The debate about access to new-generation medicines by patients in Ireland remains caught in the endless tug of war between budget and opportunity. But it is one where all parties seem reluctant to address the elephants in the room.
Medicines account for more than 13 per cent – about €3.3 billion – of a health budget that is permanently under strain. That money is already fully spent. Allocating funds to new and often expensive cutting-edge treatments that come on stream every year requires either more budget headroom or savings from the bill for existing medicines.
That is what successive pricing and supply agreements between the industry and Government have sought to achieve – with limited success as myriad patient stories illustrate.
The industry continues to argue that the products it develops and which can either save or improve the quality of patient lives take an inordinate time to get through the Irish reimbursement pipeline.
A report from industry group, the Irish Pharmaceutical Healthcare Association (Ipha), says that, on average, it is taking more than 600 days to get a decision and have medicines available to patients – far longer than in other countries and close to three times as long as even the Irish protocols say they should.
All of these drugs, remember, already have approval from the European regulator, the European Medicines Agency (EMA). So, all that is up for debate is can the State afford them and, if so, at what price.
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Both sides call on each other to be more creative, or innovative, in their approach to pricing but neither will commit to funding the established of an electronic medical records system necessary for such approaches.
The Ipha report is chock full of data but while the industry snipes at State delays it is very coy about why so many companies do not even attempt to get Irish approval for the EMA-approved medicines. How many? Shucks, no one seems to know.
Meanwhile an increasingly two- or even three-tier system is evolving – those who rely on the public health services, those who have private health insurance and now those who have the ability to pay privately for things even their private health insurer will not cover.
