A medical specialist is questioning the quality of drugs being prescribed to public patients as part of a cost-cutting scheme. A Department of Health report on the generic drugs shows a number of pharmacists and doctors are concerned that patients are not getting the best-quality medicine. Prof Michael Murphy, who chaired the Review Group on the Indicative Drug Target Scheme, set up by the Department of Health, said yesterday that research is needed into generic drugs sold on the Irish market.
If the Department is to continue to promote wider use of these drugs, which are not branded and are cheaper, he said, it needs to be able "to tell patients with confidence that the drugs they are receiving are as reliable as a more expensive product that they might have otherwise received".
Of the pharmacists surveyed for the report, which was published last week, almost two-thirds said they saw an ethical dilemma with the cost-saving scheme, and 86 per cent said the reason for this was "the discrepancy between optimum patient care and costs".
The report also expressed concern that 37 per cent of pharmacists said they had seen patients who had been denied necessary medication because of the budgeting policy. Almost one in five doctors said they knew of doctors who deny patients optimum drug treatment as a consequence of the scheme, under which doctors get a proportion of the savings made by prescribing such drugs for investment in their practices.
Some countries have quality-control systems to randomly test generic products on the market, he explained. "After carrying out these tests they have product data on the reliability and unreliability of generics on their market," said Prof Murphy, professor of pharmacology at UCC. He said there had been a number of articles in medical literature instancing the poor quality of some generic products.
The report showed that almost two-thirds of GPs surveyed believe some generic drugs are unreliable. But, interestingly, almost the same percentage of doctors said they did not have an ethical problem with the scheme.
"I think that GPs are enthusiastic about this approach because of the opportunities it has provided general practice for improvement to its infrastructure, which was badly in need of investment, and this is an understandable part of human nature," said Prof Murphy, speaking at the annual meeting of the Irish Pharmaceutical Healthcare Association.
"Clearly doctors and pharmacists are aware of these reports. However, we do not have a process in place in Ireland to adequately assess the quality of marketed pills," he said.
The review was set up to establish the effect of the scheme on the quality of patient care. The Minister for Health, Mr Cowen, said he was satisfied with the success of the scheme as most doctors were now achieving "more rational and cost-effective prescribing". The average annual rise in drug costs is around 6 per cent.