditure on medicines and investment in resources “has to deliver real returns for the taxpayer consistent with security of supply”.
“The state is prepared to pay, of course, for necessary treatments and ensure patients get therapies they need at a cost that represents value,” she said, adding that as Government and the medicines industry sit down to negotiate a new pricing and supply agreement, “we have to recognise that there are finite resources and every investment has opportunity cost”.
The conference heard from two cancer patients about their experience accessing treatment.
Miriam Staunton was diagnosed with stage 3 melanoma in 2018 a the age of 45. At the time, her oncologist told her he was not in a position to offer her anything systemic at this point which she later understood meant that there were treatments available but not in Ireland.
It meant she had to wait until she progressed to stage 4, when the cancer had spread to her liver, to access the treatment unavailable to her previously “because I was not sick enough”.
When “fit and healthy” lecturer Bernard Mahon was diagnosed with inoperable stage 4 stomach cancer last year, he was told there was an immunotherapy which, when combined with chemotherapy, worked well for people in his position.
It was not available on the public health system but, as it was accessible to private patients, he was relieved, only to be told that his insurer did not cover that particular therapy.
“The thing that struck me was how unfair it is,” he said.
Referring to Ipha data showing that it was takes more than 600 days, on average, to get Irish funding agreed for medicines already approved by the EMA, he said: “We haven’t got time. When we see the 400, 500 days, to people like us that means something dramatic – it is not for you.”
