Saturday 17 March 2018

Patients urged to switch depression drugs and save

PRIVATE patients can save around €200-€250 a year by switching to a depression drug that is just as effective and safe as the dearest version, according to the Health Service Executive (HSE).

The HSE said its panel of experts had analysed the selective serotonin re-uptake inhibitor (SSRIs) and selective serotonin noradrenaline re-uptake inhibitors (SNRIs), which are prescribed by doctors to around 150,000 people for the treatment of depression.

Prof Michael Barry, who heads the HSE's medicines management programme, said they selected the drug citalopram (celexa) as the preferred SSRI, while venlafaxine (effexor) was its choice of SNRI.

In both cases, the drugs are about half the price of the most commonly prescribed drugs in the range. The GMS cost for a month's supply of citalopram is €13.34 compared to €29.52 for escitalopram (lexapro).

Both drugs cost the health service €55.7m in 2013.

Prof Barry estimated that €19.5m could be saved if doctors prescribed these two drugs of choice for new patients alone.


The HSE has done a similar analysis for a number of other drugs for the treatment of high cholesterol, stomach complaints and high blood pressure.

This had already led to a change in prescribing patterns and savings, he said.

"There is no difference in the effectiveness or the tolerability between the most expensive and our preferred drug," he added. "Somebody who is paying for the drugs out of their pocket would save around €200 to €250 a year.

"Out-of-pocket payment is important because they are important in determining drug utilisation."

He said that he regularly sees cost playing a role in whether people take their medications regularly.

Overall, the State's bill for all drugs came to €1.8bn last year but if cost-containment measures were not enforced, such as cutting fees to pharmacists and wholesalers and reducing the price of medicines, it would be €3bn, he added.

"We have to have a sustained approach to get the best value out of medicines," he added.

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