BOTH PUBLIC and private patients will see the price of their medicines drop under legislation to be introduced next year.
Under the new system pharmacists will be obliged to tell both public and private patients if there are cheaper generic medicines available when they hand in prescriptions to be filled.
Up to now pharmacists have had to dispense the precise brand of drug prescribed by a doctor, even when less expensive versions of the same medicine were available. The legislation will allow them dispense a cheaper generic equivalent, something pharmacists have already been seeking.
Furthermore, under a new system called reference pricing, which is already in place in many European countries, lists will be drawn up by an expert group within the Health Service Executive of all branded and generic drugs that have the same constituents, and that can, therefore, be used interchangeably. The State will only pay for the cheapest one for a medical card holder, no matter which one is prescribed.
Drug companies will be invited to put forward their best prices for drugs on the list and it is hoped this competition will drive prices down further.
Minister for Health Mary Harney said millions would be saved by the introduction of the changes. If the scheme had been introduced in 2009, it is estimated that some €78 million would have been saved on the top 100 drugs dispensed under State schemes.
Mark Moran, who chaired a joint Department of Health and HSE working group on reference pricing and generic substitution, details of which were published yesterday, acknowledged that for a small number of products, such as medications for epilepsy, it would not be advisable for patients to switch between different brands. In such cases patients’ drugs would not be included on the list of interchangeable medicines.
Substitution will only be allowed where it is safe to do so, he said.
In cases where medical card patients insist on getting branded drugs prescribed for them by their GP, rather than a cheaper generic equivalent on an interchangeable list, they will have to pay the additional costs themselves.
The list of interchangeable medicines drawn up by the HSE will be updated at least once a year. The HSE has already identified 100 potentially interchangeable medicines.
Uniquely in Ireland, the costs of many generic drugs are higher than branded ones because a deal was reached by the State with the manufacturers of branded drugs earlier this year, saving €100 million annually.
However, negotiations with generic drug manufacturers are now taking place and are expected to end by September, when the imbalance will be redressed.
The Irish Pharmaceutical Healthcare Association, which represents multinational drug firms in Ireland, said going for the lowest-price supplier with reference pricing rather than an average of a number of prices could endanger continuity of the drugs supply to patients.
The Irish Pharmacy Union welcomed generic substitution. However, it urged Ms Harney to be very cautious in taking steps towards the introduction of reference pricing. “We would also be concerned that reference pricing could lead to medicines shortages,” it said.
Meanwhile, legislation governing the introduction of prescription charges for medical card holders, to be published next week, will allow for “some exclusions”, meaning not all medical card holders will have to pay the 50 cent charge for each item prescribed, Ms Harney said.