merrion street

 Róisín Shortall TD, Minister of State for Primary Care at the Department of Health today, (5

December 2011) welcomed the initiatives contained in the Budget to enhance Primary Care. 

She said that “The Programme for Government provides for a significant strengthening of primary care services with the removal of cost as a barrier to access to General Practitioner (GP) services. In line with this commitment, access to GP care without fees will be extended in 2012 to claimants of free drugs under the Long Term Illness Scheme. Almost 56,000 people will benefit from this initiative.” 

The Long Term Illness Scheme provides, through community pharmacy contractors, free medicines and appliances to persons who are suffering from a specified illness. At present Long Term Illness card holders do not receive free GP care unless they are also holders of medical cards.  Extension of free GP care to all claimants of medicines under the Long Term Illness Scheme will require primary legislation. 

The intention is to extend free GP care in 2013 to patients who receive medicines under the High Tech Drugs Scheme. Access to subsidised GP care will be extended to all in the next phase and universal access to GP care without fees will occur in the final phase.

The Minister also set out the level of savings being achieved on drug prices. 

A number of measures have been taken in recent years to reduce the price of drugs, but expenditure by the HSE on the GMS and community drug schemes still amounted to approximately €2 billion in 2010. These measures are essential if we are to continue to afford reimbursement of new medicines coming on stream, many of which will have a significant budget impact. 

In 2011, members of the Irish Pharmaceutical Healthcare Association (IPHA) agreed a series of measures to deliver savings on drug expenditure of €200 million in 2011. As a result, the prices of over 1,000 medicines have been reduced since January this year.    

Further reductions in the prices of generic medicines were implemented in August 2011 following discussions with the Association of Pharmaceutical Manufacturers in Ireland (APMI). 

Further discussions will take place with IPHA aimed at reductions in the price of patent protected drugs in 2012. 

Further reductions are expected following the introduction of reference pricing and generic substitution in 2012. The Government approved the General Scheme of the Health (Pricing and Supply of Medicines) Bill at the end of September and the legislation will be published in 2012. 

This legislation will introduce a system of reference pricing and generic substitution for drugs prescribed under the GMS and community drug schemes.   These reforms will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in significant savings for taxpayers and patients. 

Reference pricing is a scheme employed in many of our EU partners where a group of interchangeable medicines (e.g. generic equivalents) is identified and a maximum reimbursable price set for any medicine from this group. A physician is able to prescribe the brand/drug of choice and the patient is able to have dispensed the brand/drug of choice but the State shall only reimburse the value of the lowest priced medicine in the group. 

Generic substitution allows for a pharmacist to substitute interchangeable medicines. Allowing generic substitution is an essential component of a successful reference pricing system. Generic substitution provides the patient with a choice on an interchangeable medicine when a particular brand or none has been prescribed. 

The potential short-term savings from increased use of generic medicines has decreased following recent price reductions. 

We will also be taking initiatives in relation to over prescribing to identify at GP and hospital level where there are issues in respect of particular drugs where cost efficiencies can be achieved.