Heart patients' €5 drug caught in HSE funding logjam
A life-saving drug for heart failure patients certified as being "cost effective" 12 months ago is still awaiting reimbursement approval from the HSE and Health Minister Simon Harris, the Irish Independent can reveal.
Entresto, a potentially life-saving drug for heart failure patients, is the latest medicine to be caught up in the funding logjam that is causing deep concern among health professionals.
It is estimated the drug would cost less than €5 per day to administer to patients, yet the cost of admitting a heart-failure patient to hospital is €7,800.
Crucially, the drug is recognised as an effective alternative to hospitalisation and was given the green light last July by the National Centre of Pharmacoeconomics (NCPE).
Entresto is routinely available in most European countries and was even fast-tracked for reimbursement in the United States.
However, the HSE has confirmed that it does not have the funding for Entresto, having referred the matter to Mr Harris in May of this year. Eight other treatments were also referred to the department.
Both the HSE and Mr Harris were strongly criticised last night by Labour TD Alan Kelly for the delay in the reimbursement.
Along with Entresto, the list provided to the department also includes cancer drugs such as Erivedge and Lynparza, as well as Brintellix, which treats depression.
However, Entresto is the only drug on the list found to be cost effective by the NCPE, a key influencer in the purchasing of drugs.
By referring the list to Mr Harris's department, the HSE indicated it wants to purchase the drugs but cannot afford to do so.
This was confirmed by the Department of Health last night.
"The funding implications of these nine treatments are currently under consideration by the department," a department spokesperson told the Irish Independent.
"Each of these treatments were referred to the department because the HSE decided to support the reimbursement application, but considered that this could not be funded from within its current budgetary envelope and also taking account of the cumulative costs over a five-year period. The HSE advise that the cumulative cost over five years of these treatments is approximately €120m.
"It should be noted that the final decision in relation to the reimbursement of all medicines remains the statutory responsibility of the HSE."
The Department of Health has already gone to Government this year to seek funding for the cystic fibrosis drugs Orkambi and Kalydeco after a long-running campaign by patients and protracted price negotiations with pharmaceutical company Vertex.
Speaking to the Irish Independent last night, Labour Party health spokesperson Alan Kelly said the way in which the HSE and Mr Harris had dealt with the issue was unacceptable.
"Not alone is this health necessity but it is also a financially good move in respect of the taxpayer," Mr Kelly said. "Is Minister Harris really going to allow this issue to drag on beyond the summer recess, not ensuring that heart patients have access to a life-changing drug."
The HSE's request to Mr Harris to fund this drug was confirmed in response to Fianna Fáil TD Billy Kelleher.