Bill promotes use of cheaper generic drugs by doctors

MINISTER FOR Health James Reilly has said all doctors employed by the State are being asked to prescribe cheaper generic drugs “in the national interest”.

The Health Service Executive is also writing to all community pharmacists from today asking them to intensify efforts to make savings, he said.

The initiative was agreed at last Friday’s meeting of the Cabinet subcommittee on health, which discussed the HSE’s €280 million spending overrun this year.

“As a result of the financial pressures that we are experiencing and will experience into the future, more cost-effective prescribing by doctors and pharmacists is clearly in the patient’s interest and the national interest,” said Dr Reilly.

Arising from the meeting, the HSE has also been told to report on progress in making greater savings in the areas of sick leave, overtime, use of agency staff and costs associated with medical cards.

“Sick leave costs the HSE €280 million a year,” said Dr Reilly, “agency staff a further €250 million and overtime €240 million. It is clear we have the capacity to make major savings without hitting services.”

New legislation which allows pharmacists to fill prescriptions for branded drugs with cheaper generic alternatives comes before the Seanad on Thursday. At present, pharmacists are not legally allowed to provide medication other than the brand prescribed. Medical card patients who opt for costlier, branded medicines over cheaper generic alternatives will have to foot the bill for the difference in price, under the legislation.

Private patients could save money under the proposals in a new health Bill, where their pharmacist suggests substituting a cheaper alternative to the medicine prescribed by their GP.

The Bill allows pharmacists to sell generic drugs to customers, even where their doctors have prescribed more expensive brand-name medicines. An exemption will be provided to allow GPs to write on a prescription that a particular drug should not be substituted, but the doctor may be required to give clinical reasons.

The Health (Pricing and Supply of Medical Goods) Bill 2012 was published last week and is likely to pass into law by the year’s end. The aim is to promote competition between suppliers of interchangeable or generic medicines and to ensure value for money in the supply of medicines, according to the explanatory memorandum.

It says the introduction of generic substitution and reference pricing has the potential to deliver significant savings for the State in the medium to long term. The Department of Health has said it hopes to cut the drug bill by €50 million a year using generics.

Generic substitution allows pharmacists to substitute a cheaper generic alternative, at the patient’s request, when a more expensive product has been prescribed. The designation of interchangeable medicines will be the Irish Medicines Board’s task.

The board will also be responsible for setting a common reimbursable price for groups of medicines. Only the reference price will be reimbursed by the State. “Patients can avoid out-of-pocket payments by opting for a generic medicine at or below the reference price,” states the memorandum.

Reference pricing coupled with generic substitution provides patients with an incentive to opt for the cheapest product, but does not impose any unavoidable additional costs on patients, it claims.