THE HEALTH Service Executive (HSE) has pressed the Department of Health in recent months for new rights to allow it to exclude, on economic grounds, new drugs or medicine coming on the market from the list of products it would pay for.
HSE chief executive Prof Brendan Drumm also lobbied the Department of Health as part of recent talks with the pharmaceutical industry for “a clear statement” on the rights of the health authority to delete specific products from its reimbursement lists.
He also said in correspondence with the secretary general of the Department of Health Michael Scanlan last December that the HSE needed “to establish a formal process whereby assessments on reimbursing new chemical entities are carried out on a once- or twice-yearly basis following specific evaluation of the items by the HSE”.
However, Mr Scanlan said that in return for a deal with the Government on proposed price reductions, the Irish Pharmaceutical Healthcare Association had, among other issues, sought assurances that there would be no unilateral decisions taken by the HSE to prevent new products joining the reimbursement list.
“With regard to the arrangements for adding new products to the market and/or removing existing products, I would suggest that most, if not all, products have some therapeutic benefit for some patients in some circumstances,” wrote Mr Scanlan in a letter of reply to Prof Drumm.
“Accordingly, our view is that instead of prohibiting or withdrawing reimbursement altogether, we should put arrangements in place which would ensure that products are prescribed and dispensed only in circumstances where, and for so long as, they have a demonstrated clinical benefit.”
Mr Scanlan also said that virtually all of the measures taken in recent years to curtail the rate of increase in spending on prescribed drugs had focused on the cost of the products or on the level of co-payment to be made by individuals.
“It is clear, however, that the volume of medicines prescribed is a key expenditure driver. It is essential, therefore, to take steps to improve prescribing behaviours in a way that maximises health outcomes while minimising expenditure”, he said.
In February, several weeks after the correspondence between Prof Drumm and Mr Scanlan, the Minister for Health Mary Harney announced a new deal with the Irish Pharmaceutical Healthcare Association on substantial price reductions.
The Minister said that 40 per cent price cuts on 300 of the most common off-patent drugs, which formed the centrepiece of the deal, would save taxpayers and consumers considerable amounts of money – well over €90 million for taxpayers and several millions for consumers when they paid for drugs themselves.