HSE must fund new high-tech drugs, says Department of Health

The Health Service Executive has the funds to sanction nine new high-tech medicines for serious conditions, whose use has been delayed for a year or more, the Department of Health has claimed.

The nine medicines for conditions including cancer, heart disease and depression have been waiting for ministerial sanction and funding after being approved for use by the HSE.

Under a framework agreement for the pricing and supply of medicines signed last year, drugs approved for use by the HSE but for which they have no funding go forward to the Minister. He then decides whether to seek Cabinet approval for extra resources.

This is what happened notably with cystic fibrosis drug Orkambi following an intensive lobbying campaign by patients and their families.

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Budget allocation

However, in a letter to the HSE, the department this month said it is the HSE’s responsibility to find money for new drugs in its existing budget allocation.

It added that it believed the money is already available.

“Having regard to the PCRS [primary care reimbursement service] budgetary performance to date and the most recent projections to year end, there is scope for the executive to consider the reimbursement of these medicines within the current year,” the department’s letter states.

The HSE is €21 million under budget for the first six months of the year. While this would meet the cost of the new medicines this year – assuming no budget overruns elsewhere in the HSE – there is no certainty that the HSE would receive the necessary additional budget to meet the full-year cost of providing the medicines next year and beyond.

‘Affordable’

A spokesman for Minister of Health Simon Harris said on Thursday that, “given the very significant sums of money involved, and taking account of competing demands for funding across the health service, any funding decisions must be affordable and sustainable in 2017 and future years.”

He added: “In line with the Health (Pricing and Supply of Medical Goods) Act 2013, the decision on the reimbursement of any medicine is a matter for the HSE.

“Minister for Health Simon Harris has asked that this issue be resolved as a matter of urgency, so that patients are not adversely affected.”