Cost of medicines

Sir, – Many of my patients travel to nearby Fermanagh to fill their prescriptions because it is cheaper to do so there. Paul Cullen reports that the Irish Pharmaceutical Healthcare Association has stated in a booklet that the price of new medicines must reflect a "fair return" on investment ("Pharma lobby warns against new drug price cuts", October 28th).

A question that ought to be asked more rigorously is, how many of these new medicines offer a real improvement on existing cheaper medicines? The fact is that few new medicines are what is known in the industry as “breakthrough drugs” (ie offering a real advance in treatment). Many new medicines are “me too ” medicines (ie they do much the same thing as existing medicines).

The State bill for reimbursable medicines is over two billion euro annually. Surely we should be comparing all new medicines with existing medicines and only reimburse at a higher price if the newer medicines are shown to offer a genuine improvement for patients? – Yours, etc,

Dr GARRETT IGOE,

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Virginia, Co Cavan.