Tuesday, January 24, 2012
Pharmacists should be able to offer patients cheaper drugs as an alternative to more expensive brands prescribed by GPs, experts have said.
The Economic and Social Research Institute (ERSI) has recommended that, provided two drugs have the same chemical properties and the same effect, patients should be able to choose which to buy.
Paul Gorecki, research professor at the think-tank, said this would save the Department of Health and the taxpayer money, and encourage competition in the pharmaceutical market.
The ESRI report proposes further reductions in the price paid for patented prescription drugs by the HSE. However, it makes no predictions on the overall savings that could be achieved through such reform.
Pharmaceuticals currently account for 17.5% of public health expenditure with €1.9 billion being spent on prescription drugs in 2010.
The report showed savings of over €17m could be achieved by switching from the top 20 prescribed drugs to a generic equivalent.
The study, commissioned by the HSE, acknowledged significant progress has already been made in reducing the cost of delivery of pharmaceuticals both for the HSE and cash-paying patients through lower wholesale margins and pharmacy mark-ups. The main author of the report, Professor Paul Gorecki, said there was a need for further cost savings as Ireland had experienced one of the highest annual growth rates in pharmaceutical expenditure of any OECD country.
He said consumers were likely to be asked to make greater contributions towards the cost of drugs as a result of austerity budgets.
The monthly threshold for the Drugs Payment Scheme was increased by €12 to €132 in the latest budget while the controversial 50 cent charge per prescription for medical card patients was retained.
The price of prescription drugs is currently composed of the ex-factory price, a wholesale mark-up, a retail mark-up and dispensing fee. Under the existing system, the HSE agrees to pay the manufacturer of a patented drug which can only be sourced from one supplier the average price of nine EU countries where the product is available.
The report recommends that, in future, the price should be based on the lowest priced EU member state subject to twice yearly reviews. It claims such a measure would see ex-factory prices fall by 20%-25% for such drugs.
It also proposes that major savings could be made by switching from a leading brand to a cheaper, generic alternative. The ESRI recommends the HSE should issue tenders for such high volume interchangeable drugs and calls for the removal of the present prohibition on pharmacists from offering a generic alternative from the brand written on a prescription by a GP.
It also recommends that pharmacists should provide patients with data on dispensing fees and mark-ups.
The ESRI suggests they should also be allowed to advertise that they will pay, in whole or part, the contribution of patients towards payments to state pharmaceutical schemes, which is currently banned.