Thomas Molloy

Tuesday 29 July 2014

It's a bitter pill, but we could learn from NHS

A partnership between the HSE and Britain's health service could bring financial benefits, writes Thomas Molloy

Published 19/01/2014|02:30

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A bitter Pill...

WE pay far too much for medicines. The Government pays too much when it spends €2bn a year doing deals with pharmaceutical companies and individuals pay too much when they shell out a few euro at their local chemists.

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A particularly egregious field when it comes to over payment is generic drugs. The generic equivalent of Eli Lilly's bi-polar treatment Zyprexa retails for €99.89 here in Ireland and costs just €4.10 in Britain. That means that our nearest neighbours pay 24 times less than we do for the same treatment.

There are many explanations for this but the most pressing reason is the Government's desire to suck up to the pharmaceutical companies that employ so many people here. Whether even one drug company would really pull out of a low corporate tax country like Ireland over a tiny reduction in their sales is far from clear.

Nobody has ever done a analysis of what these extra costs add to the HSE's budget every year but it is dead money that could be spent much better elsewhere in the system.

The Troika certainly believed the existing system was nuts and tried hard to reform it but it ultimately failed when confronted with so many vested interests. That Troika pressure did lead to the passing of the Health (Pricing and Supply of Medical Goods) Bill 2012 but the act has done little to push down prices.

The system is so bad that even the head of the HSE's new national drug purchasing programme has admitted it is "difficult" to defend the prices his employer pays for generic drugs. In fact, he told RTE's Morning Ireland that it "isn't right" that we pay so much more for generic drugs and "it's very difficult to defend this situation".

So what should we do? One obvious solution would be to link what the HSE pays for drugs to what the National Health Service (NHS)pays in the UK.

There would be many benefits to handing over the power to negotiate to the NHS. By partnering with the NHS we could use that agency's superior negotiating abilities and purchasing power to slash the prices the HSE pays for drugs. We could also abolish the quango that deals with these issues for the HSE. There might be some small dent to our national pride but saving money in the health system means saving lives.

While we are at, we could also adopt the NHS's National Institute for Health and Clinical Excellence which examines whether medicines offer value for money. This sounds cold-hearted, and perhaps it is, but medicine is a cold-hearted business at times.

By spending less money on drugs that only work in limited circumstances, the NHS has more money to spend on other services such as preventive medicine. Hospitals here regularly use drugs which other health services cannot afford. Even when the HSE has banned expensive treatments, we have seen the decisions overturned thanks to political pressure.

It makes for good headlines, but it hardly makes sense to decide on complex medical treatments this way. It is time we took a leaf out of the NHS's book to pay less for drugs and to buy the right drugs.

Irish Independent

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